More recently a diverse group of participants at a 1999 Alberta Health Summit identified 14 basic values and principles for the health system. Elsewhere, the re-examination of core values and principles in relation to healthcare is taking place internationally. Universal coverage means coverage for all, not coverage of everything. Provider payment is not made by the patient at the time he or she uses the health service. If this is the case, this underscores the need for a wide-ranging dialogue among a representative group of Canadians with a view to developing consensus on the fundamental values and principles that should define medicare in light of the transformed delivery system.
Governance is the process of effective coordination when power and knowledge are distributed.
For example, the provinces and territories did not generally participate in the National Forum on Health. In general, governments have discounted the role that NGOs and citizens might play in policy-making and in promoting policy among their members. If we are to achieve a vision for a sustainable medicare program in the challenging decades ahead, it will be critical to resolve the imbalance along these axes. Governments must begin to work collaboratively with other stakeholders, including citizens, as they have among themselves over the past few years. The population must be engaged in a deliberative dialogue process that will enable Canadians to understand the challenges before us,identify options and make choices that are congruent with our values.