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opinion

A nurse records progress on an iPad as surgeons operate on patient Paul Szasz in the Multi-Purpose Operating Room (MPOR) at Toronto General Hospital in Toronto, Ont. Feb. 13/2012.Kevin Van Paassen/The Globe and Mail

Canada ranks higher than most other countries for its spending on health care, though the days of big increases are coming to an end. Austerity, which is a global phenomenon in health care, should be embraced as an opportunity to innovate.

Recent figures from the Organisation for Economic Development and Co-operation show Canada is the fifth highest spender of health as a share of its gross domestic product [11.4 per cent in 2010] and seventh highest on health expenditures per capita [$4,445 U.S. in 2010] - both higher than the OECD average of 34 member countries.

And yet for all that money, there are still troubling access issues: only about half of sick patients are able to see a doctor the same or next day, the wait times for specialists are long and there are too many avoidable emergency room visits. Many patients find the system unnecessarily difficult to navigate.

The system's 1950s acute-care model is not equipped to deal with the burgeoning group of aging patients whose multiple chronic conditions demand comprehensive care, not repeated physician visits in a fragmented system.

Despite that, Canadians often enjoy a feeling of superiority when comparing this country's health spending to that of the United States. But it's easy to compare yourself to the worst country in terms of health care spending. The U.S. is highest in both categories of health expenditures as share of GDP [17.6 per cent] and per capita [$8,233].

This should not obscure the fact that Canada also spends more than it can afford.

Transformative change to health care doesn't typically take place in good times, when the system is awash in cash. Rather, the necessary impetus for change is now, in an age of cost containment.

Provinces need to examine whether they are getting value for money. Hospitals need to find new ways to innovate. Mergers and partnerships need to be sought. Patients need to demand a better experience. That will all help to improve the system.

And governments need to go further by expanding the role of the private sector. Its ability to generate efficiencies to help deliver publicly-funded health services could play a key role in ensuring a strong system is passed to the next generation.

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