Our hope is that this document will serve as a catalyst for political and healthcare leaders. The Medicare system that Canadians value and cherish is at risk. And yet, apart from courage and leadership, there is little standing in the way of substantive reforms which would preserve and even enhance our system of healthcare and health services. Certainly, as we noted in our 1996 document, nothing in the Canada Health Act precludes any of the steps to healthcare reform which we advocate. The Role of Government Provincial governments have a limited but essential role in providing funding, setting standards and goals and evaluating system performance.
Several barriers exist to changing the role of government.
Systemic change takes time and requires sustained will and leadership. Government departments are not structured in a way that is either appropriate or consistent with an integrated approach to healthcare delivery. There is a lack of good information that would allow proper performance evaluation. There is also a fear that, by setting goals and standards, governments will be held accountable by the public for meeting them. The public is also not well informed about the need for change and is understandably fearful of proposed changes which it does not understand.