Here are the major themes of the initiative:

• Outcomes-based planning means that patients would immediately be directed toward the most-effective and least costly treatment. Why are we afraid of results-based methodology and accountability?

• Administrative change does not improve healing - getting patients better, faster. Can we get injured or ill people back to productive lives and work more expeditiously, with less cost for them and the system?

• How can we end the shell game of cutting specific costs and services from one budget, and then transfer these responsibilities to other insurers, employers and the public? Moving problems does not treat the patient.

• Has patient care become merely an excuse to enrich health professionals, equipment manufacturers, administrators, pharmaceutical companies, consultants, insurers, contractors and suppliers?

• The health system is frequently more concerned about catering to professional and employee monopolies than it is in quality, economical patient care.

• Why does the "health crisis" disappear from news columns after professional contracts get signed?

• According to the Canadian Medical Association, 40 cents of the payroll dollar is attributable to health costs, including lost employee time due to illness and injury.

• Since 30 per cent of all visits to medical doctors and health professionals are for spine related illnesses and injuries, why does the system not insist that primary diagnoses and care is delivered by those most thoroughly trained to recognize and treat these problems?

• The gatekeeper role exclusively held by medical doctors frequently puts them in position of diagnosing and/or treating conditions for which they have little or no qualifications or expertise. Often, the "referral" role of MDs with respect to specialists, dietitians, physiotherapists and other professionals, simply compounds the costs, delays treatment and extends patient suffering.

• There should be far more effective use of nurse practitioners, naturopaths, chiropractors, podiatrists and other health professionals. Expanding the coverage of Medicare to encourage the use of these services would actually save substantial amounts of money.

• As much as 50 per cent of all the drugs prescribed in Canada are wasted. Dramatic action is necessary to more accurately prescribe the proper pharmaceutical for each patient and each condition, and to curtail a tendency to keep experimenting "until we get it right." Misuse of drugs has become a major contributor to disease in Canada, and an alarming factor in cause of death statistics.

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