Health care: From entitlement to empowerment

TheStar.com – opinion/editorialopinion
Published On Thu May 12 2011.    Anne Golden and David Stewart-Patterson

Canadians understand clearly that our public health-care system is in deep trouble. We know that it is fiscally unsustainable. We know that other countries get better results for less money. We know that an aging population and new treatments keep driving up costs faster than our ability to pay. We know that the boundaries between what is covered and what is not are creating both inefficiencies and unfairness.

Canadians generally assume, however, that all we need to do to fix these problems is elect some leaders with the guts to make tough choices. This blithe assumption is way too simplistic. Political will is important, but the reality is that there are no easy solutions, at least not ones that will work.

The simplest and most obvious solution is to throw more money into public health care. When the recent election campaign focused on health care, one party leader after another pledged to keep increasing federal transfers to the provinces at 6 per cent a year, and the issue went away. Federal grants have been rising at three times the rate of inflation for almost a decade now and the problems are still with us.

The time has come to move beyond rhetorical nostrums and grapple with the true complexity of health-care issues. We need to think through specific options, cost out individual actions, understand how they would interact with other parts of the system, learn from each other in identifying best practices, and then build consensus around an integrated plan for building a health care system that will be efficient, effective, equitable and sustainable.

This is why the Conference Board of Canada has launched the Canadian Alliance for Sustainable Health Care (CASHC) to focus on concrete actions that could be taken by businesses and by individuals as well as by governments and public sector institutions. Business leaders in particular are playing a key role because they have a vital interest in ensuring a healthy labour force, attracting global talent to Canadian communities and creating a real competitive advantage for Canada within the global market.

We must consider from the outset not just what our health-care system costs, but also what it adds to our economy and to our society, and we must recognize in particular how technology is transforming both what is possible and what we want.

Canadians are no longer passive recipients of what the public system chooses to provide. Our expectations have moved into the online age: We want instant access to the catalogue of what is available, to comparison shopping, and to reliable and timely filling of our orders.

Technology is empowering us to improve our own health-care experience: to check what we are told by health-care providers, to get a second opinion, to find out about alternative treatments, to make our own judgments about which course to pursue. At the same time, a system pressed for more choice and faster delivery is downloading more chores, forcing patients and family members to find their own way through an increasingly complex system.

What this means is that we must change the way we think about health care in Canada. If we continue to treat health care solely as an essential public service, as a sacred entitlement of Canadian citizenship, we are doomed to perpetuate the trend toward higher costs, higher taxes, longer lineups and wait times and growing frustration.

We need to move instead toward health care based on empowerment, recognizing that this must go hand in hand with greater responsibility. This is true for each of us as a consumer of health care. It is equally true for the businesses, health-care institutions and governments that must now embrace the complexity of Canada’s health-care challenge and get down to the tough job of finding ways to make the public system work better for everyone.

Anne Golden is president and chief executive officer of the Conference Board of Canada, and David Stewart-Patterson is the Conference Board’s vice-president of public policy.

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