The twelve papers in this third volume of the research program for the Romanow Commission offer a detailed analysis of the governance of health care in Canada from the perspective of constitutionalism, intergovernmental relations, and societal context. In the first section, the authors deal with the formal division of powers regarding health care as outlined in the Canadian constitution and the Charter of Rights and Freedoms. The second section outlines the strengths and weaknesses of the intergovernmental governance of health care. Finally, the third section focuses on governance of health care outside of the governmental sphere. The theme that resonates throughout the contributions - and which is in itself a call for deeper analysis - is that health care governance has become locked in a cycle of mutual recrimination, blame assigning, and blame avoidance from the federal and provincial levels right down to the level of the individual citizen.

The twelve papers in this third volume of the research program for the Romanow Commission offer a detailed analysis of the governance of health care in Canada from the perspective of constitutionalism, intergovernmental relations, and societal context. In the first section, the authors deal with the formal division of powers regarding health care as outlined in the Canadian constitution and the Charter of Rights and Freedoms. The second section outlines the strengths and weaknesses of the intergovernmental governance of health care. Finally, the third section focuses on governance of health care outside of the governmental sphere. The theme that resonates throughout the contributions - and which is in itself a call for deeper analysis - is that health care governance has become locked in a cycle of mutual recrimination, blame assigning, and blame avoidance from the federal and provincial levels right down to the level of the individual citizen.

The Fiscal Sustainability of Health Care - the first of a three-volume set of selected papers from the Romanow Commission - comprises the most influential discussion papers on the fiscal sustainability of public health care in the future. The subjects covered include the current and potential cost drivers of the system, the financing and delivery of health care, fiscal federalism, and international trade regimes. While some of the contributors are among Canada's best known and respected figures in the field, others are relatively new scholars from Canada and abroad who bring fresh perspectives and new insights to the issue of fiscal sustainability. Presenting divergent diagnoses and policy prescriptions, the papers collectively highlight the many factors that governments and health care sector managers must confront to keep the Canadian health care system viable in the 21st century.

To help Canadians digest this deluge of advice and to trace the roots of the decisions to be made in 2003, this brief paper summarizes the main themes in the eight reports and identifies the areas of agreement and disagreement. [...] Romanow and Beyond: A Primer on Health Reform Issues in Canada 1 Introduction Canadians are currently awaiting the release of the final report from the Commission on the Future of Health Care in Canada (the Romanow Commission) expected at the end of November 2002. [...] Increase the Role of the Private Sector A number of reports raised the issue of increasing the role of the private sector. [...] A twenty-four member forum was established by the Prime Minister in 1994 to involve and inform Canadians and to advise the federal government on innovative ways to improve the health system and the health of Canada's people. [...] An eleven-member Committee of the Senate of Canada was authorized in March 2001 to examine the principles on which Canada's publicly funded health care system is based; the historical development of the health care system; health care systems in foreign jurisdictions; the pressures and constraints of Canada's health care system; and, the role of the federal government in Canada's health care syste.

In April 2001, the Prime Minister established the Commission on the Future of Health Care in Canada. Its mandate was to review medicare, engage Canadians in a national dialogue on its future, and make recommendations to enhance the system's quality and sustainability. The 47 recommendations in this report outline actions that must be taken in 10 critical areas, starting by renewing the foundations of medicare and considering Canada's role in improving health around the world.