OUR CLIENTS: Government of Canada
 Report on
Citizens’ Dialogue on
the Future of Health
Care in Canada, 2002
Citizens' Dialogue
on Canada's
Future: A 21st Century Social Contract, 2003
Report on
Citizens’ Dialogue on
the Future of Health
Care in Canada
For
many years the Canadian Health Care System has
been the jewel in the crown and a fundamental
element of the Canadian political identity: a
first rate, government-run healthcare program
that provided top-level care to every Canadian.
But over the past several years, the jewel has
tarnished somewhat, and more and more Canadians
have complained about rising costs, increasing
waits and declining quality.
Canadašs federal government
established a national commission to recommend reforms to address these
concerns. Instead of relying solely on consultation with experts and
representatives of special interests, the commission wanted to find a way to
elicit and incorporate the views of unorganized citizens into their
recommendations. But they recognized that polls and focus groups alone could
not provide the insight they needed.
While polls and focus groups clearly
demonstrated that the public was dissatisfied with what they viewed as a
serious decline in the quality of their healthcare system, these
traditional means of soliciting public input were far less clear when it
came to understanding what sorts of solutions the public might be willing to
support and the conditions for that support.
The Commission retained Viewpoint Learning to
conduct a series of ChoiceDialogues around the
nation. In each daylong dialogue, a randomly
selected, representative sample of Canadians
considered four very different values-based healthcare reforms. These
choices ranged from significant tax increases to pay for increasingly
expensive public health care to a shift towards a more market-based system
in which people with money could buy better coverage.
All four options had significant support within
elite circles.
Conducted in early 2002, the dialogues showed
Canadian policy-makers that their latitude for
action was far broader than polls had indicated.
One proposal in particular had powerful benefits
and appeals for Canadians – once they had a chance
to work through the implications of this and
other choices – that were not clear to policy
makers beforehand.
The Commission was able to use these insights
into the public's core values
on healthcare as a compass in its subsequent conversations with experts
and special interests. This was reflected in their final report to
governments, entitled "Building on Values."
This project
provided leaders with information that could not have been unearthed any other
way –
information that guided the reform proposals that were subsequently
developed and now are being implemented.
Citizens' Dialogue
on Canada's
Future: A 21st Century Social Contract
The success of the health care project led the Canadian government
to commission Viewpoint Learning to conduct 10 dialogues in which citizens
worked through their vision for Canada's social contract over the next
decade, and the choices and tradeoffs they would be prepared to make or support
to achieve that vision. These dialogues demonstrated that Canadians are ready
to revise the roles and responsibilities of governments, business, communities
and citizens to reflect the changed circumstances of the 21st century (and
that their responses differ significantly from those found in the United States).
By
articulating Canadians' deep-seated values, these dialogues provided leaders
with a roadmap for reforms that citizens were and were not willing to pursue.
The sponsoring departments and agencies have used these results in developing
their policies and, in particular, to prepare for the recent transition to
a new Prime Minister and government in Canada.
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