As 2007 closes out, let us be thankful for what Canada’s health care system is able to provide. Looking forward to 2008, let us also understand how a variety of solutions contribute to solving health care needs around the world.

According to The Economist of Dec 19^th, the International Finance Corporation (IFC), a private-sector arm of the World Bank plans to set up an equity investment fund to invest in the health care system in Africa as part of a $1 billion health-care strategy.

The IFC’s chief executive Lars Thunell anticipates objections. Is this privatization through the back door?

But his belief that Africa’s governments “simply do not have the resources and capacity to do everything”, has allowed him to move ahead with the IFC’s plans.

Some big donors such as the Bill & Melinda Gates Foundation which supports the IFC’s new approach are finding that even as they continue to fund Africa’s public sector, it is the poorest of the poor who are often getting health care through the private sector. This is truly a paradox when African ministries are overwhelmed by aid money.

$16.7 billion in spending on the region’s health care comes from private enterprise and charities. McKinsey, a management consultancy suggests that this share is likely to grow larger to almost 60% by 2016.

It is important that Africans who need care get it and that the private capital raised does not go only into facilities that only serve the urban rich. Technical fixes are being proposed that include regulatory reform to repair weak standards and that will allow partly subsidized but market-driven health-insurance plans.

Julian Schweitzer, director of health at the World Bank is reported as saying: “The public sector can pay, but anybody can deliver services”.

In Africa, it appears that movement towards separating financing health care from the delivery of health care may be one way that the poor may get the health services they deserve.

In Canada, the split in private/public funding of health care is roughly 30/70. However, as more advances have been made in pharmaceuticals and more treatments found, it may be difficult to hold the private portion in check.

It may be worth considering if Canada’s 30/70 split is being made in the best way.

Is it possible for government to cover more catastrophic drug coverage and a more comprehensive pharmaceutical program while allowing private providers to compete for more basic forms of preventative care or more standard procedures?

Is it possible for more private providers in Canada to deliver care more efficiently while being paid publicly?

Is it possible that there are benefits to separating the delivery of health care from the financing of health care?

I believe that the answer is “Yes” to all of these questions and that future needs require us to consider all of the above.

Best Wishes for 2008!