Search tips
Search criteria 


Logo of cmajCMAJ Information for AuthorsCMAJ Home Page
CMAJ. 2010 April 20; 182(7): 699.
PMCID: PMC2855922

Rearranging deck chairs

Ross McElroy, MD, Retired family physician

Attempting to address Canada’s clearly financially unsustainable health care system by focusing on centralization or regionalization1 is analogous to rearranging the deck chairs on the Titanic. A reality check! Regionalization or centralization has only modest potential to address the underlying causes of financial unsustainability. Contributing to unsustainable health care expenditures is the exponential growth in three main areas: investigative technology, surgical and medical treatments, and pharmaceutical products. Another major contributor is a free comprehensive, health care. There needs to be more patient responsibility to follow healthy lifestyles and more financial responsibility for health care premiums, drugs and received care. These payments could be made at income tax time for the previous year’s services. The maximum amounts paid by patients (18 years and older) for premiums, prescribed drugs and health care would be determined as a reasonable percentage of income above the poverty line. Thus the poor don’t pay and low-income families pay very little. Very fair … very Canadian!


For the full letter, go to:


1. Collier R. All eyes on Alberta. CMAJ. 2010;182:329. [PMC free article] [PubMed]

Articles from CMAJ : Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association