Canada Plans Major Expansion
of Health Care System
Excerpt By Randall Palmer, Reuters Health

OTTAWA (Reuters) - Canadian Health Minister Anne McLellan proposed on Tuesday a major expansion of the publicly funded but creaking medicare system to include home care and catastrophic drug coverage.

McLellan gave no cost estimates for the additional spending for the health system, whose universality is one of the salient differences between Canada and the United States but whose waiting lines have become a major source of irritation.

Canadian Prime Minister Jean Chretien has said he is ready to pony up substantially more money at a Feb. 4-5 meeting with the country's provincial premiers but said he would not be able to meet all their demands.

The Canadian health system is administered by provincial governments to national standards and funded partly by the federal government.

McLellan said the February meeting has the potential to be the most important session on the health system since Canada adopted medicare four decades ago.

"Certainly the stakes have never been higher or more serious, and neither has the responsibility," she said in a speech at the University of Ottawa.

New health spending, Canadians' top priority, promises also to be the most prominent feature of the federal budget that Finance Minister John Manley plans to deliver in late February.

In broad terms, McLellan appeared to endorse several of the recommendations made in November by an official commission headed by former Saskatchewan Premier Roy Romanow.

In particular, she said the federal government believed catastrophic drug coverage--coverage for very high prescription drug costs--could be achieved by the end of 2005 with federal support.

She also pledged federal aid to extend the publicly funded system to include care at home on the grounds that it is cheaper than hospital care.

"We must bring home care under the umbrella of medicare," she said.

The minister also advocated bringing half of Canadians under the care of "multidisciplinary health care organizations"--which would put more emphasis on prevention and less on emergency rooms--within five years.

She said more investment was needed in diagnostic and medical equipment and in switching to electronic health records from the current paper files.

Romanow recommended spending a total of C$15 billion ($9.8 billion) extra over the next three fiscal years.

In particular, he put a federal price tag of C$1 billion a year on catastrophic drug transfers, C$2 billion over two years for home care, C$2.5 billion over two years for primary health care and C$1.5 billion over two years for diagnostic services.

One of the problems in getting national medicare agreement is that some of the provinces, which ultimately pay for the health system, want only a lump-sum transfer from Ottawa without being forced to allocate the money to specific areas.

Reference Source 89

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