By Jeffery Simpson, January 10, 2022
With Canada in the grips of a new wave of the pandemic, and new lockdown measures imposed to preserve our fragile health-care system, maybe now Canadians can start to have a serious discussion about why this country is so resistant to bold reforms to improve the way we pay for and deliver medicare.
As it happens, this month marks the 20th anniversary of the release of one of Canada’s most serious efforts to assess the problem and propose novel solutions. Titled “A Framework for Reform,” what we know as the “Mazankowski report” was the work of an impressive group of experts from within and beyond Alberta under the leadership of former federal deputy prime minister, Don Mazankowski. They were not alone; other medicare studies in the era were led by Roy Romanow, Michael Kirby, Claude Castonguay, and Kenneth Fyke. But Mazankowski’s may have been the most bold.
Sadly, 20 years later, and 10 years after the publication of my book, Chronic Condition, which covered many of the same issues, most Canadians remain wedded to a badly flawed health-care system that’s still in dire need of reform.
The Mazankowski approach slammed into political walls everywhere. Even former premier Ralph Klein, who had established the Mazankowski Advisory Council on Health, recoiled from the report’s most controversial recommendations. Medicare, even in Alberta, was too firmly entrenched in the psyche of Canadians as a symbol of their citizenship. Canadians saw medicare as an example of equality and fairness. Its growing costs and evident weaknesses — lack of consistently timely care and uneven access, except for emergencies and life-threatening problems — could not shake medicare’s grip.