If you are a Canadian living in the United States, there is one lesson you learn very early on: avoid at all costs any discussion that involves health care. It's unwinnable.

Most Americans have this picture in their heads of the Canadian health-care system. It involves horse-drawn wagons moving through the early dawn, hauling bodies to the local cemetery of those who died while waiting in long lineups for treatment.

Also unwinnable would be any suggestion that health-care standards in the U.S. can be matched anywhere else in the world.

Beating the drum: California Gov. Arnold Schwarzenegger speaks on behalf of health care reform at a White House-sponsored regional forum in California in April 2009. (Hector Mata/Associated Press)

This view is overwhelmingly held here despite statistics that show Canada's life expectancy is now 80 years compared to the U.S. figure of 77.5 and that the infant mortality rate in Canada is 5.08 deaths (per 1,000 births) while the U.S. figure is 6.89.

Life expectancy and infant mortality rates are considered by most international agencies to be the best measure of a national health-care program. But they are not the kinds of facts that Americans like to focus on.

Wait times

Despite my own advice, I have disregarded it on occasion and found myself in a fruitless discussion with my American friends that usually centred around wait times.

In a 2001 survey, the policy journal Health Affairs here found that 27 per cent of Canadians reported waiting four months or more for elective surgery, while only five per cent of U.S. residents reported such waits. No statistic has been beaten into the minds of Americans more than this one.

The health-care industry here has made it the mantra of any discussion on medicare both on Capitol Hill and at the kitchen table.

The problem with the statistic is that it is pure hokum.

To start with, almost 50 million Americans have no health insurance at all. If you can't afford to see a doctor, there is no wait time.

Read the Health Affairs survey closely and you will find that it also reported 24 per cent of all Americans did not receive medical care because of cost; that 26 per cent did not fill a prescription, again because of cost; and 22 per cent said they did not get a test or treatment that had been recommended because they couldn't afford it.

Now, I am aware of problems with the Canadian system and the national debates that surround it. But when arguing with my American friends, I have always accepted the Canadian view that despite sometimes lengthy wait times no one goes without care, instead of the American view that, if you can't afford it, you go without.

It's not been a winning argument, at least not until recently.

Enough already

There are clear signs now that the American public has had enough with their two-tier health-care system. Skyrocketing costs for private insurance are part of it.

But another huge factor is the roughly 600,000 job losses in each of the last few months. The vast majority of those losing their jobs are losing their health benefits as well.

Restructuring companies are retrieving some of the high costs of employee health plans from unions that are battling to save jobs and forced to accept changes to their benefit plans.

Losing your job is certainly devastating, but the accompanying fear of being unable to provide health care for your family is also wreaking havoc with the American psyche.

In 1994, when Bill and Hillary Clinton attempted to introduce a new health plan, they were sandbagged by a Congress that was interested primarily in satisfying the health insurance and medical industries.

So badly beaten were the Clintons — the first big political defeat of the Bill Clinton presidency — that they never again tried to reform the system, despite the huge number of Americans with no health care as a basic right.

A new momentum

But it is a different Congress today and the debate is being driven by an angry, voting public, not by the health industry with its selective statistics.

Barack Obama's election promises to reform health care as well as the deteriorating economy mixed with a Democratic House and Senate all came together and the dynamic changed.

While President Obama was making headlines on his European tour, his biggest accomplishment may have occurred back in Washington: his first (huge, $3.7-trillion) budget sailed through Congress.

It contained some predictable losses as budget cutters chopped away at the fat and partisan targets. But the allocation to pump-prime a national health insurance plan was left untouched.

That alone makes it almost a certainty that by the end of this year, every American will have access to some kind of health insurance.

What's also fascinating is the way in which the insurance industry and the pharmaceutical companies have accepted the new reality.

Insiders say these companies have realized that their old gravy train is now parked on a siding and that working with reformers is a much better option than the out-and-out warfare the Clintons faced.

Industry will still attempt to fight off the efforts of many Democrats who want to go for broke and establish a broad government-run insurance program that could someday lead to a full, Canadian-style, "socialized medicine" system.

The current plan seems to be leaning towards government-subsidized premiums for those who can't afford the full shot themselves. Americans will have to brace themselves for some serious debate in Washington and the fact that any new, encompassing system will be expensive.

But as President Obama argued both during the campaign and then from the White House, the costs now to get the program underway will give way to savings in the future, for American employers as well.

As for the rest of us, just think, no more arguments about Canadian and American health care. But there is the other big topic. Who's the better hockey player: Alexander Ovechkin or Sidney Crosby?