Perhaps donald trump did Canadians a favour by attacking our health-care system, even though what he said was grotesquely distorted.

Given the state of negotiations between Ottawa and the provinces over the size of the federal share of health costs, Canadians can be forgiven for not seeing beyond two levels of government haggling over money and turf. But Canadians should realize that their future health care is at stake and it won’t be saved by simply throwing money at an outmoded system.

The Canadian medicare system, now approaching 50 years of age, was designed in an era when the average age of Canadians was about 27, compared with 47 today.

Pledging quality care for all was considerably easier for politicians when hip transplants, heart disease, dementia and other chronic diseases weren’t on the minds of youthful baby boomers.

Today, 16% of the Canada’s population is over age 65, and those aging baby boomers account for almost half of the $219 billion that Ottawa, the provinces and territories spend on health care a year. And Canadians continue to endure long wait times and less value for their tax dollars.

The Parliamentary Budget Officer has been warning for several years that health care is in danger of becoming unsustainable in most provinces unless spending obligations change.

In the current health accord negotiations, the premiers are arguing that Ottawa should pick up 25% of all health-care costs. But that isn’t likely to make much difference to patients. According to the Canadian Institute of Health Information, the feds are currently contributing 23% of those costs.

The premiers also are looking for reinstatement of the yearly 6% escalator in the Canada Health Transfer, which expires next year, to be replaced by annual increases of 3%.

But federal reluctance is understandable. The escalator was given to the provinces and territories under the previous Health Accord that expired in 2014 to improve health care across the country. The real issue that must be faced sooner or later is that Canada’s health care is a bloated system of many jurisdictions that needs to spend a lot smarter.

The current state of the system is graphically illustrated at any local hospital with its perpetually crowded emergency room or now ubiquitous patients on gurneys in hallways.

At your local hospital, you can expect at least 15% of the beds to be occupied by elderly patients no longer requiring acute care, but without any place to go because we, as a society, have not been investing in long-term chronic-care institutions and other forms of community care. In some provinces, such as New Brunswick, one in four beds is tied up this way.

Hospitals in Canada are frequently over 100% capacity. As a result, patient care is often rushed and surgeries delayed. This is why Canadians have to wait nine months for a hip replacement.

But hospitals were never supposed to be in the housing business. Many in the medical profession believe medicare will not survive in Canada unless seniors’ care is redesigned intelligently. This means health care for most Canadians won’t get better until it improves for the aging.

The Trudeau government is pledging to spend $3 billion a year for the next four years on home care, with the hopes of prodding the provinces to invest in community-care infrastructure. But the provinces are balking at accepting money with strings attached.

As the 2016 report on health innovation in Canada, led by Dr. David Naylor, president emeritus of the University of Toronto, noted, there is no shortage of fresh innovative thinking in this country regarding how to provide care more efficiently. But health-care culture, with its abundance of bureaucracies, competing professions and territorial institutions, is standing in the way of change.

Prime Minister Justin Trudeau is right to be insisting on change in the way health care is provided. In an age when wearable technology costing $60 will monitor your blood pressure, governments should embrace private-sector innovation to boost health-care productivity. Our public health-care system needs a renaissance while we still have one.

© 2016 Investment Executive. All rights reserved.