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No. The Canadian government spent $1B on a simple gun registry, a basic CRUD app that barely worked. US 'healthcare.gov' doesn't need to be that complicated, but it was $2B, screwed up by a Canadian contractor, CGI. A small team of Google devs had to come in and fix it.

Most companies that screw things up that bad, will fail. If they don't, it's still their right to waste money on dumb projects - it's their money.

Government failures (at least in Canada) generally exceed those in the private sector for that reason, exposing the dire systematic problem if 'no competition, no oversight, lack of competency' on a scale rarely seen elsewhere.

Not only is there 'no incentive' to fix problems, often there's also a negative incentive.

It's 2020. The technology to put my medical history online has been available for 20 years. Ontario, Quebec etc. have still completely failed to do this. I still have no easy way of finding out which clinics are available for me, and when I do go to a new one, they have to open an entirely new file, totally unaware of my historical medical issues. To make matters worse, it's literally illegal for me to pay anyone to provide me with medical services. It's kafkaesque.

A very basic medical history system, that merely documented doctors notes etc. could be done 'on the cheap' (relatively speaking) - but it's far from happening.

Even an intelligent regulatory mandate could solve the medical records issue, i.e. providers must participate in XYZ system, with ABC components, designated by the government. But we can't even have that.

It's really bad and I don't see any path to getting better until government develops a whole new attitude towards IT.



I don't think your information is up to date. I'm in Quebec, and my hospital and its clinics have all their information available in a portal. Test results are communicated electronically between sources. I don't speak French well so don't use it, but apparently there is also a provincial level portal. [1] gives an overview of how it all fits together.

Granted, it is all happening slowly. I worked in ehealth in Ontario around 2000 and they were providing huge incentives for organizations to go digital, but most didn't want to due to habit, and because each institution is run as an empire.

And ultimately, the results from each system, even if it's the same test, are often not really comparable, so the dreams of results that can be compared by the consumer, and precise reasoning systems for actual AI are another generation after consolidation.

1. https://www.quebec.ca/en/health/your-health-information/queb...


Replace government with large, complex organization. There is litle difference. I've worked in government and large companies, and they are pretty much the same.

The only difference is the governance structure. In .gov, you tend to have professional / civil service people at the senior director level who know their business inside and out, with a political layer of management who drive change and vary in competence.

Medical records are a great example of how .gov/.com doesn't matter. When stuff gets complex, IT sucks.


"Replace government with large, complex organization. There is litle difference. I've worked in government and large companies, and they are pretty much the same."

I don't agree at all.

Big corporations can fail to do many things where it's not really important, so it might seem like 'failure' but mostly it's a function of market conditions. Other big failures (say Boeing 777) are understandable due to complexity.

Very few groups on earth can build such airplanes.

Anyone can build a gun registry.

I loathe how long it takes my bank teller to speak to me, but my banking services are in the end, amazingly cheap for what they provide.

Governments do a reasonable job at things like contract allocation for road maintenance, some kinds of construction, but they generally do a bad job operationalizing anything.


> To make matters worse, it's literally illegal for me to pay anyone to provide me with medical services.

This is not at all true in Canada. I'm really confused by this statement.


Yes, it is absolutely true. Literally from the Canada Health Act: "Private health insurance plans are prohibited from duplicating coverage for health services provided in Canada which are insured under the Canada Health Act."

If you start to provide services normally covered by the government, you will be shut down, or you'll have to take your case to the Supreme Court where this law is still being tested.

There are places that provide parallel services, they operate in a grey area. For example, the Supreme Court of Quebec ruled that private services can be provided for treatments wherein the government does not provide 'timely service' i.e. 'wait times are too long'. But exactly the parameters of those 'wait times' nobody knows, and the only way to find out is to go to the Supreme Court. So not a good business plan.

The laws vary from province to province however.

[1] https://www.canada.ca/en/health-canada/services/health-care-...




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