Professor Michael Bliss is a well-respected Canadian public intellectual. I hope I am not doing a disservice to his commentary to say that its common theme, on many topics, is that he would like Canada to become more like the United States.
This comes across clearly in his op-ed in Tuesday’s Globe and Mail, which, in as many words, proposes a new Royal Commission to work out a blueprint for privatizing Canadian public Medicare on the U.S. model.
In setting out his argument, Prof. Bliss dismisses the Romanow Royal Commission as a proposal to spend more money on the status quo. This is a misreading of the Romanow report, crafted by a Royal Commissioner with deep experience with both the benefits and the hard economic realities of Canadian Medicare over three decades of service in provincial government.
It is true that Roy Romanow rejected the American model for health care. Not just because it produces inferior health outcomes compared to public systems. But because American health care is simultaneously grossly expensive, with out-of-control annual cost increases.
It is also true that Mr. Romanow proposed that Canada’s public health system be built on — with a catastrophic pharmacare program, homecare, and a move toward a “primary care” model — change paid for through a modest increase (compared to American growth rates) in federal transfers.
These steps would improve health services — by ensuring people can afford critical drugs; heal at home; and be dealt with as a person instead of as a transaction by the health system.
These steps would also control costs in the public health system. Using the public system’s power as a group buyer to hold down the spiraling costs of pharmaceuticals. Getting people out of crowded hospitals (the fundamental solution to crowded emergency rooms). And evolving toward a better model to compensate health providers.
Better services — better management. This mix of idealism in intent and pragmatism in implementation is what you’d expect from a leader who grew up in the Tommy Douglas-Allan Blakeney tradition, as Mr. Romanow did (I got to work for him there).
And that is what those who hope to profit from the “monetization” of Canadian health care really fear — that our public system will be well-managed, as Mr. Romanow proposes.
The American health gold rush wouldn’t happen here. The profiteers would have to look elsewhere for the next bubble to cash into.
In speaking for the other side of this debate, Prof. Bliss reminds us that some real issues are at stake in this federal election. Who should we trust on this basic choice about public health care: the way we do things here in Canada, or the way they do things (and don’t) in our friendly neighbour country to the south?
Will we renew our system, or take Prof. Bliss’s underlying advice and volunteer it as our candidate for the next gold rush?
This article was first published in the Globe and Mail.