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Canadian Public Health Association

A Fine Balance: conclusion

A Fine Balance:   A Public Health Perspective on Health System Reform


Public health involves many balancing acts; there is no single "biggest bang for the buck," no "one size fits all." We have to aim for the greatest overall benefit to the population, while ensuring that we address the specific needs of vulnerable or disadvantaged groups. We need both an emergency response capacity and the ability to forecast and plan for outcomes that won't happen for decades or generations. Evidence-based decision-making is a norm, but sometimes we have to act in the absence of conclusive evidence.

So we're sympathetic to the dilemma faced by the Commission in its deliberations on how to ensure the long term sustainability of a "universally accessible, publicly funded health system, that offers quality services to Canadians and strikes an appropriate balance between investments in prevention and health maintenance and those directed to care and treatment." There are many dimensions along which we can identify a need to strike a balance, but the fulcrum is our understanding of health as a public good: we urge you to speak out unequivocally in support of a publicly funded health system that benefits all Canadians. If we still believe in health as a public good, in collective social responsibility for our shared problems, not only can we afford to publicly fund our health system, we can't afford not to.

Respectfully submitted,

Christina Mills, MD, FRCPC

President, Canadian Public Health Association

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