Securing our
Health System
for the Future

Canada’s universal healthcare system is putting enormous pressure on provincial and federal treasuries at a time of fiscal deficits. Healthcare costs are rising as a percentage of GDP due to our aging society and healthcare inflation. Our existing health coverage is both unsuited to our country’s current health needs (focused on acute rather than chronic care) and uneven across the country.

Dr. Philippe Couillard, PC, MD, is presently a Strategic Advisor, at SECOR Group. From 2003 – 2008 he served as Québec’s Minister of Health and Social Services. He has held many positions within medicine, including as Professor at the Université de Sherbrooke and chief surgeon and director of the Surgery Department at the Centre Hospitalier Universitaire de Sherbrooke. He is the chairman of the Health Research Foundation of Canada, a director of two Canadian biotechnology companies and a partner at Persistence Capital Partners, a private equity investment firm. Dr. Couillard is a member of the Queen’s Privy Council for Canada and sits on the Security and Intelligence Review Committee.


Philippe Couillard

Seven years ago, our country’s first ministers gathered in Ottawa with the intention of achieving an accord that would fix healthcare “for a generation”. Sadly, this ambition remains unrealized. What progress there has been has taken place on the “production” side of our healthcare system: wait-times for targeted procedures have improved (albeit at considerable cost). On the negative side, there remain significant cross-country disparities in coverage for prescription drugs, home and long-term care. Attempts to improve accountability have fallen short of expectations.

Read pages 1-7 in the section PDF

We need physicians to participate in the management of the system

What we have ended up with is too much measurement and too little management

Francesca Grosso is a Principal at Grosso McCarthy, a consulting firm specializing in health care strategy and policy. Francesca served as Director of Policy to the Ontario Minister of Health and Long Term Care from 2001 – 2003. Prior to this she was Vice President of Healthcare at Environics Research Group. Francesca worked with Michael Decter to establish the Health Council of Canada and has been involved in the establishment of several other federal healthcare agencies. She co-authored, with Michael Decter, the 2006 book, Navigating Canada’s Health Care: A User Guide to the Canadian Health Care System.

Michael Decter is a Harvard-trained economist and leading Canadian expert on health systems. He served as Deputy Minister of Health for Ontario and as Cabinet Secretary in the Government of Manitoba. He has published several books on healthcare and has held many senior positions in health management and health-focused organizations, including being the Founding Chair of the Health Council of Canada. He currently serves as President and Chief Executive Officer of the investment management firm, LDIC Inc. Michael was awarded The Order of Canada in 2004.


Francesca Grosso and
Michael Decter

Maintaining a high quality healthcare system in the current era of slower economic growth and greater healthcare demand will be a huge challenge for Canada. The task of addressing and managing this challenge falls largely to public sector decision makers. Such decision makers must cope with the combined effects of two key factors: (i) an aging population and higher dependency ratios but also (ii) the vast number of new healthcare interventions, both diagnostic and in treatment, and the seemingly boundless public appetite for these. It is not aging per se that is the problem but aging in the context of increased healthcare options.

Read pages 8-13 in the section PDF

Mark Stabile is Founding Director of the School of Public Policy and Governance at the University of Toronto and Professor of Economics and Public Policy at the Rotman School of Management. He is also a Research Associate at the National Bureau of Economic Research, Cambridge Massachusetts and a fellow at the Rimini Centre for Economic Analysis, Italy. From 2003 – 2005 he was the Senior Policy Advisor to the Ontario Minister of Finance where he worked on health, education, and tax policy. He has also advised the Governments of both Canada and Ontario on health care reform.


Mark Stabile

Well before the great recession of 2008, Canada’s healthcare system was sending out signals that it had a financing problem. Healthcare costs in Canada have outpaced growth in tax revenue and gross domestic product (GDP) for much of the past few decades. While there have been times of faster and slower growth, on average between 1980 and 2006 the annualized growth in healthcare expenditures was 7.5%. The average annualized growth in GDP over that same period was 6.1%.

Read pages 14-19 in the section PDF

Use the 2014 negotiation to agree on a framework for diversified public funding

Securing Our Health System for the Future


2011-12-19 14:59:52

Well, so much for the 6% escalator promised in the last election…