Healthcare continues to be the number one issue for most Canadians. In an Angus Reid poll from May 2000, 52% of respondents identified healthcare as their top national concern with another 90% identifying healthcare as the highest priority for our governments in the future. Why The reason is clear from the same polling data: 80% of all Canadians believe the healthcare system is in crisis.

Canadians deserve to hear the real story about the state of Medicare. The reality is that the five "sacred" principles of the Canada Health Act (universality, accessibility, comprehensiveness, portability, and public administration) are, for the most part, violated each and every day in Canada.

Universality Yes, we all have the universal right to queue up on a waiting list. But a person living in Saskatchewan can wait twice as long as a patient in Ontario for some cancer therapies. Also, Worker Compensation Boards purchase services from health facilities to avoid waiting lists and jump the queue.

Accessibility Increasingly it's a function of where you live in Canada. Just one example: in vitro fertilization (IVF) treatments are covered in some provinces but not in others.

Comprehensiveness Again, which services are covered heavily depends on which province you reside and what services public administrators deem to be medically necessary.

Portability Sure, so long as you have your chequebook to cover differences between provinces regarding fee schedules and insured versus non-insured services.

Public Administration Private funding now represents 29% ($27.5 billion) of total healthcare spending in Canada. The private-sector already effectively deliver health services including running ambulances, nursing homes, and MRI clinics.

Indeed, a May 1999 Angus Reid poll found that 71% of Canadians want to change the Canada Health Act because its five founding principles do not meet the country's current health care needs.

Clearly, public confidence in our current healthcare system has diminished to an all-time low. The politicians have been reading the polls and have responded to public concerns by devoting more and more public spending. In September of last year Ottawa and the provinces signed a five-year deal that will increase transfers to the provinces in support of healthcare by $2.8 billion in the fiscal year 2000-01 and will boost federal funding from the current $15.5 billion to $21.1 billion by 2005. The feds have also promised another $1 billion for new technology over the next two years, $800 million for primary care reforms, and another $500 million for a national electronic health information system.

The federal and provincial governments should be commended for acknowledging the serious problems facing our country's healthcare system. But simply pouring more money in the top is not the long-term answer. And by refusing to look outside the parameters of the Canada Health Act, policy makers are excluding a whole range of potential remedies.

We need a sustainable and effective healthcare system. It's time to modernize the Act to include principles such as quality, accountability, sustainability, and choice. It's time to 'think outside the box'.