I want to return to my earlier metaphorical connection between the debate on Net Neutrality (aka “Save the Internet“) and Canada’s angst over private medical care. In part this is driven by the arrival of this week’s issue of Maclean’s magazine and its “Complete User’s Guide to Private Medical Care in Canada.”

Metaphors aren’t always appropriate; they often don’t fit. Still, there is no reason why we can’t look at other experiences in order to try to learn, develop best practices and improve the end result.

I think that looking at healthcare, as a cloud, can have a number of similarities with ‘the internet’. Like the internet, healthcare is a concept rather than a tangible entity. People are concerned about fair, high quality access to healthcare, and it is sometimes publicly funded, privately provided together with every permutation of these.

Similar to the internet, there is a populist view that a public healthcare system should deliver a uniform quality of care to all. In the view of some, for both healthcare and the internet, such a model just doesn’t work. Loads of experts can examine why this is so, but one can point to the failure of public funding to be able or willing to cope with appropriate levels of capacity planning, technological change and ongoing investment.

As a result, the delivery of healthcare is failing on many measures of satisfaction: it is hardly uniform quality (some regions of the country or province have longer or shorter waiting lists for similar procedures); it is not offering flexibility in solutions; and, public healthcare is not making sufficient use of advances in technology, due to lack of capital and ongoing operating funds.

As seen in the Maclean’s feature, private health clinics are a reality across Canada. To those who predict that this means the end of Canada’s democratized health care, I would argue that this may actually be the beginning of democratized premium health care.

The upper crust has always had access to preferred, private health care. They are happy to jet to US or other foreign clinics to access the best care money can buy. The arrival of private clinics in Canada means that more of us can get the same level of service, at a cost premium but within the reach of far more.

At the same time, there is no harm being done to the public system. If anything, there is a reduction in demand for public health care, so there is a net benefit to everyone.

How does this relate to Net Neutrality? Having premiums paid by content providers in order to gain preferred access to their customers is similar in many ways. Maclean’s talks about the way that health insurance companies have negotiated arrangements with hospitals and certain clinics. The concern is that there be degraded service to the rest of the public internet. If content providers are satisfied with the current level of service, then they can continue as today on a permissive basis, with no quality of service guarantees.

Don’t confuse tiered service with discrimination. As Dave Greenfield wrote last month, “Is it fair that Business Class customers get better treatment than Economy class? You bet.” That means you (or your content provider) may have to pay a premium, if you both want delivery with a premium grade of service.

That isn’t discrimination.

I received a private comment about one of my net neutrality posts from an anonymous admirer saying:

Hmmm. While the internet may have evolved from the US defense department, I would submit that it’s growth and popularity arrived when its power was unleashed by private investment – culminating in that thing they called the ‘tech bubble’. The internet, in the hands of government, was nothing like the service that has been built, improved, expanded, morphed and driven by profit-motivated corporations.

My concern with governments getting back into the provision of public communications services is that they may get tired of the planning, the investments, the ongoing management required to keep services state of the art and provide uniform high quality service to all.

Look at the history of government run telecom utilities around the world. For that matter, look at the history of public works projects. They start out as a good idea at the beginning, but the upkeep turns out to be hell. It’s natural – there are other priorities that should come first for tax dollars. The trend is for government to withdraw from the industry, eliminating ownership and heavy regulation, not for it to re-enter the business as an owner.

Government-run telecom went out of fashion when the Berlin Wall came crashing down.

Bell’s Enterprise group has landed a major win that has to feel sweeter than most. Bell announced that it will be supplying an IP-based outsourced call centre solution supporting more than 6000 seats in almost 100 locations to TD Bank Financial Group.

Of course, it is always nice to win a deal of this size. There are two extra layers of icing on this cake:

• taking the business out from Allstream and beating TELUS, who have been trying to sell their hosted IP voice solutions for longer than any major carrier; and,
• TD’s Board of Directors includes Darren Entwistle of TELUS and John Bragg of Eastlink, the cable company that has been beating up Bell’s sister-company, Aliant, in eastern Canada.

Bell won this deal in a regulated framework. Would TD have paid less in a forborne environment? Enterprise Presidents Isabelle Courville of Bell and Joe Natale of TELUS will appear on a panel together at The Canadian Telecom Summit on June 12-14.

On Monday, Mark Evans wrote a piece on Net Neutrality Ignorance. I am not sure I agree with his contention that

I think we could argue that our Telecom Act is already clear on points of discrimination and in carriers acting on the content of transmissions. More recently, as we have written before, the Telecom Policy Review panel examined the issues and came out with what we termed ” A Solomonic balance of interests.” The CRTC has examined the question and has said that it will deal with contraventions as they arise. Which they are doing.

It is hardly a ‘cautious Canadian approach’. We have existing legislation that covers much of the concern. We have had a review of the issue, with active public participation and had a report issued already. Are we really in limbo or do some folks just not like the current balance? I think we are ahead of the pack on this one, despite some people not being happy with the outcome – but duhhh… what else is new in Canadian telecom regulation?

Mark’s post refers to Save the ‘Net advocate Dave Weinberger, who writes about the potential loss of Innovation, Open Markets, Free Speech, Creativity and Democracy itself! Let’s look at one of his arguments:

Where does he get the idea that carriers “block users from being full-fledged creators”? Did all of the carriers in Dave’s area conspire together to refuse to sell him symmetric access? Or, does Dave really mean to say that he was too cheap unwilling to buy a business grade high speed internet access service with loads of upload and download speed. Apparently, Save the ‘Net folks wants symmetric access for $40 per month – or maybe they want government provided municipal service, so that they get other people to pay for their service.

Let me explore this paragraph a little further. We are supposed to believe that carriers are conspiring with the Hollywood studios to keep little guys from publishing content. This conspiracy presumably extends to the carriers coercing the studios to pay extra fees for their content to be carried, in exchange for the carriers prohibiting little folks from being full-fledged creators.

I guess all of the studios and carriers must be on side with this conspiracy – otherwise, I can’t wait to see Oliver Stone’s movie version.