A blogger named Jonathan Ross at the BlogsCanada politics e-group suggests today that Roy Romanow has no business commenting on last week’s Supreme Court ruling on health care.

[Romanow’s report was] little more than a prescription to throw more money at the system rather than suggesting and initiating real institutional and philosophical change.

Romanow missed the best chance in a generation to create a substantial and carefully considered national debate on how to modernize and maintain our public health care system. Instead, he chose to take the easy route, solidifying an ineffectual status in history for his commission and its recommendations.

Sorry Roy, but the issues associated with the misguided Supreme Court ruling were inevitable, making your silence on them 3 years ago a huge opportunity lost.

Um… no.

There’s an unfortunate habit a lot of people have of blaming Royal Commissions, their reports and the folks who write them for the government inaction that too often follows. But I can’t imagine anyone plowing through the 300-plus pages of Romanow and coming away with the idea that all he really had to contribute was “Spend more money.” (Midway through, there’s a sex scene that just seems to be padding things out, but other than that it’s all substance.)

You can judge for yourself by reading the final report at the commission’s web site; for what it’s worth, here’s how I replied:

I think, Jonathon, that you’re confusing the amount of media attention that Romanow’s various recommendations received with the attention he gave them. Of his forty-seven recommendations, one dealt with funding levels; another dealt with the creation of earmarked funding envelopes; a very few others recommended consolidating various budgets.

That’s a relatively small footprint in a report that covers much larger ground. Romanow spent far more time detailing the kind of primary care reform that could help contain costs, prevent illness and yield better outcomes; changes in home care and long-term care; improvements in the training and recruitment of health care professionals; better ways of regulating and administering drug patents; planning and delivering Aboriginal health care; and much more.

And even with all of that said, Jim [Elves, who commented just above me] is right: money does play a key role in all of this. The only leverage the federal government has in enforcing the Canada Health Act is spending – and Romanow predict the jam that Ottawa is in today.

In the words of the report, “If the status quo continues, the result will be the eventual unravelling of Canada‚Äôs health care system into a disparate set of systems with differing services, differing benefits and differing ways of paying for health care across the country. This is not what Canadians want or expect for their health care system or for their country….

“[I]n recent years… the federal government has attempted to maintain its role as the defender of medicare‚Äôs national dimensions while simultaneously reducing its responsibility and risk for managing the increasing costs and changing expectations within the system. This has put the federal government at odds with the provinces.”