“We would literally hit the roof if the U.S. put a 70 per-cent tariff on Canadian value-added shipments.” he said at a lecture at Trent University in November.

This rise in the value of the loonie against the greenback means a 70 per-cent rise against China’s currency- “raising the prospect that Canadian manufacturers will find it necessary to send yet more work off shore”.

His concerns seem to be mainly with the complacency about Canada’s willingness to compete and he mentions Ontario stands out as “profoundly indifferent” to any economic reform that would make the province significantly more competitive.

The “old paradigm” doesn’t work any more he says. He explains this as being a result of a change from the Industrial Age to the Information Age. In the Industrial Age, he argues that the principal economic dynamic was government-driven, nation-centred capitalism. In the Information Age, the principal dynamic is commerce-driven, globe-centred capitalism. Canada’s governments have not adapted to the transformation.

Some facts according to the article: advances in Canadian productivity have lagged behind the US for years and now Canada trails in productivity, ranking 21st out of 30 OECD countries in 2006; and The World Economic Forum ranks Canada 16th out of 125 countries. In 2001, Canada ranked 3rd.

Professor Courchene proposes policy reforms that would see more acceptance of private sector initiatives. According to the article, he has a blunt warning for Canada as the world moves into a fully global, knowledge-based, e-networked world:

“In the new economic paradigm, nations will either innovate or die”.

To back this up is a report from the International Conference Board in Brussels released this week showing comparative productivity stats on the world’s major trading nations. Canada’s 2007 productivity growth rate (GDP per hour worked) increased only 0.2%, the third worst performer out of about 50 nations. On a per-capita basis, Canada barely makes the top 20, sharing the stage with the lower ranked nations with bad productivity numbers.

And so it is not surprising in this milieu, to see Canada’s health care sector being less productive as well. A new study from the Canadian Institute of Health Information shows that Canada’s younger physicians are billing less compared to their older predecessors and that more than half of physicians across the country worked less than one Full Time Equivalent (FTE), a yardstick to measure variations in workload by age and gender.

One of the calls for change by the Canadian Medical Association is for more innovation in health care

An excerpt from the speech by Dr. Brian Day, CMA President, to the Economics Club of Toronto on January 15, 2008:

"... Well, our health system must adapt to the new reality of 21st century medicine. We can, and should have the best health system in the world. To achieve that we must reject continued indifference to the need for change.

Political leaders across the nation know, but need to be reminded that our system faces serious challenges.

Everyone in this room knows this.

Today, the well being of patients is all too-often trumped by posturing, and politics. We must create a system that revolves around the needs of patients, not the other way around.

Let's face it. Decision makers in the past have repeatedly made mistakes in health policy. Have they learned from those mistakes? Many have. Some so well that they have repeated the mistakes, with great precision, over and over again.

For example, 15 years ago they listened and succumbed as experts advised them that an oversupply of doctors was increasing the costs of health care.

Then they listened as self proclaimed health advocates and coalitions, persuaded them to forget accountability, keep the status quo, and simply pour more taxpayers' money into a failing system.

They listened again as other experts assured them that health care was immune from all accepted economic principles.

Each time they were wrong.

Today I will talk about what the CMA sees as the "unfinished business" of Medicare in Canada - Medicare for the 21st century.

I will share dramatic data that shows the staggering economic impact of long waits.

I will show that waiting for care is a double curse. A curse on patients who suffer and deteriorate while waiting. And a curse on the economy of our country.

Finally, I will announce a major campaign that will drive forward the CMA's recommendations on building a health system that puts patients first.

A system that embraces healthy competition, consumer responsiveness and empowerment.

A system that ensures accountability for governments and health providers.

A medical system for the 21st Century…………..

The CMA believes this can be done by investing in five key areas.

1. We must invest in preventative care, health promotion, and emphasize self-responsibility and patient-consumer empowerment

2. Invest and embrace patient focused care, productivity and excellence

3. Invest in innovation and technology

4. Invest in repatriation and retention of doctors and medical students

5. Invest in training the doctors we need ..."

Moving into the 21^st century and as various health care advocates are calling for more “self-care” to save our health care system we should be considering what motivates people to change to be more productive in their professions, their businesses and livelihoods and equally as important, how they can be encouraged and inspired to take more responsibility for themselves, for their families and for the well-being of Canada and the world beyond our own borders.

It is quite likely that more regulation and more government-driven approaches are not the full answer. I think Professor Courchene and Dr. Day would probably agree