A Canadian take on American health care.

• Author: Fulton, Jane
• Position: Viewpoint

Most Americans think the Canadian health-care system is worlds apart from their own, but we have much more in common than meets the eye. In both countries, we spend more than we have on health care, partly because our citizens share an attitude about services that is atypical in the global village. In many other countries, people are comfortable with a basic package of services provided at a reasonable price that doesn't burden business. The challenge the Clinton administration faces in gaining congressional and public acceptance for its health-care package is getting American citizens to think the same way. Germany, Japan and Sweden all faced explosions in health-care costs 15 years ago. These countries accepted difficult challenges and created health care programs that work for them.

We can do the same. The significant impetus for health-care reform in America has not come from bureaucrats or Congress. It's come from business, which can't continue to carry this burden alone. The business sector is the economic engine of the United States, and we must create a health-care system that does not destroy it.

Growing health-care expenditures without parallel improvements in the health of the public will bankrupt the United States and Canada. It's driving up the deficit in both countries. If we continue to spend money on health care at the current rate, neither country will have much left over for education, technical training, job creation or research and development. Health-care reform will be tough, and implementing it probably will take years. But the longer we wait, the bigger the deficit, because both Canada and the United States are borrowing money on the world exchange to pay for health care.

Not only are we spending more, but we're getting less. Canadian life expectancy is lower than that of our global competitors, and our infant mortality is higher. Plus, our workers' compensation costs are enormous. That's true in the United States, too. In Washington, D.C., four blocks from the White House, the infant mortality rate is 40 per 1,000, the highest in the industrialized world. Overall, infant mortality in the United States is 10 per 1,000, versus six per 1,000 in Canada. And last year, 600,000 American women got no prenatal care of any kind.

THE ENTREPRENEURIAL SPIRIT

Many Americans think Canada has a national health-care system. That's not quite accurate. We have national health legislation that requires each province to create and deliver health care. Health care is publicly financed, but the government doesn't deliver the service. Ninety-five percent of our hospitals are privately held corporations with powerful CEOs and...