Ottawa, 25 May 2011 -- Canada 2020 hosted a panel discussion on Health Care 2014: Creating a Sustainable Health Care System. With the current Federal-Provincial health care agreement expiring in March, 2014, Canada 2020 wanted to contribute to the debate over the shape of a future agreement. This is the presentation by Michael Kirby, Chair, Mental Health Commission of Canada. Visit www.canada202.ca for details.

1. Six Challenges Facing Canada’s Health Care System An event organized by Canada 2020 May 25, 2011 By Michael Kirby Chair Mental Health Commission of Canada

4. The aging of the population

5. The growth in pharmaceutical costs

6. Technological advances

9. Challenge 2 Convincing Canadians that some of their central beliefs about the health care system are not true; they are myths. For example: A Universal health care system does NOT need to be FREE. Canada is the only country with a universal health care system in which co-payment of some kind is not paid by at least some citizens. Medicare was created to be a public health services INSURANCE program, NOT a public health services DELIVERY system. The current health care system is not entirely publicly funded. Only 70% is publicly funded, the remaining 30% comes from private sources, mainly individuals. These myths severely constrain public discussion of health care issues in Canada.

10. Challenge 3 Determining whether Canadians want challenge 1 solved by: a) increased taxes which governments put into the health care system; Or b) individuals putting money directly into the system through, for example, a co-payment for certain services or buying health insurance to cover some, or all, of the services which are currently “free”.

11. Challenge 4 In the answer to challenge 1: If a) is chosen, what type of taxes do Canadians want increased If b) is chosen, what direct payment system do Canadian prefer; And how to Canadians want the fairness of the current system preserved (eg. The quality of health care a Canadian receives must not depend on an individuals’ income).

12. Challenge 5 In addition to increased funding, the health care system must also be made more efficient Making the current health care system more efficient requires VERY significant structural change, no matter which set of proposals for change are adopted System change is frequently strongly opposed by people employed in the system and the organizations they work for. The health care system is no different. How can such opposition be overcome?

13. Challenge 6 If the health care system is to meet its original objectives of covering all health care services, and live up to the principles of the Canada Health Act, two system expansions are required: A) prescription drugs And B) clinical counselling (talk therapy) by mental health professionals outside of hospitals other than psychiatrists (eg. psychologists, social workers etc.)