Abstract

Albertans are seeking a "Third Way" for Medicare; Canadians generally are struggling with the issue of "sustainability."The transformation of the Veterans Health Administration suggests that the key to sustainability is not levels of spending per se but public confidence that a system delivers value for money. The VHA regained confidence by defining its value ("Quality") and being accountable for delivering it. The US health system is no model for Canada, but Quality and Accountability should be part of a Third Way, incorporating the best ideas from the US into a renewed public system.