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Another difficulty is ideological resistance to such innovations as increased private health service delivery and performance-based funding

Claude Castonguay, under whose direction Quebec’s medicare system was instituted four decades ago, has written a new book

In an open letter to the premier published this week, he says that what is needed is an overall plan

The Quebec government has reacted by convening a panel of experts whose mandate is to evaluate the feasibility of a pilot project on activity-based funding for the hospital network.

Reforming hospitals' funding model also paved the way for other changes to the English health-care system that have produced beneficial results. Patients can now choose the hospital in which they will be treated, and hospitals compete to attract them.

Yanick Labrie is an economist at the Montreal Economic Institute.

It urged Klein to build firewalls around Alberta, to limit the extent that a hostile federal government can encroach upon a provincial jurisdiction.

debate at the Manning Centre in 2009

Boessenkool also said during the debate that by far the most important thing the Conservative government has done is it "stopped cold...a national, government-run, unionized child care system and instead redirected billion of dollars so parents can make their own choices about their families."

on the verge of a breakdown

Euro-Canada Health Consumer Index

dollars spent voluntarily for private care free up more money for the public system

Removing the Canada Health Act prohibition against private care would reverse the flow of money going to international hospitals, better utilize our excellent health care professionals, and foster job-creating investment

It predicts that these costs in Canada would rise from under eight per cent of GDP in 2010 to more than 13 per cent by 2050.

Unlike Reagan, Prime Minister Stephen Harper has never publicly discussed his "starve-the-beast" plan, but it's pretty clear that that's what he's doing.His former chief of staff, Tom Flanagan, de-scribed it as the prime minister's long-term plan: "First depriving the government of surpluses through cutting taxes . and then it makes it easier to make some expenditure reductions."

The white paper draws lessons from seven comparator countries (U.K., Australia, Germany, U.S., France, Switzerland and the Netherlands), which formed the foundation for the Centre’s key recommendations for Canada’s health care system. The Centre’s recommendations include the following: Create financial incentives using insurance programs or personal health budgets that empower consumer decision making to drive competition and innovation among health system stakeholders. Make the case for innovation adoption by empirically measuring and capturing the impact of innovation on health system sustainability and patient outcomes. Transform Canada’s health system from a dominant acute care focus to a community-based system focused on chronic illness management and prevention. Create accountability systems whereby health providers, and physicians in particular, assume 24/7 responsibility for managing health and wellness in communities.

arm citizens with the tools and resources to manage their own health and welfare in partnership with health providers

MacKinnon suggests diverting services away from traditional hospitals, which in her words, are "expensive, heavily unionized, and therefore difficult to manage efficiently." She believes services delivered by private clinics, focusing on specialty care, can deliver better ser-vices at a lower cost.

She also wants patients diverted from expensive and crowded emergency rooms and other costly facilities to primary health clinics where family doctors - on salary rather than fee for service - would work as part of a team, including physiotherapists, counsellors, nutritionists and others. Public-private partnerships should be used to build more long-term care facilities so that elderly patients can be cared for in less expensive purpose-built facilities.

Two contributors suggested making health-care services a taxable benefit. Another suggestion was to allow patient copayments for medical services.

Brian Lee Crowley and Jason Clemens are the editors of the Macdonald-Laurier Institute's recent publication, Canada's Looming Fiscal Squeeze: Collected Essays on Solutions, available at www. macdonaldlaurier.ca.

She also wants patients diverted from expensive and crowded emergency rooms and other costly facilities to primary health clinics where family doctors - on salary rather than fee-for-service - would work as part of a team

Public-private partnerships should be used to build more long-term care facilities

Two contributors suggested making healthcare services a taxable benefit. Another suggestion was to allow patient copayments for medical services.

Brian Lee Crowley and Jason Clemens are the editors of the Macdonald-Laurier Institute's recent publication, Canada's Looming Fiscal Squeeze: Collected Essays on Solutions (macdonaldlaurier.ca)

the principles of universality, inter-provincial portability and comprehensiveness should all be retained in their current form

Some sections of the Canada Health Act do, however, need to be revised

Section 8, which contains the requirement for public administration, requires a single, non-profit insurer, thus preventing competition and alternate forms of ownership and operation of the insurer

Section 12 covers accessibility and is one of the more problematic sections

It is also intimately related to sections 18 through 21. These sections disallow the use of extra billing and user charges. We recommend repealing these prohibitions

We also recommend that Section 12 focus on accessibility for those experiencing low income by encouraging the provinces to shelter such people from the burden of user fees, co-pays, or other financial contributions.

The federal government has taken some productive first steps in reforming the transfer payments and accordant conditions attached to them. However, the federal government must now revise the Canada Health Act

Jason Clemens and Nadeem Esmail are co-authors of First, Do No Harm: How the Canada Health Act Obstructs Reform and Innovation, which was recently released by the Macdonald-Laurier Institute.

Brett J. Skinner is founder and CEO of the Canadian Health Policy Institute and author of "How to Grow the Economy by Liberating Healthcare" (forthcoming).

Canadians spent almost $200-billion on health care in 2010, equal to about 12% of GDP

The health-care industry is also a job-creation machine.

current market demand for health care exceeds the current market supply

economic growth in the industry, is artificially constrained by limited government resources and policy barriers to private-sector funding and delivery