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In a six-week series of interviews, Canadians with a variety of experiences discuss the major challenges our country is facing and how best to address them. This instalment deals with building healthy communities.

Janet Rossant, chief of research at the Hospital for Sick Children in Toronto, was interviewed Nov. 12 by Brenna Atnikov, a consultant with Reos Partners.

Atnikov: What keeps you up at night?

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Rossant: With our aging population, we have to relook at how we deliver health care. Among other things, we have to develop a more integrated model that moves health care back into the community and into the home. Treating chronic diseases at home can offer a much better quality of life than doing so in a hospital, and the cost is less. But to do so, we need strong home-care systems to provide appropriate support for patients and their families.

Health-care costs continue to rise. Today, they are running close to 50 per cent of provincial budgets. As researchers, my colleagues and I have to look quite hard at what we do, because the health-care system has only restricted dollars to be able to invest. We have to look at the business case of whether what we are developing is going to be something governments will pay for. They're going to ask, "Is this treatment really going to save us money? Is it so much better than anything done before that it's worth the investment?"

Atnikov: If things turn out well in Canada over the next 20 years, what would have happened?

Rossant: We will start to see technological changes in health delivery that are not necessarily going to cost more than we currently spend, including new drugs and one-time curative treatments. A whole new area will be patient-specific medicine, for example, identifying the genes that are wrong in a cancer and using a particular drug to treat it. You're saving money because you're only treating the right people at the right time with the right drug. Patient-specific stem cell therapies will be available to cure diseases like diabetes, Parkinson's and vision loss. When we spread that sort of personalized approach out across many different diseases, it will reduce our overall costs, improve treatments and make for a healthier society.

Atnikov: If things turn out badly in Canada over the next 20 years, what will the story have been?

Rossant: We made it difficult to bring creative people here. We need to be open to people coming to and going out of Canada. We failed to invest in fundamental research, innovation and the creative force. If we don't focus on the future and build on our strengths, we will become a so-so nation. We will not achieve the impact that we can across the world in the arts, science, business, finance and politics.

Atnikov: What energizes you about Canada?

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Rossant: We are a multicultural country that accepts and embraces people from all over the world. People come here for many different reasons, and that mixture of skill sets and viewpoints gives us huge opportunities. We have vibrant urban centres that continue to grow. When you bring people into close proximity and provide the right infrastructure, you can cause interactions that lead to new ideas and inventions. At the same time, vibrant urban centres almost always have an underclass. We have to provide stepping stones for people to move through the system and a social net to support them when they can't. If we don't enhance our urban centres, then we stand to lose against the rest of the world.

Scientific research will be an important driver of the economy of the future. It works best in environments and cultures that support collaboration and co-operation – something that we offer in Canada. When people come here, they are always amazed by the culture of collaboration and "co-operativity." Some say that, to be the best, we have to be competitive. But by collaborating, we can bring new ideas to the table and also pragmatically share our limited resources in order to make an impact beyond the dollars that are invested.

Possible Canadas is a project created by Reos Partners, the J.W. McConnell Family Foundation and a diverse coalition of philanthropic and community organizations. For longer versions of these interviews, or to join the conversation, visit possiblecanadas.ca

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