Recent reports on our healthcare system come to consensus on healthcare reform fundamentals such as wellness, primary care reform and improved information technology, but the reports do not agree on service levels and their cost - let alone how to pay the bill. This paper asserts that these issues must be the subject of focused and honest discussion involving healthcare providers and the public, led by government. Improved system efficiency will not close the gap between growth in tax revenues and the annual increase in health cost. Because Canadians have chosen a publicly funded system, we cannot rely on the market to decide service levels and costs for quality, accessible healthcare. Now that the reports are in, it's time for our political leaders to take action on the more difficult issues.