Bioethics Blogs

Be Brave: From Contemplation to Action in Canadian Health Care

Marika Warren and Kirstin Borgerson discuss a key obstacle to improving the Canadian health care system.


In late June, André Picard gave a presentation entitled “Inequality: Bad for our Health, Bad for Business” at the North End Community Health Centre’s first annual Advocacy Breakfast. As the public health reporter for the Globe and Mail, Picard is particularly skilled at bringing research data and patient narratives together. Some of the arguments he advanced are familiar, such as the economic argument for universal health care (we all benefit from having a healthy workforce). Others are less familiar and deserve more attention than they’ve received; we trace one such argument from his presentation and add our reflections on it below.

Picard identified a tendency for Canadians to feel relieved (and, frequently, morally superior) for having avoided the inequitable and inefficient American health care system, without acknowledging that our system lags behind many other health systems in the industrialized world on measures of quality, access, efficiency, healthy lives, and equity. What this persistent comparison does is entrench a complacency about the status quo in health care and encourage a tendency to think that the way to improve our system is to pump more money or health providers into it. But we don’t (merely) need more of the same in Canadian health care; we need thoughtful and strategic changes aimed at improving equity, access, and quality of care along with concrete recognition that most determinants of health have very little to do with health care (for example, the North End Community Health Centre is currently targeting child literacy in its activities).

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.