Okay.
To your second question first, if I may, I think what you are really alluding to is the philosophical debate that has to occur. It has to occur in a non-partisan way, without party lines. I won't even say across party lines. We need our constituents, our public--my patients, your voters--to engage in the debate about whether or not we continue to expect to have in Canada a single-payer system that is 100% taxation based and that provides first dollar coverage for everything, because if we continue to have those three expectations and on the other side of the equation governments are telling the voters that we don't want to raise taxes, I'm sorry, we have a null equation; it doesn't work. We either have to say yes, these three elements are what we want and we're going to raise the taxes to pay for it, and who knows what our taxation level will get to, or we have to agree that there are other mechanisms that we need to look at, both in terms of funding and in terms of delivery that will address some of the escalating cost issues. Those are some of the proposals you've been hearing from my predecessors in this position over the last two to three years. We need to open our eyes, open our minds, and really think and talk about what it means to deliver health care in Canada.
That is the answer to how we can keep doing this and how we can keep it under 50% of provincial program spending. We're not going to keep it under 50% of provincial program spending if we don't answer those questions.
To the question of health human resources and specifically physician flow and the cost of physicians, the whole issue of licensure, as you know, is up for discussion under some of the changes that are being brought about under AIT. The Federation of Medical Regulatory Authorities of Canada, FMRAC, are looking at how we address the issues of licensure and how we make it more possible for our medical human resources to be used across the country more effectively.
I spoke earlier about telehealth. Telehealth requires broadband capability and it requires physicians to have IT infrastructure. It also requires physicians to be able to work in provinces other than their own, so if I'm practising in Sioux Lookout, Ontario, and I need a telehealth opinion from a consultant in Winnipeg, that consultant in Winnipeg needs to be licensed in Ontario. Under our present model, that means individual applications by that physician to each province. It means individual adjudication by colleges of physicians and surgeons as to whether or not to grant that licensure, and it costs the physician money every year for annual licence fees. In today's world, where portability and a virtual reality of being able to exchange information and provide opinion, that's nonsense, in my opinion.
