Pipes discusses health care reform in America. She uses her background as a native Canadian to compare and contrast America and Canada's systems. She is critical of Canadian-style single-payer systems. Instead, she advocates health savings accounts and association health plans in order to "empower the consumer." For the former, she cites John Mackey's plan with Whole Foods as a model.

Aside from consumer-based reform, Pipes advocates several things: America moving away from employer-provided health insurance, tort reform, and the introduction of more technology in the medical field on the administrative side.

She then comments on Medicaid and the number of chronically uninsured.

Pipes finishes by analyzing and critiquing Canada's health care. She focuses on waiting lists and rationing. She says Canadians regularly come to America for care they cannot get quickly enough in Canada. Further, she claims there is an exodus of doctors from Canada.