Overall System Structure Wild Cards

Major economic downturn
Single national health care system
Atlantic provincial union
Canada-U.S. free mobility of capital/labour
World Trade Organizations (harmonize standards)
Effects of loss of cultural identity
Change in balance for public/private funding
Increased immigration/refugees

Organization and Approaches to Health Care Wild Cards

Physicians happily on salary
Spiritual care as important approach
Genetic selection
Regional health authorities disintegrate
Holistic health centres, with alternative therapies
Super communities doing outreach to hospitals
Hospitals perceived as dangerous places (iatrogenic deaths)
Paid personal health advocates
Completely self-managed care, aided by artificial intelligence measures
Democratization (technology as equalizer of knowledge; community empowerment; equal partnerships among disciplines)
Healthy lifestyle incentives (e.g. tax benefits)

Miscellaneous Wild Cards

Breakthrough in major illnesses
Pandemics, new diseases, re-emergence of old diseases
Information privacy leads to shutdown of research
Gender mainstreaming in research, causing impact on government programs design

Priority Risky Research Wild Card

Test and research assumptions about 'sacred cows' in health care/health services (e.g. cancer care is best delivered through large centers)
Costs of using innovative interventions that have no research basis
Large demonstration projects
Study of decision making to determine the type of evidence used in the process
Recognize research done in other jurisdictions
Conducting advocacy for evidence-based decisions

Other Issues

Implications of genetic and nanotechnologies
How to deal with effective but extremely expensive technologies/interventions in public system
Find determinants of 'good health'
Impact of complementary and alternative therapies
Effect of growing voluntary sector
Increased inequities between developing and developed world
Medical error detection leading to over-treatment