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For more than three decades Canadians took pride in having one of the best health care systems in the world. In recent years, however, that pride has turned to dismay as reports of system failure and patient suffering proliferate across Canada. Long waiting lists for treatment, crowded emergency departments and unacceptable delays for diagnostic testing are now the Canadian norm, rather than the exception. Timely access to needed care is no longer a cornerstone of the Medicare program. This is not what Canadians envisioned for Medicare. British Columbia’s physicians share the public’s concern over the current and future state of our medical care system.

The goal of this paper is to lay the groundwork for a fundamental discussion about the future direction of our health care system. To this end the paper proposes a revised set of core objectives for Canada’s health care system, which focus on patient care, system and management issues – objectives which protect and enhance the principles of the Canada Health Act. These key objectives provide a framework for developing a more sustainable and accountable health care program.