Opinions on Medicare

Polling data in the last few years have consistently cited medicare as among the most important political issues in the minds of Canadian voters. Along with peacekeeping, medicare was found, based on a CBC poll, to be among the foremost defining characteristics of Canada.
It has increasingly become a source of controversy in Canadian politics. As a recent report from the Health Council of Canada has noted "Herein lies one of the puzzles of Canadian health care: Canadians increasingly view the health care system as unsustainable and under threat, even as their own experiences with the system are mostly positive."[15]
As analysts have noted, the root of the concern may be traced to successful cost control efforts in the mid 1990s, where public health expenditure per capita, in inflation-adjusted dollars, actually fell.[16] These efforts arose from efforts by the federal government to deal with its deficit, which led to cuts in their transfers to the provinces, and in turn to squeezing hospital budgets and physician reimbursements. The number of physicians being trained was reduced. The result was seen in increased wait times, particularly for elective procedures. More recently, government has been reinvesting in health care, but public confidence has been slow to recover.
A number of studies have compared Canada with other countries, and concluded that each system has its own strengths and weaknesses. One widely-cited statistic which has been used to argue that Canada was under-performing came from the World Health Organization, which ranked Canada as 30th in 2000. However, the basis for these rankings has been highly contentious. As Deber noted, "The measure of "overall healthsystem performance" derives from adjusting "goal attainment" for educational attainment. Although goal attainment is in theory based on five measures (level and distribution of health, level and distribution of "responsiveness" and "fairness of financial contribution"), the actual values assigned to most countries, including Canada, were never directly measured. The scores do not incorporate any information about the actual workings of the system, other than as reflected in life expectancy. The primary reason for Canada's relatively low standing rests on the relatively high educational level of its population, particularly as compared to France, rather than on any features of its health system." Other countries had similar complaints, and the WHO has not repeated this ranking.
2003 Accord
In 2003, the prime minister and the provincial premiers agreed upon priority areas for reinvestment. The 2003 First Ministers’ Accord on Health Care Renewal reaffirmed their commitment to the principles of the Canada Health Act. They indicated the following principles:
"Drawing from this foundation, First Ministers view this Accord as a covenant which will help to ensure that:
• all Canadians have timely access to health services on the basis of need, not ability to pay, regardless of where they live or move in Canada;
• the health care services available to Canadians are of high quality, effective, patient-centred and safe; and
• our health care system is sustainable and affordable and will be here for Canadians and their children in the future."
The accord set the following priority areas: primary health care, home care, catastrophic drug coverage, access to diagnostic/medical equipment and information technology and an electronic health record. The extent of progress in meeting reform goals has varied across these areas.