Unpredictable. Unfocused. Just like life.

Dr. Brian Day, new head of the Canadian Medical Association, wants to change the way hospitals in Canada are funded:

Dramatically altering how hospitals are financed to eliminate block funding and replace it, at least in part, by "patient-focused funding" in which the hospital would get money based on the number patients treated, as well as the quality and timeliness of care.

In Canada, hospitals receive a block of funding for the year based on the anticipated number of patients they see and procedures they perform. There is no correction if those numbers change.

So the goal of a hospital administrator becomes to spend less - to see fewer patients and to perform fewer procedures, a direct contradiction to the way a health system should perform. There is also no incentive to invest in any new equipment.

A couple of nights ago my wife had a mammogram, which showed a clip in her breast to mark where a calcification deposit had been removed when we lived in Boston. The technician was surprised that the machine saw this. Apparently in her previous two mammograms in Canada the machines had not been powerful enough to detect the clip. What else might this older equipment be missing?

Hospital should certainly be funded based on actual patient and procedure numbers.This might also lead to some competition among hospitals, leading to an improved patient experience.

It is ridiculous to think, as some do, that everything is perfect with Canadian healthcare system as it is:

Mary Ferguson-Paré, president of the Registered Nurses' Association of Ontario, said the suggestion that the Canada Health Act needs be "modernized" and "revised" is smoke and mirrors, and the reality is Dr. Day wants to promote private, for-profit medicine.

She said the ingenuity and the capacity already exists within the publicly funded health-care system to deliver effective and efficient care.

That ingenuity and capacity may already exist, but it will take some serious discussion and a big push to unlock it. Claiming that everything is wonderful as is does gives people a false sense of security and does nothing to make that happen.