Healthcare report roundup — left, right, and centre

Here's the digested read of what the reports said, and how likely the
decision-makers are to take heed.

BY PETER WOODFORD WITH SUSAN USHER

To view the Healthcare report roundup click here. (pdf format)

REPORT MANDATE TOP WILL THEY DO IT?RECOMMENDATIONSROMANOW REPORT
Title: Building On Values:Commission on the Futureof Health Care in Canada Type: Royal CommissionAuthor: Roy Romanow, former NDP Premier of Saskatchewan To “recommend policiesand measures to ensurethe longterm sustainability of a universally accessible,publicly funded health system… also undertake dialogue with Canadians on the future of Canada's public health care system.” • Increasing federal healthcare contribution to 25% • Reducing waiting times • Find provincial/federal consensus on healthcare Mr Romanow’s call to raise the federal contribution to medicare to 25% has captured the policymaker zeitgeist. Mr Romanow told the Toronto Star, medicare “is as sustainable as Canadians want it to be.” KIRBY REPORT Title: The Health of Canadians —The Federal Role Type: Senate report Author: Michael Kirby, Liberal Senator and on Board of Directors for private health insurer and major nursing home company Extendacare. To look at the fundamental principles of public healthcare in Canada and study foreign models for the sake of comparison. The role of the federal government in delivering healthcare was also examined.• Rethink the Canada Health Act • Redouble efforts to improve aboriginal health • Create 24/7 multi-disciplinary primary care teams • Introduce maximum waiting time guarantees• Make studying medicine more accessible to the poor Issues covered are all top priorities of the provinces and though progress is being made, change will be slow. None of the major parties has mentioned a Canada Health Act rethink as Mr Kirby suggested. The Kirby report has been attacked because its author's alleged conflict of interest.FYKE REPORT Title: Caring for Medicare: Commission on Medicare Type: Provincial report — Saskatchewan Author: Ken Fyke is a former deputy minister of health in Saskatchewan To make recommendations for a sustainable universal healthcare system that stays true to the principles of publicly funded medicare.• Close some rural hospitals • Centralize healthcare services • Improve electronic record-keeping • Create a ‘Quality Council ’to evaluate services Though Saskatchewan Premier Lorne Calvert’s NDP government has itsmain power base in urban areas, they're still holding off on implementing the unpopular rural hospital closures. MAZANKOWSKI REPORT Title: Premier’s Advisory Council on Health Type: Provincial report — Alberta Author: Don Mazankowski, Deputy Prime Minister under Brian Mulroney, sits on the Board of Directors for private health insurer Great West Life To find sustainable solutions for the provinces' healthcare woes. Also mandated to explore incentives and find out how to make the system a ‘partnership’ between users andhealthcare providers.• Delisting some services• Creating healthcare savings accounts for people to track their usage of the system• Co-payments up to 3% of a patient’s taxable income (exempting the poor)• Rejection of private administration of healthcare Mr Mazankowski’s report has given Alberta the confidence to move ahead with reforms that are much more radical than what's being put forth elsewhere. Like Michael Kirby, Mr Mazankowski has caught flak because of his connection to private health insurance. CLAIR COMMISSION Title: Emerging Solutions: Report of the Commission of Study for Health and Social Services Type: Provincial report— Quebec Author: Michel Clair, former Hydro Quebec chief, appointed by Bernard Landry’s Parti Québecois government Formed to hold public debates and find solutions to healthcare problems in Quebec. Public, ‘expert,’ and caregiver opinions were sought on the organization and financing of health services• Make primary care the foundation of the system• Make prevention a central element• Allow more local decision-making• The private sector could play a very positive role in biomedical research, information technology, real estate management and certain auxiliary services Some recommendations have already been implemented but one of the report's researchers, Dr Howard Bergman complained of government“cherry picking… and picking the wrong cherries.” The Johnson/Mulroney report on the Montreal superhospitals reflects Mr Clair’s openness to a private sector role. NEW BRUNSWICK REPORT Title: New Brunswick Premier’s Health Quality Council Author: Shediac-based lawyer Michel C Leger and a fairly apolitical council, drawn mostly from academic and healthcare management backgrounds To make plans to move toward a health syste with regional health authorities and regional health boards. Also, to create a Health Care Report Card, health quality standards, performance measures, and develop a new Patient Charter of Rights and Responsibilities.• Immediately increase availability of nurse practitioner training• Allow Regional Health Authorities to carry over surpluses as an incentive for better management• Create a health research institute for NB. Broadly speaking, the New Brunswick report findings aren’t controversial. Many of the recommendations (for example creating a research institute) have already been successfully implemented in other provinces.