The report of the Ontario Social Assistance Review Commission, released October 24, offered some important steps toward health-focused change. Its release was set to spark a badly needed discussion on reform of a broken and anemic system. The surprise resignation of Premier Dalton McGuinty changed that -- this debate has been conspicuously absent.

The Canadian Medical Association's 145th annual meeting is taking place this week. The mantra of the meeting is health equity, and Sir Michael Marmot, the white knight of social determinants, undoubtedly provides the human and scholarly element the issue of inequality deserves. There may be no better person to articulate Canada's barriers to better health outcomes.

Woody Allen once said that basketball transports us to a primitive place for higher learning. The loose arrangement of strangers balling on public pavement illustrates many of the ivory tower's arguments surrounding health insurance. We can try breaking it down like this...

The implementation of Obamacare seems anything but straight forward. Costs have soared despite the fact that most reforms don't kick in until 2014; several states have effectively rebelled; one basic reform (the long-term care insurance) was already scrapped. The debate over American health care seems no closer to resolution.

Harper's unilateral offer promises increases in federal funding that are unsustainable. With health care set to eat up 80 per cent of provincial budgets by 2035, if no substantial reforms are implemented we will have serious consequences for the ability of provinces to spend on departments other than health care.

Today, the premiers are meeting in Victoria. Top of the agenda: health care. It's a meeting that will be long on rhetoric but short on purpose. Historically, such meetings allow premiers to bemoan the lack of stable, long-term funding from Ottawa.

Here's the paradox in modern health care: medicine has never been better, but we seem to be getting collectively less healthy. Obesity rates continue to rise dramatically: One in four Canadians are overweight and among the heaviest of the Western world.

There is no single reform that is going to make medicare work better. But there is a general approach that would be useful. And that alternative approach recognizes the limitations of centralized planning and the need to allow more private money and leadership into the system.

Health care, which pollsters insisted was the issue of greatest concern to voters in the federal election, was summarily dismissed by our political parties with a unanimous promise made up of two simple words: "more money." But throwing ever-larger amounts of taxpayer dollars at the problem without measuring value often simply results in more waste and duplication.