The campaign to let private-sector companies provide more publicly funded health-care services was given some momentum yesterday when Roy Romanow promised that his commission on the future of health care will give the idea a full hearing.

The former Saskatchewan premier is taking a broad view of his mandate from the federal government, saying it is incumbent on him to look at all options.

"If this is going to be truly a process of listening to Canadians, which I want it to be . . . I want to hear what Canadians feel," Mr. Romanow told a news conference in Saskatoon to mark the first official day of his commission's work.

"If a premier or premiers have put this issue on the table, it's not productive for me today to make a judgment call. I want to hear what the arguments are."

His statement means that, in effect, he has accepted the challenge thrown out to him last week by Ontario Premier Mike Harris, who argued that Canada needs a "revolution" in the way health care is provided if the universally accessible medicare system is to be preserved.

Mr. Harris said governments need to look at imposing user fees and means tests, and at increasing the use of private companies, including privately run hospitals.

Yesterday, he went further, saying that foreign-controlled companies should not be excluded.

"There are some companies that may have foreign connections, or ties, or Canadian subsidiaries, that do deliver services in Canada," the Premier said. "What is important, I think, is that we not put our head in the sand, we not rule things out."

Ontario Health Minister Tony Clement said in Toronto that Mr. Romanow's comments were good news for those who want a no-holds-barred debate on how to ensure that governments can continue to deliver health care.

"It looks like we're going to be making beautiful music together," Mr. Clement said.

Federal Health Minister Allan Rock also endorsed Mr. Romanow's openness to listening to different ideas.

"I know that Mr. Romanow has spoken with all the premiers and I know he's very interested in their views," he said in Ottawa. "I hope and expect that he will be working closely with them and taking their perspectives into account."

Mr. Romanow also said he will look at the issues of funding the health-care system. This is a continuing irritant. The provinces complain that the federal government forced the start-up of medicare more than 30 years ago by promising to pay 50 per cent of costs. That share has fallen to as low as 13 per cent, like in Ontario.

"We may very well want to take a look at the . . . funding arrangements in federal-provincial matters," Mr. Romanow said. "We know this has been a source of some contention over the last little while."

Mr. Romanow has acknowledged that provinces have the prime responsibility for delivering health care by asking them to appoint a liaison to work with his commission and ensure their interests are heard.

He is expected to take 18 months reviewing the issues, including the shortage of doctors, nurses and technicians, long waiting lines and the soaring costs of new drugs and technologies. The first nine months will be spent seeking input from policy experts, health-care providers and the public. The second half will include a "dialogue" with ordinary Canadians.

The commission's final report is expected in November, 2002. Mr. Harris says this will be too late in view of the crisis in health-care costs, and has promised Ontario will hold its own "constituent assembly" to look at revamping the health-care system.

Mr. Romanow stressed that he does not see "anything particularly harmful or dangerous" in Mr. Harris's call to look at all options for saving publicly funded health care.

"Rational men and women should look rationally at the options which fit, and by the way, [at] those which might not fit, in the Canadian system," he said.

But Mr. Romanow stressed the importance of framing the debate clearly. It is important to differentiate "between private, for-profit care which is outside of the publicly administered program, and privately operated but within a publicly administered health-care system."

He added: "The latter has been a feature of Canadian health care for many years. . . . It might require revision . . . based on new technologies, new pharmaceuticals and new procedures. . . . I'm not making any judgment calls."