“Dr. Anne Doig says patients are getting less than optimal care and she adds that physicians from across the country – who will gather in Saskatoon on Sunday for their annual meeting – recognize that changes must be made.

We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize,” Doing said in an interview with The Canadian Press.

The pitch for change at the conference is to start with a presentation from Dr. Robert Ouellet, the current president of the CMA, who has said there’s a critical need to make Canada’s health-care system patient-centred.

His thoughts on the issue are already clear. Ouellet has been saying since his return that “a health-care revolution has passed us by,” that it’s possible to make wait lists disappear while maintaining universal coverage and “that competition should be welcomed, not feared.”

In other words, Ouellet believes there could be a role for private health-care delivery within the public system.

He has also said the Canadian system could be restructured to focus on patients if hospitals and other health-care institutions received funding based on the patients they treat, instead of an annual, lump-sum budget. This “activity-based funding” would be an incentive to provide more efficient care, he has said.”

A few weeks ago, I wrote that as the left is making efforts to Frenchify our health care system, in France, the trend is moving toward some privatization. Over the last few months, conservatives have pointed to problems in the Canadian system, including long waiting periods and rationing of medical treatment, as an argument against implementing a government-run health care system in this country.

Canada and England control costs in a similar fashion – they create a budget for how much will be spent on health care, and they stick to it. So, in order to determine how that money gets spent and who gets treatment, they must ‘prioritize’ (read: ration) who gets what treatment and when.

The health care debate has highlighted the problems with this type of system. But, an admission from the Canadian Medical Association itself speaks volumes. Even with the news that the Obama administration *might* be backing away from the public option, the fight’s not over yet. We’ve heard stories from Canadian citizens who waited years for treatment, while their afflictions progressed to the point where it was too late for some. But, I for one, haven’t heard much from Canadian medical professionals themselves. And it’s crucial for Americans to recognize the problems these countries face and that many believe that the only cure for these problems is to move toward a system that looks more, not less, like the current American system. (Of course, for that reason, I don’t see this story getting much attention in the media.)

The French are so attached to their system, that they will not support any changes in the system. And by any, I mean they are unmovable on this topic. When a recent hospital began charging patients 1.10 an hour to park, residents became infuriated, stating that this goes against the very nature of universal health care.

French citizens’ stubbornness regarding any changes to the system must mean the system works well, right? I recall a conversation I had a few years back, discussing the difference between maternity wards in America and in France with an American friend and his French wife. I was told that in France, the maternity wards are like hotels. They are comfortable, family-friendly, peaceful places to bring a new life into the world.

Sounds like a nice idea, right? Then how come the woman mentioned in the WSJ article, Laure Cuccarolo got stuck giving birth in the back of a fire truck? Because of France’s inability to deal with rising health care costs, the hospital closest to her had to shut its doors. When her baby came a month early, she found herself 30 miles away from the closest hospital, called a fire truck to her aid, and the rest is history.

France’s health care system (indeed, it’s entire economic model) is a perfect example of what happens when a citizenry becomes indebted to big government. The best way to create this kind of society is to start with health care. It’s also the best way to create an entire society of people who want, want, want without ever working to earn those wants. Their system is the perfect example of what happens when everyone wants the best, and no one wants to foot the bill.

This is what our President is promising. As Peggy Noonan points out, President Obama, his administration and his supporters misunderstood the mandate handed down by voters last year. After 8 years of President Bush and controversies over an extended war effort in the Middle East, voters voiced their demands for change – for fresh ideas and governance, for more transparency and accountability. But, their desire for change did not eradicate their good ol’ American common sense. You cannot promise to cut costs while providing people with more options – that just doesn’t make sense. And, you cannot step in and interfere with medical costs without interfering with the quality of medical care – that doesn’t make sense either. And, with a failed stimulus, a Democratic-led Congress that hasn’t met a spending bill it hasn’t liked, and most recently a $1 billion failed cash for clunkers subsidy, Americans have their doubts as to what government can and cannot handle competently. And, they sure aren’t willing to take risks with their health care.

This ceremonial commitment came on the heels of Democrat’s revealing their willingness to use reconciliation to push universal health care legislation through soon. While the announcement was a nice gesture, it left many of us wondering, where’s the beef? First, with no enforcement mechanism, the government cannot force the companies to follow through on their promises. And secondly, if realized, these savings wouldn’t benefit the government alone, but would also accrue to the consumers of health services. In other words, the money saved won’t be put in a big pot that the government can reach into to fund their healthcare initiatives.

So what did this announcement really mean? For example, might the President be willing to explore reforming healthcare without instituting socialized healthcare? That seems unlikely. The more likely explanation is that up until now, the major road block to providing a public, government-run health insurance has been finding a way to pay the ever increasing bill for such a Medicare-style entitlement, and the President believes that “lowering the costs of health care will complement the overall reform of the health-care system” that Congress is getting ready to take up soon.

What about the insurance companies? Why would they be willing to get on board with an administration and Congress that is set to pass legislation that could devastate, if not eliminate, their industry? The New York News Blog provides a rundown of opinions on this issue that range from believing that this group has accepted what’s coming down the pipeline and is now ready to stand shoulder to shoulder with this administration to suspecting that the industry hopes that universal healthcare will “give them a huge revenue boost in the short term – and then every lobbyist … will fight those spending reductions over the long term”.

Some examples of the cost-cutting measures offered up include making payment systems more effective, reducing administrative costs and improving technology. However, similar efforts have failed in the past, and experts say it will be difficult to squeeze that kind of savings out of these kinds of proposals.

So, the question remains, did these health companies come to the table because they wanted to be players that would help reshape healthcare as we’ve known it? One person suggested they wanted a seat at the table so as to avoid being on the menu. Yesterday’s announcement may have been long on admirable goals and short on the details as to how we get there, but one thing is for sure: this administration and Congress is intent on passing healthcare reform and soon. Yesterday’s announcement may have been unclear and may not have seemed like the game changer we expected on the surface, but with even the health companies seeming to accept government-run healthcare as inevitable, it was the first symbolic step toward socializing healthcare in America.

*Originally published May 12, 2009 on the American Issues Project Blog, here.