Terence Corcoran: Canada needs a new national health-care commission

Skip to Content News Archives Economy Energy Oil & Gas Renewables Electric Vehicles Mining Commodities Agriculture Real Estate Mortgages Mortgage Rates Finance Banking Insurance Fintech Cryptocurrency Work Wealth Smart Money Wealth Management Investor Personal Finance Family Finance Retirement Taxes High Net Worth FP Comment Executive Women Puzzmo Newsletters Financial Times Business Essentials More Innovation Information Technology FP500 Podcasts Small Business Lives Told Tails Told Shopping Financial Post Store Obituaries Place a Notice Advertising Advertising With Us Advertising Solutions Postmedia Ad Manager Sponsorship Requests Classifieds Place a Classifieds ad Working Profile Settings My Subscriptions My Offers Newsletters Customer Service FAQ News Economy Energy Mining Real Estate Finance Work Wealth Investor FP Comment Executive Women Puzzmo Newsletters Financial Times Business Essentials This advertisement has not loaded yet, but your article continues below.HomeFP CommentTerence Corcoran: Canada needs a new national health-care commissionFormer investment executive Tony Fell launches campaign to replace silence with solutions.Attempts to solve wait times or the doctor shortage may lead to local reforms, but they will not begin to deal with the larger issue: The Canada Health Act needs to be renewed. Photo by Dylan DesRoches/Getty ImagesAlmost a quarter century ago the former head of RBC-Dominion Securities, Tony Fell, delivered a grim assessment of Canada’s national health-care system under the Canada Health Act. In a speech at the Canadian Club in Toronto, titled “Healthcare at the Cossroads,” Fell ran through a long list of inadequacies, failures, challenges and funding problems. His 2002 speech could be delivered at any club meeting today.THIS CONTENT IS RESERVED FOR SUBSCRIBERS ONLYSubscribe now to read the latest news in your city and across Canada.Exclusive articles from Barbara Shecter, Joe O'Connor, Gabriel Friedman, and others.Daily content from Financial Times, the world's leading global business publication.Unlimited online access to read articles from Financial Post, National Post and 15 news sites across Canada with one account.National Post ePaper, an electronic replica of the print edition to view on any device, share and comment on.Daily puzzles, including the New York Times Crossword.SUBSCRIBE TO UNLOCK MORE ARTICLESSubscribe now to read the latest news in your city and across Canada.Exclusive articles from Barbara Shecter, Joe O'Connor, Gabriel Friedman and others.Daily content from Financial Times, the world's leading global business publication.Unlimited online access to read articles from Financial Post, National Post and 15 news sites across Canada with one account.National Post ePaper, an electronic replica of the print edition to view on any device, share and comment on.Daily puzzles, including the New York Times Crossword.REGISTER / SIGN IN TO UNLOCK MORE ARTICLESCreate an account or sign in to continue with your reading experience.Access articles from across Canada with one account.Share your thoughts and join the conversation in the comments.Enjoy additional articles per month.Get email updates from your favourite authors.THIS ARTICLE IS FREE TO READ REGISTER TO UNLOCK.Create an account or sign in to continue with your reading experience.Access articles from across Canada with one accountShare your thoughts and join the conversation in the commentsEnjoy additional articles per monthGet email updates from your favourite authorsSign In or Create an AccountAmong the crossroad issues — Fell resisted calling them crises — were doctor and nurse shortages, emergency room backups, shortages of medical equipment, cancer surgery wait times of up to two months, along with average national wait times for an MRI hitting 12 weeks.Get the latest headlines, breaking news and columns.By signing up you consent to receive the above newsletter from Postmedia Network Inc.A welcome email is on its way. If you don't see it, please check your junk folder.The next issue of Top Stories will soon be in your inbox.We encountered an issue signing you up. Please try againThat was 2002. Nothing much has changed since then. The average national wait time for MRI in 2025 was 18 weeks. Canadian health care today has driven past the crossroads and entered crisis territory, a reality that has motivated Fell to take health care reform to a new front.Last month, in a full-page advertisement in The Globe and Mail, the now 87-year-old Fell described Canada’s health system as a crisis that requires more than random fiddling by central planners attempting section-by-section repair of the multitude of causes behind health care failures.The ad, attributed to “Anthony S. Fell, Citizen of Canada,” states that “Canadians deserve better healthcare. It’s time for solutions, not silence.” The system “was built on compassion. Now it needs renewal.”What makes Fell’s proposal different is the idea that the system needs an overall review that rises above the multitude of individual problems and the tendency to impose micro-solutions. Attempts to solve wait times in emergency rooms or the family doctor shortage may lead to local reforms, but they will not begin to deal with the larger issue: The Canada Health Act needs to be renewed.Fell calls for the establishment of an “independent, non-partisan Commission to study high-performing healthcare systems and recommend practical solutions.” Members of such a commission should include experts in health care, economics, law and patient experience. They should examine systems in Scandinavia, Germany, the Netherlands, Australia and Singapore. The commission should also engage with Canadian professionals and patient groups.Fell does not make this point, but appointees to the commission should exclude representatives of unions, activist groups, associations and institutions that have vested interests in particular structures or outcomes.In an interview, Fell recalled that the last formal commission-level review of the Canada Health Act was released a few months after Fell’s Canadian Club speech. The head of the 2002 Commission on the Future of Health Care in Canada was Roy Romanow, who Fell describes was “a full-fledged NDPer and a socialist” who fundamentally opposed forms of private health care.In his 340-page one-man report, Building on Values (doesn’t that sound familiar?), Romanow forcefully stated his opposition to forms of private health care. The consensus view of Canadians, Romanow claimed, was that health care should not be a business. “No! Not now, not ever. Canadians view medicare as a moral enterprise, not a business venture.”This advertisement has not loaded yet.This advertisement has not loaded yet, but your article continues below.Romanow specifically singled out privatizing MRI imaging as a ”troubling” development that would defy equal assess principles. He therefore recommended that diagnostic services such as MRIs be classified as “insured services” within the Canada Health Act, which explains the ongoing MRI wait times problem.Resolving the public-versus-private debate has been central to the future of Canadian health care for decades. Fell points to existing and emerging private innovations that today open the door to reform, including private-not-for-profit institutions that provide services more efficiently and at reduced cost to government.A new example is the Schroeder Ambulatory Centre in the Toronto suburb of Richmond Hill. Funded with more than $300-million in donations from former financial entrepreneur Arthur Schroeder, the seven-storey facility will annually provide orthopaedic surgeries and a broad array of imaging options to as many as 8,000 patients. The centre will charge the government 25 per cent less for procedures and invest all profits in the facilities.Fell points to the Schroeder centre as one example of how private innovation could transform the system. Public attitudes have “changed dramatically over the last 10 years and would be more receptive to a private sector alternative,” said Fell.Whether there has been such a shift in pubic opinion is itself debatable, just as everything about health care is ideologically controversial and filled with practical conflicts — which is why Fell’s call for a new national commission is an important and critical proposal. Canada needs an open public review of the health care system that draws national attention to accurate depictions of the problems and solutions.The endless current localized debates and posturing could be clarified and become topics of reasonable debate if a commission were to begin exposing facts and sound economic options. Resolving immediate issues, such as doctor shortages and emergency room wait times should be separated from long-term solutions more dependent on restructuring, private investment and forms of competition. Canadians should recall that the shortage of doctors in Canada can be attributed in major part to provincial government-imposed limits on the number of medical graduates, decisions made based on inaccurate forecast models and cost-control objectives that ignore service issues.Another aspect of Canadian health care policy is the lack of consistency in government policymaking. Fell pointed out during the interview that governments are obsessive about the need for competition in the broad economy, but not health care. They claim Canada lacks competition in banking and grocery stores, where four or five players compete with each other and scores of small firms. Having only one non-competitive health-care system, however, is not a problem.Is Fell’s commission plan feasible? He proposed giving the commission 12 months to research and deliver a final report to Parliament. That seems improbable given his recommendation that the commission by made up maybe a dozen individuals with differing expertise.Even so, it may be the best alternative to the current lack of meaningful public debate. In Ottawa, where the government has set out a dozen strategic priorities to make Canada Strong, health care is being ignored. As Fell’s ad put it: “The time for political silence is over. The time for smart, evidence based reform is now.”Notice for the Postmedia NetworkThis website uses cookies to personalize your content (including ads), and allows us to analyze our traffic. Read more about cookies here. By continuing to use our site, you agree to our Terms of Use and Privacy Policy.