Two years ago, the Health Action Lobby (HEAL) began an unprecedented and concerted effort to build a national consensus on Canadian health policies for the future. It was the first time in Canadian history that such a diverse group of non-governmental organizations had joined together to work toward a common set of goals.

Key among these goals is safeguarding the integrity of Canada's national system of universal health insurance programs. These programs are subject to substantial internal and external pressures. There are pressures to provide higher quality of health services by eliminating those that are of limited benefit and by promoting efficacious services. There are the pressures of a globally competitive environment and of the spillover from the health debate in the United States. Amid economic conditions in Canada that have been more severe and more prolonged than anyone might have imagined, this multifaceted concern about the sustainability of national health programs continues to provide the impetus for HEAL's collaborative efforts. Indeed, while economic prospects are somewhat brighter today than two years ago, the need for continued fiscal responsibility is widely-recognized.

This brief addresses this longer term reality and the concomitant need to redirect our energies toward managed change in the health care system.


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