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Saturday, July 09, 2011

Mechanisms of Health Care Reform

On Tuesday June 7th, Maclean’s magazine, the Canadian Medical Association and CPAC hosted an open dialogue on health care at the National Gallery of Canada in Ottawa. It was entitled: Health Care in Canada: Time to Rebuild Medicare.

The two-hour, video-taped conversation demonstrated how passionately many Canadians feel about health care and that the delivery of health care in Canada isn’t meeting their needs and ought to be changed. One participant referred to the health care budget in Ontario, for instance, that now represents 40% of the Province’s overall budget and is beginning to crowd out other concerns like education, social and correctional services. CIHI estimates that health care spending in Canada was $191 billion in 2010 or 12% of GDP and that by 2031 this should rise to 19% of total GDP -- a rate of growth that seems unsustainable. So the question was posed: what would a reformed health care system look like?

Despite the obvious lack of political appetite for change, participants at the Macleans event were much more pragmatic about the prospect of change and suggested that we focus on how to make things better given the existing legislation. “Could we make use of an amending formula to make adjustments to the Canada Health Act like they do with US Constitution?”, asked one participant. If the major outlines won’t change, then are there smaller, less controversial avenues we can pursue?

To this I would say that there are. In fact, there are several things that might be done to begin shifting the system in a new, more responsive and sustainable direction. I offer three such mechanisms for change below. They include adding a preamble to the Canada Health Act; moving to incentivize change through the application of flat fees for services; and the institution of individual health accounts. (more...)

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