The good news about being a wishy-washy centrist like me is that unlike Napoleon I never have to worry about whether my left flank is covered, as Don McCanne does it for me. Today he found this letter in an Alberta newspaper which shows that using new organizational techniques the waiting time for hip replacement in Alberta was cut from 47 weeks to 4.7. It’s worth reading the letter that details this, as it also shows that numerous lies continue to be told about health care in Canada by the ideologues up there and down here.

But the key point is that public as well as private sector organizations can make the organizational changes necessary to improve productivity — in this case each surgeon has apparently doubled the number of operations they perform. While the details about how it happened are limited, as are hints on the extra money it cost, it is clear that there was no increase in the amount of most expensive resource — the surgeon. After all it takes a few decades to get a new one out of the shoot and the Canadians sensibly limit the number that they produce. Something Americans don’t see the need to bother with, despite the havoc it wreaks.

Of course whatever your system of payment or the organizational form of your providers, you are going to be able to make improvements in  the way care is delivered.  But that’s not the case if your insurance system is as screwed up as ours is, and the real innovation comes in how to avoid insuring anyone under-65 who needs the care, or how to “persuade” the government to make sure that its over-65 insurees get all the care they need — and much, much more.