The Mazankowski Report is a very important contribution to the debate washing over Canada with regard to the future of its most cherished social program, medicare. While a complete analysis of the report is not possible in this brief comment, several observations and arguments should be made. First, the report's recommendations for a greater role for private financing undermines the other excellent recommendations made with regard to greater accountability, the rigorous pursuit of quality and greater flexibility regarding the role of the private sector in delivery (as opposed to financing). Second, the report's specific recommendation to establish a permanent, independent panel to determine what services should and should not be publicly funded is a worthwhile reform, but not for the reasons envisaged by the report's authors - that is, because it will result in a reduction in the range of services funded and save public dollars. Rather, it is a worthwhile initiative because engaging in a transparent and explicit determination of what is in and out of the publicly funded basket is likely to result in more political support for publicly funding a wide range of care rather than less.

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