In a rare collective action, Canada's premiers launched an ongoing print and TV advertising blitz, giving us a multiple choice math test. The question: How much does Ottawa contribute to the cost of healthcare � 50%, 25%, or 16%? The last figure is the right one, but these 'Premiers for Health' make the point that in reality it's very, very wrong. The numbers reflect Canadians' views on healthcare: it used to be good, it might get better, but right now it sucks.

The premiers want the feds to pass surpluses in this year's budget on to healthcare immediately and commit to increasing the federal share of provincial/territorial health spending to 25% by 2009/10. The collective cry was issued through the Premiers' Council on Canadian Health Awareness, which was formed to "enhance public awareness of the challenges of and solutions for the future of healthcare in each jurisdiction."

Where the provinces may break ranks is if the federal transfer does not increase. Alberta has already wondered aloud about the advantages of forgoing such a piddling amount in order to free itself of Canada Health Act constraints. At the same time, the message from on high at the International Monetary Fund is that Canada should stop spending so much on healthcare, use more private providers, and start getting patients to cough up something toward their treatment.

With the numbers in the multiple choice test now firmly imprinted in the minds of Canadians, failing grades from Ottawa may be used most of all to justify extreme responses in redesigning healthcare.

� Susan Usher