When it comes to health care, the facts are irrefutable. Our single-payer public system with its long waiting lines, rising incidents of labour unrest and politicians who continue to believe that more money is the answer to all our problems has led Canadians to an axiomatic conclusion: the system doesn't work.

The resultant debate on reforming our health care system has become dangerously polarized. The false choices that apparently confront us are a staunch defense of the status quo or a slide into an 'evil for-profit American style system.' We will refer to those who frame the debate in these terms as health care luddites.

What this discussion lacks is a rational focus and an acceptance of financial, demographic, utilization and technological realities that point to the need to employ some sort of more balanced blend of public and private service providers as we struggle to build a 21st century health care system that works.

However, right under my nose a ray of hope has emerged. The Region of Ottawa Carleton (ROC) has just decided to continue with a process that invites private sector ambulance services to submit proposals to run the ROC's ambulance system.

Presently response times for ambulances in the urban core of the ROC run between 12 and 15 minutes. This lags far behind the North American average of 9 minutes. And when it comes to life and death scenarios, minutes count. It will require a lot of ingenuity to upgrade this service which benefits 700,000 residents over an area which is four times the size of Toronto.

To deal with this problem, the ROC put out a Request for Information (RFI) and, as mentioned earlier, has decided to take the next step and commence a Request for Proposal (RFP) process where public and private providers will be invited to submit their solutions.

Predictably, the luddites are up in arms. Unfounded fear mongering has set in with claims that heart attack patients will be asked for VISA numbers in mid-coronary. Then there's the charges of dirty ambulances, poorly trained paramedics and the oldie but a goodie "profits before people" to round out the propaganda campaign.

Thankfully, this misinformation effort, complete with multi-colour brochures, a 1-888 number and targeting and home harassment of pro-RFP councillors (can you say big money disguised as a grassroots effort ) failed to deter the ROC who will continue with the RFP process.

What the luddites fail to understand is that their fears are, for the most part, red herrings. Quality indicators such as maintaining adequate response times, ensuring well-trained staff, upgrading the vehicle fleet, serving all areas of the region, integrating services with partners such as hospitals and homes for the aged, questions of ownership of equipment, etc., can all be written into the terms of a contract.

This is where the 'for-profit motive' and the 'mandate to provide public services' conveniently intersect. The private (or public company) only gets paid if it lives to the terms of the service contract. And the contract is designed to ensure that patient safety and health concerns are paramount. It's not rocket science just good public policy.

The one stumbling block left is the drive to get Queen's Park to devolve responsibility for ambulance dispatch to the Region. Whether it is a public or private entity that eventually provides ambulance services, it must have control of dispatch operations so it can best utilize ambulances and improve response times and live to the terms of a contract, which will be written in the public interest.

While this debate is far from over, the luddites have been struck a crushing blow. The ROC has made a healthy choice, not only for its taxpayers but the health care debate in general.