Full Comment - February 06, 2023


The doctor suing to free Canadian patients from deadly medicare waiting lists


Episode Stats


Length

32 minutes

Words per minute

141.46602

Word count

4,581

Sentence count

274

Harmful content

Misogyny

4

sentences flagged

Toxicity

1

sentences flagged

Hate speech

2

sentences flagged


Summary

Summaries generated with gmurro/bart-large-finetuned-filtered-spotify-podcast-summ .

Dr. Brian Day is a former head of the Canadian Medical Association. He s been active in a number of different healthcare groups throughout his long career, and he joins me now from Vancouver. Dr. Day talks about how he came to Canada and why he thinks we should have a private healthcare system.

Transcript

Transcript generated with Whisper (turbo).
Misogyny classifications generated with MilaNLProc/bert-base-uncased-ear-misogyny .
Toxicity classifications generated with s-nlp/roberta_toxicity_classifier .
Hate speech classifications generated with facebook/roberta-hate-speech-dynabench-r4-target .
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00:01:12.740 We love to have endless debates about healthcare in this country.
00:01:22.700 Do we have a public system, a universal system?
00:01:25.600 Do we allow private care at all in this country?
00:01:28.440 Of course, if you have followed the healthcare system at all, been involved, seen a doctor,
00:01:33.480 chances are you realize that we have a mixed system.
00:01:37.080 It is public, it is private.
00:01:39.080 For the most part, it's publicly paid for, but even not all of that is covered by various
00:01:44.460 provincial government programs.
00:01:46.380 But there's one man who has been involved in a fight for private healthcare in this country
00:01:51.480 for some time, and we want to talk to him in a moment.
00:01:54.180 But before we get to Dr. Brian Day, though, I do want to remind you to subscribe to the
00:01:58.920 Full Comment podcast.
00:02:00.100 My name is Brian Lilly.
00:02:01.060 I'm the guest host of Full Comment for this week, and you can subscribe on any of the platforms
00:02:05.360 that you're listening to right now or your preferred platform, be it Amazon, Apple, Google,
00:02:10.900 what have you.
00:02:12.120 Dr. Brian Day is a former head of the Canadian Medical Association.
00:02:15.920 He's been active in a number of different healthcare groups throughout his long career,
00:02:20.840 and he joins me now from Vancouver.
00:02:22.720 Dr. Day, thanks for the time.
00:02:24.180 Oh, you're welcome.
00:02:25.320 I want to ask you, tell me your backstory.
00:02:28.300 Where did you come from?
00:02:29.340 How did you end up where you are out in Vancouver practicing as a physician, as a surgeon?
00:02:36.800 So I came to Vancouver in the 70s as a trainee in orthopedic surgery, and initially was planning
00:02:45.880 to stay for just a year because I had another position back in the UK, but I enjoyed my year
00:02:57.760 in orthopedics and stayed on, and that was the story of how I came here.
00:03:01.760 So I did my orthopedic training in Canada, in British Columbia, and I've been, over the years,
00:03:11.320 involved in academic orthopedics.
00:03:13.820 I used to be in charge of the academic program for orthopedic surgeons at UBC, and I was chair
00:03:19.980 of the national committee on credentialing, the test committee on credentialing orthopedic
00:03:25.940 surgeons in Canada.
00:03:28.140 But then, you know, everything was working perfectly in our health system until the late 80s, and
00:03:35.500 then things started to go haywire and have been going, getting worse ever since.
00:03:39.920 That's what I wanted to ask you.
00:03:41.160 What was it like when you came to this country, and when did you start seeing a change?
00:03:44.880 Because you came out of a system that was even more government-oriented with the British
00:03:50.740 National Health Service than what we've generally had here.
00:03:55.520 So I'm guessing you weren't always opposed to the type of medical setup that we've got.
00:04:01.760 When did you start saying, hmm, there's a problem here?
00:04:05.420 Well, you know, you're right.
00:04:08.040 I came out of the NHS system.
00:04:11.520 I came to Vancouver at a time when, you know, doctors and nurses were in good supply.
00:04:19.420 Back then, we were fourth in the world in the number of doctors per population.
00:04:25.480 We're now 69th in the world in doctors per population.
00:04:30.520 We had no waiting lists.
00:04:33.320 Access to family physicians and specialists was instantaneous almost, you know, within a week or so.
00:04:41.380 And gradually and progressively, mostly due to government policies, they cut medical school intake by 10 to 30 percent.
00:04:52.020 They cut nursing schools.
00:04:53.300 They had this weird theory that doctors and nurses were causing the waiting lists to go up because they were treating too many patients.
00:05:03.240 So their simplistic solution was to cut back medical schools.
00:05:07.900 And they were cut back across the country by up to 30 percent.
00:05:10.540 And now they complain there's a shortage of doctors and nurses, which is a kind of, you know, ironic.
00:05:18.320 But yes, until the late 80s, there were no problems.
00:05:22.620 But then the rationing that took over started to impact and the shortages that the government itself had created started to take over.
00:05:33.280 And the big difference between the NHS and every other country in the world, and I think I stress every other country in the world,
00:05:41.200 is that none of them bans competition for the private, for the public system.
00:05:48.300 So Canada is the only health system that operates for physician and hospital services as a state-run monopoly.
00:05:58.540 Every other system in the world, including the communist countries, including the British NHS and the New Zealand system.
00:06:06.160 So our system is largely based on New Zealand and Britain, but we did one thing differently.
00:06:11.860 We banned private insurance.
00:06:14.340 And in the countries I just named, like New Zealand, even countries like Sweden and Belgium and Denmark, which are not every other country in the world,
00:06:25.920 allows a little bit of competition, both funding and delivery, from the private sector.
00:06:31.540 And I, you know, I've always believed, and I still believe, there is no monopoly of any kind, especially a government monopoly,
00:06:41.540 that serves the users of the services well.
00:06:44.580 If you've got no choice, you have a badly run system.
00:06:50.400 We see that in British Columbia, because British Columbia has a government monopoly on, say, on car insurance.
00:06:56.180 And it's not a coincidence that we have the highest car insurance premiums in the country.
00:07:02.180 And so that's been, that's, that's basically the historical situation as to how we got here.
00:07:11.620 There's a couple of different things.
00:07:13.400 There's private delivery of public services, and then there's private pay.
00:07:17.780 And I want to talk about private pay in a few minutes, but I want to ask you about this controversy in Ontario,
00:07:24.080 where the, the government is moving in what I think are very moderate baby steps,
00:07:31.860 moving towards allowing cataracts, hip and knee surgeries in private clinics.
00:07:36.560 And it's being portrayed as if it's, we're going to US style healthcare, is what Jagmeet Singh said,
00:07:45.540 as if he doesn't know that the province he represents in the House of Commons has been doing this a long time.
00:07:51.820 Tell me what it's like in British Columbia, because we don't talk enough about differences in our own country.
00:07:56.960 We don't know enough.
00:07:57.900 We know more about what's happening in the United States quite often than what's happening elsewhere.
00:08:02.380 What Ontario is about to do is something British Columbia has done for decades, I understand.
00:08:08.100 Yes, we, so the NDP government in the 90s introduced, you know,
00:08:13.180 we actually had the first contract at our private clinic with the NDP government back then,
00:08:19.160 and have, and they still to this day contract out thousands of procedures to the private sector
00:08:26.720 based on, on the rationale that they're more productive, more effective, they have less complications.
00:08:34.860 So, for example, and, and, you know, this is something that might surprise people,
00:08:41.360 but, you know, our clinic in British Columbia is ranked by the Accreditation Canada,
00:08:47.100 which is the national body that accredits hospitals and teaching hospitals across Canada.
00:08:51.340 We are the high, we've achieved the highest rating, higher than, which is, you know,
00:08:58.380 a minority of hospitals in Canada have public hospitals.
00:09:02.140 We, we know from government data that there, for every hundred admissions to a public hospital,
00:09:10.160 there is one preventable death.
00:09:12.440 We know from college, so in, in over 25 years of operations.
00:09:18.980 Sorry, can you give me that number again?
00:09:21.400 There is one preventable death for every hundred admissions to a public hospital.
00:09:26.740 In over 80,000 admissions at our surgical center, there has not been one death.
00:09:33.320 So, these, what Ford is doing will not only save hundreds of lives every year, but, and this
00:09:43.360 is also significant, the College of Physicians and Surgeons of British Columbia collects data
00:09:47.900 on complications like infections and superbug infections and all of that kind of thing.
00:09:54.580 They're almost 40 times more common in a public hospital than in a private clinic.
00:09:59.760 So, these clinics are safer, they cost less money, they are built and operate with the construction
00:10:08.660 costs, do not cost the taxpayer, and the, the technology that's included and bought by the
00:10:16.540 private sector does not cost the taxpayer a penny.
00:10:20.400 So, if they don't work out, taxpayer doesn't lose anything.
00:10:24.140 And, most importantly, if they make a profit, those, that, those clinics pay taxes to all
00:10:33.260 three levels of government.
00:10:35.260 And, so this is a win-win for the government.
00:10:39.000 But, as you, as you say, what Ford is doing, quite apart from the fact that it's going to
00:10:44.720 help patients, and it will also repatriate nurses.
00:10:51.000 So, in a single Detroit district, which is, you know, just across, not, you know, just
00:10:57.420 across the border, there are over a thousand, in one district, over a thousand Ontario trained
00:11:03.160 nurses working in the United States.
00:11:06.400 This will, this will cause many of them to come back because the working conditions at
00:11:14.180 our public hospitals have become, have deteriorated to a level that they're toxic now.
00:11:21.220 Nurse, there is actually, if you look at OECD data, there is no shortage of nurses in Canada.
00:11:28.160 We have a higher than average number of nurses per population, but the environment in our public
00:11:33.800 hospitals has driven them away.
00:11:36.380 The, part of the reason...
00:11:39.140 Well, especially in the ICUs and emergency rooms.
00:11:42.840 I mean, those, those are the ones that are really having the trouble.
00:11:46.480 Yes.
00:11:47.060 And, and I think one of the things that a lot of Canadians don't understand, and this is
00:11:53.380 at the heart of that, of the problem, is we are the only developed country that block 0.59
00:12:01.220 funds our hospitals.
00:12:02.920 So, a public hospital, like, say, the Vancouver General Hospital, is given a couple of billion
00:12:08.980 dollars every year by the government to operate.
00:12:12.780 That means that every patient that comes to an emergency department or is admitted for a
00:12:21.800 surgery or procedure is using up the budget.
00:12:26.080 Therefore, if you want to be a successful chief financial officer and administrator at
00:12:32.620 a hospital, public hospital, the last thing you want is patients, because they are using
00:12:39.840 up your budget.
00:12:41.180 It's a crazy form of funding that is unique to Canada to be carried out exclusively.
00:12:49.020 And it's nothing to do with private or public.
00:12:52.420 This is a funding system in Britain, in New Zealand, in, in France, countries that have
00:12:59.600 universal health systems, the funding follows the patient.
00:13:03.700 Here, it doesn't.
00:13:05.900 So, there is, in, in, in New Zealand, if a patient goes to a public hospital, they carry
00:13:11.420 public funding with them.
00:13:13.140 So, the, they want patients in the emergency department.
00:13:17.880 They want patients coming in for surgeries, because that brings government revenue.
00:13:23.640 Equally, those, so what's interesting, public hospitals in those countries, and also treat
00:13:30.980 private patients.
00:13:32.560 There are no way, you know, if you, if, and, and use the revenue to supplement the treatment
00:13:41.360 of public patients.
00:13:42.540 I'm an honorary member of the Cuban Orthopedic Association, the Frank Pays Hospital in downtown
00:13:48.860 Havana, only 150 beds, generates $20 million U.S. in treating private patients, mostly tourists,
00:14:01.220 medical tourists.
00:14:02.000 And they use that revenue to increase the funding of their public system, buy new technology,
00:14:11.120 treat more patients.
00:14:12.700 So, we are, we have this.
00:14:15.300 Cuba, Cuba does what we want.
00:14:16.940 Yeah, well, actually, you know, I was a guest speaker at an international conference in Budapest
00:14:23.360 a few years ago.
00:14:24.420 So, they invited me because they didn't believe Canada would outlaw private health insurance.
00:14:30.600 And, and I was the opening speaker.
00:14:34.200 And, you know, delegates from all over the world were there.
00:14:39.400 Afterwards, the delegation from China came up to me and said, you know, you remember Tiananmen
00:14:46.540 Square?
00:14:47.020 And I was shocked they would bring up Tiananmen Square.
00:14:49.440 I said, yes.
00:14:50.200 Well, there were 100,000 protesters.
00:14:53.740 I said, yes.
00:14:54.880 I said, if the Chinese government tried to outlaw private health care, there would be
00:15:00.000 100 million protesters because in China, we don't believe the government owns your body.
00:15:06.820 And that is the, that is pretty well the stance taken by Canadian governments.
00:15:13.240 More than half of all the hospitals in communist China are private.
00:15:17.940 This is, this, so, so there isn't.
00:15:20.200 There isn't one private hospital in Canada.
00:15:22.920 It's, you know, one thing we might ask Jagmeet Singh is, because I use education as an analogy.
00:15:29.720 There's no one out there suggesting that we outlaw private education and private schools
00:15:36.200 and independent religious schools.
00:15:38.940 And one should maybe ask Jagmeet Singh how he justifies having gone to the most expensive,
00:15:44.640 one of the most expensive private schools in North America.
00:15:48.140 One thing that you mentioned a couple minutes ago was the safety record of the hospitals.
00:15:52.600 And I was gobsmacked, or of the clinics like yours, like Canby Surgical Center.
00:15:57.600 You say that the BC College of Physicians and Surgeons tracks the safety record, and it's better than the public hospitals.
00:16:08.360 When Ford was announcing that his changes, which include allowing a limited number of hip and knee operations to be performed in these clinics,
00:16:18.640 the head of the College of Physicians and Surgeons of Ontario was calling around to other people in the health profession saying,
00:16:25.660 we've got to stop this, it's not safe to do hips and knees in clinics. 1.00
00:16:30.120 She's not an orthopedic surgeon, by the way, but she was saying that this is unsafe.
00:16:35.660 You are an orthopedic surgeon.
00:16:37.140 What do you think?
00:16:38.040 Well, she's wrong.
00:16:38.800 And I mean, the data shows she's wrong.
00:16:40.780 And by the way, the data on hospitals is government data.
00:16:43.520 The college doesn't collect the data on hospitals.
00:16:45.600 So the college collects the data on the private clinics.
00:16:47.900 The government collects it on the hospitals.
00:16:49.920 So it's government data that show the incidence of infections and complications.
00:16:55.320 Now, you have to remember, the College of Physicians and Surgeons of Ontario is one of 13 such colleges in Canada.
00:17:04.980 So we have, they're part of the massive health bureaucracy that defines Canada's health system.
00:17:11.400 There is a reason why Canada is ranked 10th out of 10, according to the Canadian Institute for Health Information Commonwealth Fund data,
00:17:22.380 10th out of 10 in amongst the universal top, you know, developed countries with universal health care.
00:17:30.980 We're ranked 10th out of 10 in quality, in overall quality and access.
00:17:36.440 We're ranked first in cost, highest in cost.
00:17:42.020 And one of the reasons is this massive health bureaucracy that we have.
00:17:46.660 We have, we have, as I say, 13 jurisdictions who act as a college to, to qualify and accredit doctors.
00:17:57.280 And other countries have one.
00:17:58.780 Equally, and in parallel, we have 14 ministers of health and 14 health ministries.
00:18:07.100 So this is why the data shows that for every health bureaucrat, public health bureaucrat that Germany has,
00:18:17.520 and in Germany there are no wait lists, for every public health bureaucrat that Germany has, we have 11.
00:18:24.240 They are consuming this massive budget that Canada uses at the taxpayer's expense.
00:18:35.940 And we should just have one Canadian health system, one ministry of health.
00:18:42.460 We should have one college that accredits doctors. 0.50
00:18:46.020 So the last thing the College of Ontario wants is for, to be open to the possibility that ending the monopoly will mean the end of this bureaucracy.
00:18:58.700 I mean, I think if we had one College of Physicians for the whole country, which is what other countries have,
00:19:06.560 the other 13 colleges, and a lot of the staff are doctors, could go back into looking after patients instead of being bureaucrats in a college.
00:19:17.120 It would add to the workforce.
00:19:19.520 So I'm all for eliminating 12 of the 13 colleges.
00:19:24.180 We need to take a quick break, but we'll be back with Dr. Brian Day in just a moment.
00:19:29.720 And when we come back, doctor, I do want to ask you about your push for private insurance and what that means for people who say,
00:19:37.400 but no, I can't afford private insurance.
00:19:40.260 I need the public system to stick around.
00:19:42.620 So we'll get to that when we come back.
00:19:44.720 So, Dr. Day, in addition to looking at different ways of delivering, and you've given us a mountain of stats
00:19:53.080 and probably sending an awful lot of listeners to Google to say, wait a minute, is that actually true?
00:19:58.720 11 health bureaucrats for every one that Germany has. 0.86
00:20:02.920 You've been involved in a court case that's been going on for a long time.
00:20:06.600 To allow Canadians to buy private insurance, or is it to pay for services?
00:20:13.060 I mean, to me, it sounds an awful lot like the 2005 Chaloui Supreme Court decision, which only applies to Quebec.
00:20:20.700 Are you essentially trying to bring that to the rest of Canada or to British Columbia?
00:20:26.280 Exactly.
00:20:26.780 What we're going, and we hopefully will get leave to appeal to the Supreme Court of Canada,
00:20:32.920 we lost at the lower court levels in British Columbia.
00:20:35.760 We weren't surprised because Chaloui in 2005, 2004-05, lost at the lower courts in Quebec,
00:20:44.920 but eventually went to the Supreme Court of Canada.
00:20:47.560 We're essentially asking the Supreme Court of Canada to make a decision as to whether patients outside of Quebec
00:20:56.920 should have the same rights under the Charter that they granted to residents of Quebec.
00:21:04.740 And we will hopefully hear about leave to appeal in March of this year.
00:21:10.980 But yes, we are asking for the right for Canadians to obtain private health insurance.
00:21:20.940 So what we have in Canada right now, or to pay, but preferably, well, our prime thing is private insurance.
00:21:28.800 What we have in Canada right now is a situation where governments across the country
00:21:33.540 have developed benchmarks on the maximum safe time you can wait before you undergo a procedure
00:21:40.840 or have a procedure once you're referred by the doctor.
00:21:44.820 And in many thousands of cases, we've got millions of Canadians waiting,
00:21:52.380 and the majority now are waiting beyond the safe time.
00:21:56.580 So we're saying to the court, should a government be able to promise health care,
00:22:04.520 which it does under the Canada Health Act, in a timely manner,
00:22:09.940 and then not deliver that care in a safe time,
00:22:16.620 and then at the same time outlaw a citizen's right to take measures into their own hand
00:22:24.860 and look after their own health with private insurance.
00:22:29.480 So we are, I'll reiterate this, the only country on the planet
00:22:33.480 where it's unlawful to obtain private health insurance for medically necessary services.
00:22:41.020 Along that line, we arbitrarily designate essential services,
00:22:47.960 such as ambulances and prescription drugs, dentistry, physiotherapy,
00:22:55.620 artificial limbs for patients who've lost a leg.
00:22:59.400 We arbitrarily designate those as not necessary and make people pay or buy insurance for those.
00:23:05.580 So, yes, we're fighting for the same rights that the citizens of every other country on the planet have
00:23:13.320 and the citizens of Quebec have, and that case, we hope,
00:23:18.380 will be heard at the Supreme Court of Canada later this year.
00:23:22.940 It's been 18 years since the Chaloui decision.
00:23:27.300 I don't think you can argue that Quebec's public health care system has fallen apart.
00:23:32.320 It's no worse than the rest of the country.
00:23:35.200 I think it's middle of the pack when I look at different barometers most times.
00:23:38.720 But it's, you know, there is a thriving private market in Quebec
00:23:46.380 that the rest of us just are not legally allowed to have.
00:23:50.400 Right. If you cross, you know, the other paradox is all you have to do,
00:23:54.580 I mean, I spent a lot of time in Ottawa when I was president of the Canadian Medical Association.
00:23:58.780 A lot of Ontario patients travel across to Quebec.
00:24:03.760 You know, just go across the bridge from Ottawa and you can get private MRIs and private health care.
00:24:10.260 And once you go across a provincial border in Canada, you're in a different system
00:24:14.940 and you're allowed to access private care if you wish.
00:24:23.460 But what we're arguing for is private insurance because most people,
00:24:28.020 I mean, about 70% of Canadians have extended health insurance that covers prescription drugs
00:24:34.220 and ambulances and dentistry and so on.
00:24:38.300 And by the way, those services are included in most countries' universal systems.
00:24:43.340 Unlike Canada's, our system isn't comprehensive.
00:24:46.520 We don't ensure, we don't cover many necessary services.
00:24:51.280 To me, it's ludicrous that the diagnosis of an infection is covered, but the treatment is not covered.
00:25:00.880 I mean, that to me makes no sense.
00:25:04.860 It's a very strange system. 0.94
00:25:06.780 And the argument about, oh, will the rich be the beneficiaries is also ludicrous.
00:25:13.140 Right now, every injured worker in the country has private health insurance if they're injured on the job
00:25:20.200 or have an illness caused by the job.
00:25:23.880 That's called workers' compensation. 0.98
00:25:25.880 They are exempt.
00:25:27.340 And as I said earlier, federal employees are exempt.
00:25:30.600 So let me ask you about that.
00:25:32.380 You treat, I just want to jump in on that point.
00:25:35.340 Your Canby Centre treats federal workers.
00:25:38.620 Do you do knee replacements on federal workers in your private clinic or procedures, surgical?
00:25:46.940 We do surgical procedures on federal employees.
00:25:52.740 I mean, I've personally operated on prisoners and judges who are federal employees, so to speak,
00:25:59.840 as well as federal police officers, RCMP, and Canadian Armed Forces,
00:26:05.720 but also MPs are exempt.
00:26:10.840 I mean, to me, this is the hypocrisy.
00:26:14.640 If you're a federally employed person, you are exempt from the restrictions.
00:26:21.000 So basically what we're saying, we want the same rights for ordinary Canadians that federal employees have,
00:26:27.900 that injured workers have, that prisoners have, that judges have.
00:26:32.720 And then, you know, I do want to address this, is it private insurance for the rich question?
00:26:40.980 Because it's something that's raised often.
00:26:45.500 Let's start with this.
00:26:47.540 The wealthy, there is no country on the planet in which the wealthy suffer,
00:26:52.680 because they get on a plane and go somewhere else.
00:26:55.580 So it's not about wealthy.
00:26:57.820 Wealthy Canadians go down to the United States. 0.97
00:27:01.280 Politicians go down to the United States if they can't get access here.
00:27:06.060 We know that there are many of them have done so.
00:27:08.200 It's on the public record that Jean Chrétien has used the Canadian Armed Forces,
00:27:12.760 when he was prime minister, went in the Canadian Armed Forces jet to Minneapolis for private health care.
00:27:19.640 And all of the major politicians that you could name, I mean, fill a page of individuals who've used the U.S.
00:27:30.800 But what we're talking about is adding the legality of private insurance for medically necessary services.
00:27:40.820 So the same insurance companies that offer ambulances and prescription drugs and so on, dentistry, will be allowed to add on and cover that.
00:27:50.080 And in most cases, these premiums are supported or funded by employers in Canada.
00:27:59.060 And so, you know, this is actually something that the wealthy already are taken care of.
00:28:08.620 So let's not talk about this as a wealthy versus poor thing.
00:28:13.120 And finally, and I think this is very important, in countries where – so I lived and worked in Switzerland for six months.
00:28:23.140 Low-income individuals in Switzerland have their premiums paid by the government, private premiums.
00:28:32.160 Because Switzerland mostly has private hospitals and private insurance.
00:28:35.200 Because in Australia, you know, which is a country very comparable to Canada in terms of population and population density,
00:28:43.900 millions of Australians in the lower economic groups have their premiums for private health care funded,
00:28:55.200 either fully paid or partially funded by the government.
00:29:00.400 So if the fear – this question about the fear of introducing private insurance benefiting those with more money is a red herring,
00:29:12.700 because the government has two ways to handle that.
00:29:16.440 Number one, they can make the public system good enough that it's irrelevant because there's no queue to jump,
00:29:24.300 eliminate the queue, make the system work.
00:29:26.860 Number two, they can – if the private system is performing better – pay the premiums for lower socioeconomic groups.
00:29:37.860 One of the stats – Stats Canada right now has data showing that in Canada,
00:29:45.500 the worst health access and the worst health outcomes are in lower socioeconomic groups.
00:29:51.420 So our system is not doing what it promised to do.
00:29:53.760 Let me ask you this then to close.
00:29:56.960 What would you say to those who believe that you just want to get rid of the public system?
00:30:02.840 Because it doesn't sound to me like you do.
00:30:05.100 You want two systems that will work hand in hand rather than one above the other.
00:30:11.200 Would that be accurate?
00:30:12.240 Or what would you say to those people who say you're an attack, you're a danger to the public system?
00:30:17.700 Well, as I said earlier, you know, when I say private, I would support private non-profit to show.
00:30:24.560 This is not about private companies making a profit.
00:30:27.660 Private non-profit would be wonderful.
00:30:29.500 It would be competition for the public system.
00:30:31.780 And we do not – we have a monopoly.
00:30:36.760 We have a government that promises healthcare, fails to deliver it in a safe timeline,
00:30:43.460 and at the same time makes it illegal for you to access that healthcare independently.
00:30:49.480 This makes no sense.
00:30:51.840 So, what I am arguing for is a little bit of competition will improve any monopoly,
00:31:00.660 but no monopoly serves the user of the services well.
00:31:05.340 I don't – and if anyone can name one, I've never heard anyone –
00:31:09.660 no one's ever been able to name a monopoly that is better for the consumer.
00:31:13.920 And so, yes, we are attacked for this profit motive.
00:31:21.100 Well, as I said earlier, if these clinics make a profit, more than half of it goes back to the government anyway.
00:31:28.020 And secondly, I have no problem with private non-profit.
00:31:32.060 As long as it's not a government-run, bureaucratically overrun system, fine.
00:31:38.660 But we need competition for the state-run monopoly that defines Canada's health system.
00:31:47.400 Dr. Brian Day, thank you so much for your time.
00:31:50.160 You're welcome.
00:31:51.600 Full Comment is a post-media podcast.
00:31:54.360 I'm guest host Brian Lilly.
00:31:55.600 This episode was produced by Andre Pru with theme music by Bryce Hall.
00:32:00.340 Kevin Libin is the executive producer of Full Comment.
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00:32:21.500 Till next time, I'm Brian Lilly.