One thing Americans and Canadians can agree on is that we don't want each other's health care systems. In truth, most Americans don't know how Canada's system works and Canadians don't know much about the U.S. system. Yes, there are waiting lists for some services -- but, no, Canadians are not coming across the border in droves to get American care. Separating fact from opinion as the Canadian ambassador long ago urged was something I tried to do as I made my way across Canada while visiting there recently. In some ways, the Canadian system is very different from U.S. health care. In other ways, it's very much the same and faces similar challenges in the years ahead.
While total physician numbers are growing, for many physicians, their individual workloads appear to have declined but their compensation has not. In an era of tight public budgets, having more physicians doing less and costing more may be seen as a luxury. One thing is certain: The recent trend toward doing less for more is not a sustainable option.
Over the next three years, the Ontario government plans to begin partially funding hospitals based on the number of patients they treat and the quality of care they provide. It's an ambitious plan that could fall flat or set a new global benchmark. No country has yet managed to set a price on high-quality care.
The premiers recently announced the creation of a working group on health care innovation to examine three critical issues related to the health workforce. It will take more than an observatory to kick start real progress in the three areas identified by the premiers. Soap operas are "sticky" for a reason.