Health care costs are rising – though far less than the Chicken Littles in government would have us believe. So how do we make our public health system affordable in the long run – not just for governments but for all Canadians? Here are a few ideas.

• Four years ago the National Forum on Health – a highly qualified panel of health care researchers and professionals – recommended a national pharmacare program. A national plan would help control drug expenditures, which are one of the fastest rising health costs. Ministers of health from across Canada recently discussed a national system for buying drugs in bulk and making coverage consistent across provinces. It’s worth a hard look – as is the more comprehensive pharmacare program proposed by the Forum. Also, doctors and pharmacists need to work together so doctors are not getting their professional education from drug company reps.

• A national home care program was also recommended by the National Forum on Health. More comprehensive home care services could keep many people out of more expensive hospitals and long-term care facilities.

• We need to promote more teamwork among health care providers. The Boyle McCauley Health Centre in downtown Edmonton has salaried doctors working in teams with nurse practitioners and other professionals. This community health centre model is common in other provinces, but not in Alberta.

• We need to explore alternatives to fee-for-service payment for doctors. This system gives doctors an incentive to order too many tests and spend too little time with each patient. Evaluations in Ontario and Saskatchewan found that patients of salaried doctors cost the system less – especially for drugs and hospital visits – than patients of fee-for-service doctors.

• Health professionals need to make decisions based on evidence of effectiveness. How much money is wasted on unnecessary tests and procedures or on inappropriate prescribing of drugs?

• We need more focus on health education and promotion – both to promote healthy lifestyles and to address broader social factors like poverty that are linked to poor health.

• Finally, why are taxpayers spending millions for two new national commissions and several provincial ones to study the health system when governments have still not addressed most of the recommendations from the National Forum on Health? Instead of throwing more money commissions, our governments at the provincial and federal level should start implementing the recommendations of the Forum.

(Based on recommendations from Tammy Horne, a PhD health policy researcher who is also chair of Friends of Medicare’s research committee.)