TORONTO - The environment has not eclipsed health care as the top political issue for Canadians, but the public must do more to press governments to reform the system, the head of a landmark 18-month inquiry into medicare said Tuesday.
The environment and health care, currently among the top three priorities for Canadians, aren't "natural enemies" but in fact interrelated issues, former Saskatchewan premier Roy Romanow said following a speech on the state of health care in Canada.
Romanow said he doesn't put a lot of stock in polls that suggest issues like climate change have overtaken health care as the main concern of Canadians, and instead believes the two issues are different sides of the same coin.
"The state and quality of our environment will greatly impact the state and quality of our personal health and our community health," said Romanow, who led a royal commission on the health-care system in 2002.
"The fact is that we need to address both of these, but perhaps in different ways."
Health care has traditionally outranked all other concerns among Canadians, but that changed last November when the environment grabbed the spotlight, said John Wright of polling firm Ipsos Reid.
It was the first time in 16 years that health care wasn't the top priority for Canadians, a shift Wright attributed to unprecedented media attention devoted to the perils of climate change.
"Everyone was talking about it," he said.
"We had a whole series of reports, we had Al Gore in 'An Inconvenient Truth,' we had a lot of front-page stories that dealt with the issue . . . it's pretty evident that the profile that this issue received fed upon itself and we had people all of a sudden become concerned about it."
Health care and the environment have since kept pace with each other, although their popularity seems to swing depending on what people see, read and hear, rather than personal experience, Wright said.
"People hear about the health-care system, and they're deeply concerned about its underfunding and a whole series of other things, but if you actually ask Canadians about their recent visit to a hospital or to their own doctor, evidence clearly for the last number of years is that it's improving, and that it's actually pretty good," Wright said.
Concerns about health care in particular reached a peak in 1995 following a series of government cutbacks. According to Romanow, it happened again in 2002 when the royal commission released its findings and recommendations.
But the public's "big push" for reform five years ago has dissipated and little has been done since then to fix the system, Romanow said Tuesday at a health-care conference in Toronto.
There's been no action on aboriginal health, which he called a "national Canadian disgrace." Nor has much progress been made on home care or developing a national catastrophic drug plan, he said.
He called the current debate on public and private funding and delivery, prompted in part by a landmark 2005 Supreme Court decision, one of the biggest challenges currently facing the Canadian system.
He described the decision, which struck down Quebec's ban on private health insurance for private care and permitted patients to use private care when faced with unreasonable delays, as a "major and unfortunate intrusion" into the complex issue of health care.
The court ignored evidence that affirmed the effectiveness of the public health-care model and the perils of private systems, he said.
That decision has "re-energized" a small but powerful minority who are in favour of a private health-care system and resulted in similar lawsuits being launched in Alberta and Ontario, Romanow said.
"If citizens can speak and say, 'Hey, it is a public good, and we want to organize to affect the best outcomes,' they'll steamroll over jurisdictional issues over whether it's province or federal, and will swamp, I believe, those who argue more private care."
