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With last month’s announcement of the new Canadian health care funding formula, federal transfers to the provinces will continue on an annual increase of 6% until 2017, at which point increases will be tied exclusively to GDP. Without delving into the complex politics here, suffice to say this unilateral federal decision is generating both positive and negative reactions (and the manner in which it was proposed). But what I’m more interested in is how this significant change impacts the ongoing health care debate in this country.

Maclean’s “Best of 2011” featured an article entitled, “Our health care delusion, which brings to light some of the current realities around the functioning of our health care system. According to author Ken MacQueen, a 2010 Commonwealth Fund report found that when compared with the health care systems of a dozen other countries, “Canada scored well on leading ‘long, healthy productive lives,’ but it was mid-pack or worse on every other measure.” In recent years, one major issue that has come to the forefront is wait times, which are “widely regarded as the Achilles heel of the system.” MacQueen explains how these issues have emerged in ERs across the country; yet many Canadians still believe that we have the best public health care system in the world.

So why don’t we address this issue? Some argue that health care reform in Canada carries a lot of patriotic baggage with it, as “intelligent debate about what should be done has basically ground to a halt by incendiary claims that any attempt to update the system amounts to treason- a repudiation of sacred Canadian values.” However, there seems to be a definite need for change as the long-term sustainability of our health system has been questioned more and more in recent years. This presents an opportunity for all of us to reflect on our experiences with the health care system that so many of us take great pride in.

So how does public engagement fit into all of this? Before we can even determine what exactly we need to do, there needs to be opportunities for informing that discussion. In 1964, we had the first “real conversations” about health care in this country with the Royal Commission of Health Services (to get a sense of the conversation back then, check out the full November 2, 1964 broadcast on CBC’s National Farm Forum Radio). When asked about the importance of universal health care (which was only available to Saskatchewanites at the time), the Commission’s chair stated that “there is an obligation on society to be concerned with the health of its individuals.” Even though much has changed since then, the need to engage citizens in the health system will always remain. Why? Consider what citizens represent in the health care context: they “are not only interested representatives of the general public, but are also consumers of health services, patients, caregivers, advocates and representatives of various community and voluntary health organizations.”

So what has been done so far? This past year the Canadian Medical Association (CMA) engaged Canadians in a national dialogue on health care transformation, which consisted of an online consultation process and six in-person town hall meetings, which Maclean’s helped moderate. You can read their final report here.

Let’s just hope that momentum builds and that such efforts continue as we look to 2014…

-Tristan Eclarin-