05/26/2011 08:09 EDT | Updated 07/25/2011 05:12 EDT

Health Care: From Entitlement to Empowerment

Our fiscally unsustainable public health care system is in deep trouble. Getting the health care system we want requires a shift from a sense of entitlement to one of personal responsibility.

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It is good to see health care reemerge as an issue in the Canadian policy debate, following an election campaign in which it was all but ignored.

When the campaign ever so briefly turned to health care, all party leaders pledged to keep increasing federal transfers to the provinces at the current rate -- six per cent per year -- and the issue went away.

Yet, Canadians understand that our public health care system is in deep trouble. We know that it is fiscally unsustainable -- it already absorbs more than 40 per cent of provincial budgets, and climbing. We know that an aging population and new treatments keep driving up costs faster than our ability to pay.

We also know that other countries get better results for less money. The Conference Board of Canada's 'How Canada Performs' analysis concluded that our health spending per capita is the fourth-highest of 17 peer countries, but Canada falls in the middle of the pack -- at best -- on key indicators of population health.

We compare favourably to the United States, which gets the worst results and spends by far the most money. But countries such as Australia and Sweden show healthier populations while spending less than Canada per person, so how money is being spent is just as important as how much is being spent.

Canadians generally assume that all we need to do to fix these problems is elect some leaders with the guts to make tough choices. They assume that the answers are known. This is not the case. Political will is important, but the reality is that the solutions aren't easy. The time has come to move beyond rhetorical nostrums and grapple with the true complexity of health care issues.

This is why the Conference Board of Canada has ramped up its focus on health care. In addition to our international benchmarking, the Board operates six executive networks, and recently launched the Canadian Alliance for Sustainable Health Care (CASHC). This five-year initiative will provide research, thoughtful analysis and recommendations to improve the Canadian health system as a whole -- the public system, as well as health care practices within firms and organizations.

From the outset, we must consider not just what our health care system costs, but also what it adds to our economy and to our society. We must recognize that technology is transforming what is possible and what we want. We are empowered to check what we are told by health care providers, get a second opinion, find out about alternative treatments, and make our own judgments about our care. 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.

Ultimately, getting the health system we want -- one that is more efficient, effective, equitable and sustainable -- will require innovation, collaboration among all stakeholders and a shift in the expectations of the public from a wholesale sense of entitlement to one of empowerment and personal responsibility.