From the Globe and Mail,

Canada should remain committed to publicly funded health care, and not open the door to two-tier medicine, says a new report by a top economist.

Governments can improve efficiencies in the system, including changing the way doctors are compensated, without allowing patients to pay for some services, Don Drummond, former chief economist at Toronto-Dominion Bank said in the report released on Thursday.

I love this type of argument. We know that public health care is extremely inefficient. But rather than privatize, we can just fix the inefficiencies. Of course. So easy. I love that technocrats think they can just fix it from the top down. There is a huge gap between what they think they know, and what they actually know. The reason that private markets work is that efficiency comes from the bottom up: through trial and error, through adaptation and innovation. Central planning is, by definition, incapable of replicating this.

The lesson for healthcare reform is: we should trying to design the 'best system', rather, we should aim for a system with the best feedback mechanisms. That's bottom up, not 'top down.'