That sums up much of Roy Romanow’s report on Medicare. One way to gage the quality of a report is to check what it lists as references. The Romanow report is remarkable for what is missing from its list of references, including key studies that should be central to any investigation of health care systems.

This is troubling since the omitted information contradicts assertions Romanow has made in his frequent media visitations. During the weeks leading up to the release of his report, Romanow repeatedly said no evidence suggests private provision of medical services can improve quality and efficiency.

After the report’s release, Romanow changed that to “little evidence.” Although the report does not recommend an outright ban on private provision of medical services, it does recommend limiting their use and reducing their current role.

Let’s be clear about what’s at issue – whether to allow Canadians to choose between government run medical services and private sector competitors, with the bill paid in either case by the taxpayer.

To patients desperately needing care, it surely makes little difference whether a bureaucrat or a businessperson is in charge of a clinic. The quality and timeliness of the services is what’s important.

Private and public-run clinics would receive the same tax-funded fee from government. Private clinics would only succeed if they could offer more efficient and better service than public clinics.

If there is “no” evidence private clinics can provide superior service, then there is no reason to limit their use. They won’t survive on the same fees provided to more efficient government-run clinics. Private clinics will go bankrupt and rich investors will lose money.

On the other hand, if private clinics can provide better medical services, then it would be a deadly crime to prevent sick Canadians from seeking treatment from them as an alternative to government waiting lists.

But, if your interest is less the health of Canadians than the preservation of a government monopoly, then you’ll be anxious to limit the role of the private sector, especially if you fear private clinics could provide Canadians with choice and superior medical treatment.

People desperately needing treatment will go to where they can receive it most quickly and efficiently – whether private or public. That would be a serious threat to anyone who, for ideological reasons, wants to maintain a government monopoly.

Romanow’s claim private clinics won’t create efficiencies is closely tied to his argument that Canada – with its limits on private provision – has the best health care system in the world, save for money problems.

His report cites many World Health Organization (WHO) studies, but oddly ignores WHO’s 2000 report, which rates health care systems around the world. Canada does miserably, coming in at 30th, behind Portugal, Spain, and even Columbia. And, Canada is unique in its restrictions on private provision – restrictions Romanow perversely wants increased.

When I discussed the study on a Newsworld debate, Robert Chernomas of the Canadian Centre for Policy Alternatives – a pro-union group, which provided Romanow much of the research he did use – said WHO couldn’t be trusted because it received funding from the United States. Apparently, US conspiracies are everywhere.

If WHO is secretly controlled by the United States, it must rate the US system highly. Not at all. The US system is 37th, well behind Canada, though WHO rates the US system as the world’s most expensive. How could Chernomas’ bizarre conspiracy theory justify the exclusion of the WHO study from Romanow’s consideration?

Much other research is missing from Romanow’s $15-million, 18-month commission. The Rand study, the most comprehensive examination of patient behaviour and by far the most frequently cited research on this subject, was also ignored. So were studies of waiting lists in Canada and other international comparisons. These studies all contradict Romanow assertions.

Canadians deserve choice and timely treatment, rights enjoyed in most nations with universal medicare. Romanow’s report recommends limiting choice. It’s no cure for Medicare’s ills.