as mhealth, would bring much needed attention to an issue that has some
roots at a provincial level but requires national coordination to be successful.
Beginning talks at a top-down high level could set the stage for internal
dialogue within Canada as a political “jawboning” exercise205 to push
provincial governments and other stakeholders to come together around
developing policy around the exchange of health data. Given that the RCC
was established by the highest level of political leadership in the U.S. and
Canada, and is made up of high-level government officials from key
regulatory agencies, the RCC could use its influence to call for action in this
area even if it lacks the ability to take such action itself.206
Like many legal and policy issues, the exchange of health data boils down
to a matter of trust, whether between a patient and her physician, or between
countries. The Canadian provincial reaction to the PATRIOT Act is a clear
example: the Canadian provinces did not trust American servers and cloud
storage would keep their citizens’ information secure from unwarranted
intrusion by our federal government. Addressing these political and cultural
concerns through mechanisms such as the RCC are necessary to overcoming
these barriers to data exchange.207
When a new administration assumes office in January 2017, the new
President will have the opportunity not only to rebuild this trust with Canada
to allow the free flow of health information, but also to work together to
ensure the security and privacy of this information. Allowing the flow of data
for public health preparedness, medical research, and delivery system reform
will help improve health care in both countries.
205. MICHAEL MILAKOVICH & GEORGE GORDON, PUBLIC ADMINISTRATION IN AMERICA
255 (Katherine Hayes et al. eds., 10th ed. 2009); see also Jason Millman, HHS Jawboning
doesn’t Faze Insurers, POLITICO (May 8, 2012), http://www.politico.com/story/2012/05/
jawboning-by-hhs-doesnt-scare-insurers-076066 (discussing attempts by HHS to “jawbone”
insurers into accepting lower rates).
206. Shared Vision, supra note 183.
207. Sane & Edelstein, supra note 99, at 11 (“‘You cannot have data sharing without