Are Canadians getting the best value for the $172-billion they now spend annually on health care? Is that money delivering the kind of system we want? Where and how can we eliminate waste in the system, and what new directions should we be heading in to ensure a sustainable health care system for all Canadians and a healthier population overall?

Those are just some of the questions the Health Council of Canada is raising in a major new initiative designed to get Canadians talking about these issues. Called Value for Money, the discussion is getting underway in cyberspace, and it promises to be both eye-opening and thought-provoking. The council is inviting everyone– patients, health care consumers, frontline workers, professional associations, research institutes and others — to visit www.CanadaValuesHealth.ca to join the conversation.

“Our overall goal is to encourage debate and discussion and a better understanding of the issues,” says John G. Abbott, chief executive officer of the council. “Health care now accounts for nearly 40% of provincial budgets, and pressure continues to mount for governments to spend more. We all need to be assured of the value we receive when health care continues to command such a large share of Canada’s resources.”

Canadians care passionately about the publicly funded health system, and they want to sustain it for future generations. “And so we’re expecting a lively discussion,” he adds..

For the first time, virtually everyone in Canada will have an opportunity to be heard on these issues, thanks to internet capabilities that did not exist during past national public consultations on health care.

“We want people to think of our Web site as a giant suggestion box. Hopefully, as they share their ideas, some bold new directions will emerge that will help sustain the health care system we all value so dearly,” Mr. Abbott says.

The issue of value for money could not be more timely, he feels. The effects of a global recession are placing great strain on both personal and government resources and there is no room for waste.

In 1997, total private and public support was $79-billion but by 2007, it had more than doubled to $160-billion, chiefly because of increased use of services by all Canadians. Last year, it grew by another $12-billion. “The value-for-money debate has already found strong support among groups such as older Canadians,” says Susan Eng, vice-president of advocacy for CARP, a national advocacy group with 350,000 members, all aged 45 and up.

“We are keenly aware of the pressures on health care funding and the need to focus on value for money,” Ms. Eng says.

The generations of Canadians CARP represents were at the forefront when it came to demanding more transparency and better governance in business and in government. They now expect the same thing from the health care system.

“What we need is more accountability in the system and action that makes better use of available dollars,” Ms. Eng says. “Some studies show we waste up to 30% of the money now being spent through things like duplication of tests and services and inefficiencies. We need better models of delivery, better use of technology and ways to ensure equal access across Canada.”