Changing Our Values To Promote Healthcare System Change: Raymond Rupert MD, MBA.

Once a value system has become very powerful, then it can stay that way for many decades by suppressing the competition.  Canada’s healthcare system is built on a solid bedrock of values which are not changing. 

However, values can progress or regress. Slavery came to an end because of changing moral attitudes. The onward march to moral progress ended slavery. 

Moral regress can also occur. As it did with Nazism and Stalinism. Both socieities used slave labour to power their economies. 

Those focused on the long term, when trying to improve society’s values should focus on promoting more abstract or general moral principles. This keeps moral changes relevant and robustly positive for the future.  

Canada’s healthcare system was built on specific moral principles or values; namely, public administration, comprehensiveness, universality, portability and accessibility. 

These values which form the bedrock of the Canadian healthcare system were incorporated to minimise the cumulative suffering of patients when they had healthcare related challenges that required care both within and outside of the healthcare system. 

The original design is now over 70 years old. The healthcare system did provide good quality and timely care for decades. However, at present, the Canadian healthcare system is broken. Some say it is in crisis mode. And the cumulative suffering of patients is unacceptable in a modern society. 

Values can be highly persistent. The Bible completed almost 2,000 years ago is still relevant. The Talmud compiled over 1,000 years ago is still in practice on a daily basis throughout the world. 

The persistence of values is called Value Lock-In by William MacCaskill in What We Owe The Future ( 2022).   Perhaps Canada needs a moral entrepreneur at this time. Tommy Douglas played that role in the 1950’s. It is time for a new moral entrepreneur and hopefully from the next generation. 

What the Canadian healthcare system and society needs is a morally exploratory culture that will favour political experimentalism.  The objective should be  to create a marketplace of ideas where different ideas compete and the best ones win. 

This will increase cultural and intellectual diversity, hopefully, result in cultural plasticity. With plasticity, the system will be allowed to change, in fact it needs to be redesigned, in order to minimise the suffering of all Canadian patients. Which is, of course, the ultimate purpose of the Canadian healthcare system.