Canada, U.S. two ships passing in the ideological night

To listen to health care debates raging in the U.S.

Robert Ouellet, president of the Canadian Medical AssociationTo listen to health care debates raging in the U.S. and Canada is to hear ideology taken to extremes.

Most Canadians can't get private health care at all, and the Canadian Medical Association (CMA) is fighting an uphill battle to build a private system. In the U.S., meanwhile, modest reforms in the other direction are derided as socialism.

From a pure technology perspective both private and public systems offer advantages.

A universal system can lead to standards for Electronic Health Records and their interconnection. You cut costs by focusing on preventive care rather than acute care.

A private system can deliver enormous innovation. Rising spending is the sign of a growing market. It is no accident that the U.S. is where most pharmaceutical research takes place, where robotic surgery was pioneered.

The new CMA head, Dr. Robert Ouellet (above), suggests looking to Europe as a model for a hybrid system. The result might be, as critics there suggest, two standards of care. But there would be basic care for all, and a market outlet for those who want more.

To many Americans, of course, Europe is a fighting word, and no effort is beyond the pale to prevent us from looking to it. That's a shame, because our system is completely broken, as even conservative think tanks admit.

Perhaps compromise is possible by focusing on what technologists know:

  1. Standards and open source save money.
  2. Prevention is better than waiting for trouble.
  3. Rich people will pay for innovation.
  4. Consumers like having choices.

I don't promise this will cut health care costs. Nothing will. They are rising regardless of payment system, public or private or even hybrid. Because we're getting older, and none of us wants to die.

But if we could focus on what technology knows is true, then try to extend that consensus outward, we might find the U.S. and Canada are not as far apart as they seem.

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