That Canada's health care system is in shambles is news to no one: Soviet-style hospital waiting lists; unions that swallow up the extra money intended to reduce those line-ups; the best 1970s technology 70-cent Canadian dollars can buy; and a medical brain-drain to the United States. Likewise, the proposed "solutions" are also recycled with numbing regularity: funding increases, the re-arrangement of health boards, and the supposed cure-all power of user fees.

Like a prairie windstorm that sweeps fields clean of debris, David Gratzer, a University of Manitoba medical student and occasional political columnist, has analyzed our rotting health care system, produced a brilliant diagnosis of its ills, and written a first-class prescription on how to revive the patient's vital signs.

What makes Code Blue - Reviving Canada's Health Care System, different from all the health-care-is-in-a-crisis pulp, is his profound grasp of the "why" and his well-argued, and comprehensive prescription for the "how" to change Canada's bureaucratized medical monopoly.

For example, in one of the most astute observations of the book, the author argues that because most Canadians mistakenly equate the funding mechanism (Medicare), with the desired service (health care), they are loathe to change the funding mechanism. They're afraid, wrongly in Gratzer's view, that if you tamper with how the money reaches their doctor, then the treatment - when needed - won't be there.

Pointing the way to a healthier future, the future doctor argues that cult-like devotees to the five principles of the Canada Health Act miss the point. "Provincial portability for example, is nice, but isn't as essential as timeliness of care," argues Gratzer.

Instead, Canadians should construct their health care system on five pillars of good health care; quality, i.e. - the latest technology, modern facilities, and highly trained staff; timeliness, where illnesses are diagnosed and treated quickly; cost effectiveness; patient orientation where patients - not bureaucrats - are the ultimate decision makers about their individual care; and accessibility, where no Canadian should be deprived of needed medical care.

Revitalizing health care in Canada means re-establishing the broken payment link between doctor and patient asserts Gratzer. His solution: mandatory medical savings accounts (MSAs), along the lines of Singapore, and also some limited experiments south of the border. (Anti-Americans can relax. He argues the American and Canadian systems are in trouble for the same reason; bureaucratic decision-making by either government or Health Management Organizations is no substitute for individual choice.)

One variety of such accounts, say, where $1,000 is put into Joe Smith's medical saving account to either be cashed at the end of one year or rolled over, would promote both pro-active treatment - Joe might use part of that money to get a service currently de-listed or considered preventative but not now funded - as well as efficiency.

Because Joe knows that the money saved is his, he will look for a provider that charges $500 for a service and not $800. As for catastrophic illness or injury, that would be covered by mandatory catastrophic insurance.

Gratzer both anticipates and answers many of the expected criticisms of MSAs and his ability to foresee the critics baying at the reformist gate is one of the book's strengths, along with his humour and storytelling ability.

I predict Code Blue will be attacked and vilified, mostly by Medicare Luddites who will never take the time to read it. And then one day, politicians - who will claim it was really their idea all along - will adopt many of the book's ideas. Twenty years from now, Canadians will be grateful that they did.