Getting the facts straight about Canadian health care
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* Charlotte Gray

Official reports, especially those from government agencies, usually don't begin like this: “On Oct. 4, 1998, Calgary's Bow Valley Health Centre, a city-centre hospital, blew up. It wasn't the work of terrorists. It wasn't an accident.”

However, *Health Care in Canada 2000: a First Annual Report*, published last year by the Canadian Institute for Health Information (CIHI), eschews the jargon, passive verbs and footnotes that typically discourage close scrutiny of official reports. Canada's health ministers established CIHI in 1994 to construct a reliable national database of health information. During the upheaval of the last decade, the lack of hard information on what works and what doesn't has stymied policy-makers and confused the system's users. 

“This is the first in an annual series of reports that aims to provide reliable evidence, not anecdotes or rhetoric, about what we know about the health of Canada's health care system and how the system has changed,” CIHI says.

A major challenge for Prime Minister Jean Chrétien during his third term is to educate Canadians about how to improve health care and pay for the services they use. This report ([www.cihi.ca](http://www.cihi.ca)) — and presumably subsequent ones — will go a long way toward filling in some gaps in public knowledge.

And that opener about the Bow Valley Health Centre blowing up? “It was part of the regional health authority's strategy to restructure the city's health care system to meet the needs of the future,” the report explains. CIHI in turn used the incident to symbolize the dramatic shakeup in our health care system.

The report deals at length with issues that touch off the most impassioned public debate. For example, it looks at waiting times for cardiac care and notes that these times are often defined differently, meaning that there are conflicting data from different parts of the country. “Meaningful comparisons of wait times between provinces are not feasible,” says CIHI.

As Ottawa tries to keep the health reform momentum going and ensure that the Canada Health Act is upheld, this report may help provide a rational context within which public debate can be conducted. — 

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/164/6/852.1/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/164/6/852.1/F1)

Figure. Ultimate restructuring: Calgary's Bow Valley Health Centre was demolished in October 1998 Photo by: Canapress