[This article was originally published in Healthcare Policy 7(3)]

Objectives and methods: The re-negotiation of the 10-year 2004 First Ministers' Accord provides an opportunity to review medicare's fundamentals. We used the published results from 13 Commonwealth Fund international health surveys to assess Canadians' views of health system performance and compared these to the views of respondents from Australia, the United Kingdom and the United States.

Results: Although a majority of Canadians wish to see fundamental change to their health system, medicare performs relatively well in an international context on key dimensions of access.

Conclusion: Canadians see a need for improvement in the healthcare system, particularly access to prescription medications.

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