Assuring the affordability of Canada's health care system.

Canada's health care system is challenged by a crisis of affordability. A sluggish economy and substantial federal, provincial, and territorial debt have caused health care spending, in spite of a good record of cost control, to consume nearly 10% of Canada's gross domestic product, largely due to a denominator effect. Issues identified as warranting further investigation as potential approaches to further reducing cost in order to match available resources include therapeutic effectiveness, drug use, hospital utilization, manpower planning, consumer access, and population approaches to improving health status. An important role exists for clinical investigators to contribute to health care reform.