The Conference Board of Canada, 250 pages, October 2013

After examining health care systems in Canada and abroad, the author outlines ways to reform our system by balancing competing demands, building on successes, ensuring sustainable funding, and addressing the highest priorities.

Document Highlights

In this Scholar-in-Residence Program monograph, Globe and Mailcolumnist André Picard aims to answer one question: “How do we reform our health care system?” He says we must continue to focus on the principles of medicare: universality, accessibility, comprehensiveness, portability, and public administration. He argues that two opposing extreme views—that medicare is an unsustainable failure or an unalterable sacred cow—have made it impossible to have a constructive debate, and that the way to reform lies somewhere between them. After examining the history of health care systems in Canada and other developed countries, Picard argues that Canada’s system needs to be modernized by conciliatory, cooperative, pragmatic leaders. We need to set clear limits on what the system covers, build on successes, find the most effective funding mechanism, and address five key gaps: pharmacare, primary care, community care, social determinants of health, and health care quality.

Three distinguished health care experts offered their insights into health care reform at the 2012 CIBC Scholar-in-Residence Lecture.

Table of Contents


Introduction—Principles and Goals: What Are We Trying to Achieve?

Section I—The Path to the Present: How Did We Get Here?

  • Chapter 1—An Unhealthy Past: Life Before Medicare
  • Chapter 2—Health Care for the Masses: Medicare Is Born
  • Chapter 3—The Canada Health Act: Icon or Paper Tiger?
  • Chapter 4—Back to Earth: The Era of Cutbacks
  • Chapter 5—Is More Study Needed?
  • Chapter 6—The Fix for a Generation?

Section II—Frozen in Time: The Canadian Health Care System Today

  • Chapter 7—How We Compare: What Have Others Done Better?
  • Chapter 8—What Are the Barriers to Reform?
  • Chapter 9—National Issue, Provincial Authority
  • Chapter 10—The Third Rail: What Is the Role of the Private Sector?
  • Chapter 11—Paying the Piper: Is Medicare Sustainable?
  • Chapter 12—The Economic Footprint

Section III—Health Care Reform: What Needs to Change?

  • Chapter 13—The Path Forward: Structural Reform
  • Chapter 14—The Path Forward: Affordable Care

Conclusion—A Call to Action


Transcript of the Lecture