It’s the end of an era.

The 2004 Canadian Health Accord has expired and along with it we say goodbye to the Health Council of Canada – which was established as an oversight body, to assess and share progress (or lack thereof) on health care reform set out by the Accord.

Many are sounding the alarm. Experts argue that, without the national voice of the Council and established common goals across the country, health care reform will stall, discrepancies in care between provinces and territories will increase; and inequities will grow.

With the expiration of the 10 year, $41-billion dollar agreement between the federal government, provinces and territories comes a great deal of uncertainty. The new funding formula promises $32 billion this year, and will increase six per cent annually until 2017. After that future increases will be tied to GDP growth plus an escalator of three per cent or more for inflation.

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Headlines read “It’s a sad day for Canadian healthcare,” and health care reform advocates are warning of an increasingly American-style health system. Demands are being made for a new oversight body, a new Health Accord, and more federal tax dollars.

The Tories, on the other hand, are adamant that more money is not the answer. While they acknowledge their role to enforce the Canada Health Act, they maintain it is the job of the provinces and territories to provide services to their jurisdictions. They have a point, but the issue isn’t quite as black and white.

In spite of being one of the biggest health care spenders in the OECD, Canada is in the middle of the pack when it comes to the value we get for our money. When you look at quality of care in comparison to other countries, Canada is actually faring quite poorly.

I don’t think more money is the answer. If spending were indicative of quality healthcare, the United States would be the best in the world, in most comparisons they are faring worse than Canada, and far worse than the top performing OECD health systems. The highest quality health care systems in the world spend far less than we do so I disagree that pouring more money into healthcare is the answer.

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Let’s be honest – and take a long hard look at the past 10 years.

In theory, the Health Accord was the answer to a poorly performing system. In reality, it didn’t provide the reform we had hoped for. Ten years later, we aren’t where we should be – progress has been made in many areas, but it has been modest at best. People are still waiting far too long to see their family doctor, have surgery, and receive treatment – perhaps not as long as in 2004, but we still wait longer than we should.

Theoretically, the Health Council of Canada was developed to monitor progress and inform the public about problems and areas to be improved and, in an ideal world, the Council would have had the authority to hold underperforming provinces accountable. In reality, The Health Council made great strides in educating the public about the system’s shortcomings and sharing best practices to spearhead improvements; however they were unable to mandate best practices or hold provinces and territories accountable. The council was definitely useful, but could have been invaluable if given the authority (and autonomy) to actually fix the problems they identified.

Canada’s journey to health care reform has been slow going. It has seen its fair share of scandal and wasted taxpayer dollars – to the tune of $1 billion in one such scandal alone. One billion dollars! How can we squander a billion dollars and then balk when cutbacks have to be made?

While I am not convinced pouring more money into our system will lead to this much-talked about health care reform, I am positive that the health care system needs oversight – a watch-dog – and not just one in name; one that can bark and even bite when necessary.

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The fact of the matter is our current health care system is not sustainable – spending more money is not an option, let alone a solution. It’s time to hold political leaders accountable and implore them to base their health care platforms on patients, not politics.

Federal leadership, oversight and accountability are where actual health care reform will start. Unfortunately, they too have been taken off the table. The expiration of the Accord was a sad day for healthcare indeed.