How to undermine centralized health care and preserve universality: technology

There is a new trend emerging in Canada's $200-billion health industry that has the potential to undermine our single-payer, tax-funded health care model. The business of health care is flourishing as the baby boomers age. And as demand increases, therein lies the possibility that our canonized but operationally sclerotic institution will be transformed into a retail marketplace powered by smart phones and social media.

The existing model is based on a simple assumption: That despite being prohibitively expensive, health care is an assumed universal right and an obligation. Consequently, the model assumes the best (and perhaps only) way for Canadians to ensure universal access to high quality care involves the pooling of tax dollars into publicly funded health insurance programs.

But what if inexpensive and accessible health care poses an increasing challenge to this assumption? When companies like PayPal and Clickbank enable consumers to purchase such technology via the Internet, the single-payer, tax-funded system could become obsolete. Compared to tax-funded health care, it could become cheaper and faster for the average Canadian to order their own MRI scans and send the results to a doctor in India.

Until recently, only the rich could afford to travel abroad in order to cut wait times and obtain high quality treatment on demand. But now, treatment may be able to travel to ordinary Canadians at a cost that will be affordable to many in the middle class.

David Hsieh of emerging technologies at Cisco Systems has talked about the possibility of patients receiving virtual check-ups; this would enable them to “visit” their doctors from a remote location anywhere in the world. This is not particularly far off as unified telecommunications services such as videoconferencing are already accessible via the fibre-optic cable that connects the world from Toronto to Tokyo. With the help of a local medical assistant, anyone in Canada could access foreign medical care without leaving the country.

MRI technology has become increasingly inexpensive and more portable. In 2006, Alexander Pines and Dmitry Budker of USC Berkeley invented a device that cuts out the large, expensive cryogenic magnets that render MRIs difficult to purchase and transport. If successful, MRIs will no longer require the large 'superconducting' magnets that can only function when cooled to temperatures that run approximately two-hundred degrees below zero. The new device relies on low-powered magnets and costs only a few thousand dollars. Eventually, they hope to simplify the technology further to create a battery-powered, handheld diagnostic imaging tool that can be both portable and affordable.

Here in Canada, Telus, the telecommunications giant, is building a secure service that connects the average consumer to their health care records via smart phones and other internet channels. Known as HealthSpace, this program aims to empower consumers to manage their own family health information, everything from their medical history to their nutritional requirements.

In theory, this data could be routinely delivered to doctors, specialists and hospitals anywhere in the country. If successful, it would assist provinces like Ontario, whose own electronic health programs are still in the works.

These emerging technologies should have a very positive effect on access to, and control over preventative health care. However, high-cost services such as emergency care and long-term care might be difficult to virtualize. Nonetheless, if the burden for preventative health care is removed from the taxpayer, this should free up funding for emergency rooms, operating rooms, first responders and long-term caregivers whose services must be delivered in person.

However, the future explosion in health care technology poses a few issues. The proliferation of such technology will only increase demand. And this will feed support for increased privatization that can co-exist with services offered by government and non-profits within a universal health care model.

There need not be a dichotomy between privatized services and a government supported, universal health care system. If private health care is cheap and highly accessible, it would serve only to support single-tier access. If competition and innovation drive down prices, the government would have neither the right, nor the ability to prevent health-care entrepreneurs from pursuing retail sales in Canada.

When it comes to the future of preventative care, perhaps the government's role will shift more towards that of quality assurance. If virtualized health care becomes affordable, accessible, high quality and available within our borders, it is irrelevant whether the supplier is private or public, domestic or foreign. The goal of high quality health care for all Canadians would remain intact and would likely be enhanced.

It is therefore time to change the debate. All along, too many Canadians were worried about the high cost of technology. Yet future challenges and opportunities may arise from the low costs of virtualized health care services.

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