I think that is a difficult question. Why have we not made progress? I think it's a very complex issue. There are many reasons why I do not think we have made a lot of progress.
Change is difficult. You have a system that's been developed and has benefited people for many years, both patients and providers. It's difficult to shift from what we know, from what has worked, to try new things. The mechanisms and structures have not necessarily been supportive of making those changes. There are vested interests in the system, and some of those vested interests are very powerful.
I know there is a shift in the demographics in the health care provider population. More and more women are getting into medicine. There is an increasing desire among some in that group to look at alternative funding models because they don't want to practise medicine or health care in the way that it has been practised in the past. But that is very difficult for them to do for all kinds of reasons. Again, it's vested interests in the system.
I think everybody has the interests of the population in the communities and their patients' best interests at heart, but I just think it's very difficult to make those changes.
Again, I think it's the role of the federal government to take leadership in convening provincial and territorial governments to come to some agreements. That may be difficult, but I think it is important for the federal government to take some leadership in that.