The Canadian Medical Association has issued a five-pillar plan for what it says is a badly needed transformation of Canada's public health system to improve both patient care and value for the billions of dollars spent on health care every year.

In a new report entitled "Health Care Transformation in Canada: Change that Works, Care that Lasts," the CMA says health-care reform is urgently needed if the system is to remain sustainable in the future.

The report warns that many patients are unsatisfied with the level of care they receive across the system, and that Canadians are not getting value for dollars spent. The report cites the Euro-Canada Health Consumer Index, which ranked Canada 30th of 30 countries for value for money spent on health care.

"This important policy document will guide politicians, professionals and the public to make needed change in Canada's health care system," CMA president Dr. Anne Doig told reporters Tuesday in Ottawa.

"Our system of publicly funded health care is founded on the promise that all Canadians will receive needed medical care when and where they need it. Far too often the promise falls short. Even with its shortcomings, the present system will not be able to meet future needs."

The CMA's so-called five pillars for transformation are:

• Refocusing the system so it serves the needs of patients. The report contains a charter for patient-centred care.
• Improving access to care and the quality of care, partly through funding incentives to health-care facilities that exhibit better efficiency and higher patient satisfaction.
• Identifying and correcting gaps in care, particularly the limited access to prescription drugs in some provinces and territories, and discrepancies in the delivery of services once a patient is discharged from hospital.
• Helping health-care providers care for their patients, be it through addressing staff shortages at facilities to adopting the most up-to-date health information technologies.
• Boosting accountability and responsibility at all levels in the system.

The report's recommendations come after the CMA spent a year interviewing patients, policymakers and health-care professionals.

Doig said the primary goal is to get Canadians talking about how best to reform the system so it better serves patients. The CMA hopes that dialogue wraps up before the current federal-provincial/territorial Health Accord expires in 2014, so a new Health Accord can improve value for patients and build a more sustainable system for the future.

"We are asking that Canadians come together -- that's the consumers of health care, that's providers of health care, and that's also government, policymakers and the people who pay for health care -- to discuss and to debate and then to act," Doig told CTV's Canada AM before the report's release. "It's time that we stopped talking about this necessarily and got on to the business of fixing it."