Juno News - Canada’s Health-Care System Is Collapsing

00:00:00.000 Hi, Juno News. Alexander Brown here back for another episode, host of Not Sorry. Thrilled

00:00:07.960 to be here with you three times a week. I'm the director of the National Citizens Coalition. I'm

00:00:12.440 a writer, campaigner, communicator, jack of all trades, master of none. Love reading all your

00:00:17.800 comments. And while you are here, go to junownews.com slash not sorry for 20% off. There's

00:00:24.420 also a great deal heading into the holidays. There's so much great reporting, so many great

00:00:28.460 shows here. So do subscribe. Just when you think Canada's dire healthcare situation can't

00:00:34.080 get worse, along comes the tragic and harrowing case of Jolene Van Alstyne, a Canadian woman

00:00:40.800 forced to seek out assisted suicide because she cannot find a surgeon to treat her rare

00:00:45.880 but treatable illness within her provincial healthcare system in Saskatchewan. In a quickly

00:00:51.600 developing story, Van Alstyne was told she would need to go out of province for the surgery,

00:00:56.780 but she first needed a referral from an endocrinologist. However, none are accepting new patients. She did

00:01:03.500 what she was supposed to. She told the CBC the pain had become so unbearable that she applied for

00:01:08.760 assisted suicide with her appointment scheduled for January 7th next year. Understandably, the public

00:01:15.720 has been appalled. This is failing state levels of bureaucratic just collapse, healthcare collapse,

00:01:22.760 but in a remarkable and compassionate turn, popular American commentator Glenn Beck has stepped up in

00:01:29.380 an effort to fund her surgery. Our system has truly become a global embarrassment. I want you to watch

00:01:36.700 Beck talk about this extraordinary case in a clip from his show on December 10th.

00:01:41.480 She has now just been approved for MAID, assisted suicide, doctor-assisted suicide.

00:01:46.500 And, you know, I have been talking about what's happening up in Canada. It is so bad. So bad. They

00:01:53.940 are, it's the third largest killer now. Doctors are the third largest killer in Canada. This is what

00:02:01.140 happens when you get socialized medicine. This is why part of Obamacare includes the Complete Lives Act,

00:02:09.220 the Complete Lives Plan. It tells you when you can cut people off from medical care. She needs to 1.00

00:02:16.500 remove the remaining parathyroid gland. Well, there's nobody in Saskatchewan, no doctor that does

00:02:22.420 that. This is not a tough call here. But there's nobody in Saskatchewan that does it. Nobody able to

00:02:30.580 perform the surgery. Well, she can go out of Saskatchewan and get that, but she needs a recommendation. Well,

00:02:38.420 she can't get to a doctor to make the recommendation that she needs that surgery. 1.00

00:02:43.220 And so she could go leave the province to go get it someplace else. She's scheduled for assisted suicide 1.00

00:02:48.420 on January 7th. And now she doesn't want that. She'll gladly delay if she can live.

00:02:59.140 But she can't afford the journey. So I said, I'll fly her in. We'll find a way to take care of the

00:03:03.860 hospital costs. I mean, I'm going to need probably some help because I don't know how much this is going to be.

00:03:08.420 But, you know, if you would like to help give, we'll give you some, you know, give you a give,

00:03:12.820 send, go or something to do. What a wonderful gesture. What a shame that it

00:03:18.660 is necessary. The average Canadian needs to understand, and the average Canadian to their

00:03:23.620 credit, and they occasionally get things wrong, cough elections, needs to understand that it is

00:03:29.380 Canada that is hanging on by a thread to this failing socialist healthcare model,

00:03:35.220 not our progressive allies, not our Canada-like friends and neighbors. It's not just about

00:03:42.500 criticizing America for its model, which is far more accessible. You know, our countries we look to

00:03:51.780 and respect, they've all moved on and we have to move on too. We have to better balance our healthcare

00:03:56.900 model. As we're taping this at press time, Beck is even having to work around the apparent fact that

00:04:05.140 Ben Allstein does not have a passport to gain legal entry into the US. But his team has been in touch,

00:04:10.500 even with President Trump's State Department, to show just how extraordinary this effort has been.

00:04:16.820 As Beck says, all I can say for now is they are aware of the urgent lifesaving need, referring to the

00:04:21.540 State Department, and we had a very positive call. For all the generosity on display here that we

00:04:26.820 should be thankful for, that this is what it takes to do right by Canadians utterly abandoned and push 1.00

00:04:32.420 to government suicide over timely care, it's ghastly. All our status quos are failing all at once.

00:04:39.380 This is very much downstream of the liberal decision to break immigration of an aging population,

00:04:44.580 but there are also provinces that fail to innovate and we have clear momentum to drive healthcare

00:04:50.180 change as tens of thousands die needlessly on wait lists and we are offering suicide for the holidays.

00:04:57.780 Every policymaker and bureaucrat involved in this mess should be ashamed of themselves.

00:05:02.580 In a new report from the Fraser Institute, our healthcare wait times on referral have hit the second

00:05:07.940 worst ever at an astonishing 28.6 weeks that shouldn't be acceptable. Alberta is working to 0.99

00:05:15.540 modernize. All should join them. Let's talk to Nadeem Esmail, director of health policy at the Fraser

00:05:21.540 Institute, who helped co-author this study. And first, a word from our sponsor.

00:05:26.740 I want to give a quick word from our sponsor, Albertans Against No-Fault Insurance. So did you

00:05:32.420 know that the Alberta government is overhauling its auto insurance system under a new model called

00:05:36.820 Care First? Coming into effect in 2027, most Albertans injured in car accidents will no longer

00:05:41.220 be able to sue the at fault driver. Instead, decisions about your care and compensation will

00:05:45.540 be made by the insurance company, not your doctor, not the courts. Critics say this system puts insurance

00:05:50.580 companies first and removes key rights from victims and their families. Nadeem Esmail, director of health

00:05:56.260 policy at the Fraser Institute joins the show. Nadeem, thanks for being here. Thanks for having me on the show.

00:06:01.940 Nadeem, I wanted to start with a news of the day piece here before diving into this important

00:06:06.500 Fraser Institute study. Jolene Van Alstyne, this poor woman in Saskatchewan being led towards

00:06:12.340 assisted suicide because she's trapped in a failing healthcare bureaucratic nightmare. Glenn Beck is

00:06:18.500 stepping up. Canadians are trying to step up. What does it say about our system that she seemingly had

00:06:24.180 no options here, but the worst possible option? It's remarkable. And her story is not unique. We hear

00:06:29.860 these stories all across the country, all the time in the media. The woman in New Brunswick who was going

00:06:35.220 into MAID, but then finally was able to get her surgery in the United States, the individual who

00:06:39.780 left emergency and died on top of the 1.3 million Canadians who walked out of emergency rooms last

00:06:45.700 year. This is a healthcare system that is not living up to the needs of Canadians in spite of the fact that

00:06:51.540 taxpayers are paying for one of the most expensive universal access healthcare systems in the developed

00:06:56.420 world. It's a tragedy. It is. And I was reading that Second Street study as well from a couple weeks

00:07:04.020 ago where it's, gosh, it was tens of thousands of Canadians died on wait lists last year. And we're

00:07:10.660 all just supposed to, you said before we hopped on the call, this sort of tyranny of the status quo,

00:07:16.500 that that has become acceptable in any sort of way is so unfortunate. When it comes to the Fraser study,

00:07:22.500 which came out a day ago as of taping here, it's not good news, but maybe I'm stretching for a silver

00:07:29.460 lining to a cloud here, but it's not all bad news. What factors contributed most to the decrease

00:07:36.660 in a national median wait time from 30 weeks in 2024 to still 28.6 weeks in 2025?

00:07:44.740 I think the simplest way to put it is it's hard to spend this much money on healthcare without

00:07:48.660 getting a little something in return. That was mostly a gain on the specialist to treatment

00:07:55.300 wait time. The wait to see a specialist actually went up. So it's a little longer to see a specialist

00:07:59.300 now, but once you've got into that specialist office, it seems to be a little shorter. But

00:08:03.140 let's remember, this is the second longest wait time we've ever measured in the history of the

00:08:07.780 report since 1993. And we're still up at more than three times the weight that it was back in 93. So

00:08:13.620 we're still spending an awful lot of money on healthcare to get some of the worst waiting 0.84

00:08:16.820 lists in the developed world. Yeah, I recently, to be relatable to the audience, I had my own

00:08:25.220 circumstance where I was and I'm and I'm okay now, but I was I was passed along for for a referral. And

00:08:31.380 I had the doctor at this clinic, because I don't have a family doctor, I'm a young Canadian,

00:08:36.900 so I don't have a family doctor, like all but broke down saying like, I want, you know, you to get

00:08:41.940 this checked out as soon as possible, but it is going to be months and months and months. And we

00:08:46.260 were lucky that in that long period, that you know, things were benign. But the fact that that is the

00:08:52.340 norm is so unfortunate. Nadim, I want to touch on a number that jumps out for me jumps out to me from

00:08:59.460 your study. Across 10 provinces, the study estimated that patients in Canada were waiting for 1.4 million

00:09:06.100 procedures in 2025. Embedded in this report is the line, even if one debates the reliability of waiting

00:09:12.180 list data. This survey also reveals that wait times in Canada are longer than what physicians

00:09:17.300 consider to be clinically reasonable. What would be clinically reasonable? We do ask physicians each

00:09:24.500 year, not only what are the weights to get into their their services, but what would they consider

00:09:28.740 to be clinically reasonable? Now, let's be clear. Clinically reasonable is not reasonable for the

00:09:32.900 patient. Clinically reasonable means a woman with a lump in her breast can wait four weeks and 0.84

00:09:38.180 epidemiologically will have no difference in outcomes having experienced that delay. But

00:09:42.900 imagine waiting four weeks with a lump in your chest that might be trying to kill you.

00:09:47.220 These are medically reasonable wait times that in theory do not have a meaningful impact on the

00:09:51.700 outcome from the service. And even there, we are substantially longer than what physicians

00:09:56.100 think is clinically reasonable, at least 50% longer. And what's particularly alarming about that,

00:10:01.060 of course, is physicians' measures of clinical reasonableness have been getting

00:10:04.740 more relaxed over time. Physicians used to be much stricter in earlier years of the survey about

00:10:09.620 what they thought was clinically reasonable. They now are more willing to accept longer wait times

00:10:13.940 than they were in the past, which I don't think Canadians have changed in the last 30 years,

00:10:17.620 but physicians' acceptance of waiting time sure has. Yeah. And that's an interesting

00:10:23.620 feature for the study that you also have one of the key subjects here is adjusting for disappointment,

00:10:30.180 in a sense, that they're working within a system that they know rife with delays. And so it might

00:10:38.580 not be, I guess, clinically reasonable as sort of in the eye of the beholder. It's like whether they like

00:10:42.820 it or not, it's maybe this is the timeframe they anticipate. Now, why would the wait times vary so

00:10:49.060 significantly in the study between provinces? So Ontario is at 19.2 weeks versus New Brunswick,

00:10:56.100 which if you look at the graph too, it's mind blowing. It's like 60.9. What the heck's going on

00:11:01.300 there? We've always historically seen longer wait times in Atlantic Canada relative to central Canada.

00:11:07.700 Is that an aging population thing? It could be an aging population thing. There are also some

00:11:13.060 some smaller differences in terms of how the healthcare bureaucracies are structured in the

00:11:16.820 internals of the healthcare systems between the provinces. So we will see different levels of

00:11:21.060 efficiency, which a number of reports have looked at where you do have differences in spending and

00:11:25.380 access across this country. But historically, we've always seen Atlantic Canada lagging when

00:11:29.700 it comes to wait times. The prairie is not doing particularly well. And then central Canada is

00:11:33.780 doing a little bit better. It's when we step back and recognize that, in fact, the nation as a whole

00:11:38.500 is doing quite poorly. But certainly within this country, we don't have equal access to healthcare.

00:11:43.460 It is certainly better depending on where you happen to live.

00:11:46.500 Yeah, we have equal access to wait lists is the joke I hear, not equal access to healthcare.

00:11:52.100 What explains the large increases in wait times for specialties like an elective cardiovascular

00:11:58.580 surgery, as if there is such a thing as an elective cardiovascular surgery? But what are you seeing

00:12:04.260 there that explains that? I think if we look at the distribution of wait times, what we see is those

00:12:09.620 things that won't kill you will tend to have longer waits than those things that just might. So very short

00:12:14.980 wait times for cancer surgeries, medical oncology, radiation oncology, cardiovascular surgery, elective

00:12:21.620 cardiovascular surgery, so non urgent, but still important is sitting at about 20 weeks nationally.

00:12:26.900 And then we get into the almost one year long waits where we're looking at medically necessary plastic

00:12:31.540 surgery, neurosurgery, orthopedic surgery, patients could be debilitated, patients may die from that same

00:12:38.340 cause, or maybe an unrelated cause, but they had a worse life as they went to their final days.

00:12:43.060 But these are generally speaking, not things that are going to result in immediate death. So

00:12:47.620 they wait. And unfortunately, that's how the Canadian healthcare system works. It's

00:12:51.540 fairly good at dragging people back from the brink of death, it's just going to treat them terribly,

00:12:55.460 if not inhumanely in the process of doing so.

00:12:57.940 Yeah, when I have friends from other countries ask about Canada's healthcare and like the actual

00:13:02.740 unvarnished reality, it's like if you're dying right away, you know, it has its advantages. But

00:13:08.900 if you're in any sort of mushy middle ground, you're in for it. And that remains a concern.

00:13:15.620 Why are diagnostic wait times like 18.1 weeks for MRIs continuing to rise? Is that,

00:13:22.340 is that population numbers? 18.1 weeks?

00:13:26.660 And I guess separate question, does the Canadian public know you can get same day

00:13:30.580 non-emergency MRIs in the United States?

00:13:33.300 Or indeed, same day non-emergency MRIs in Quebec or in Alberta and Saskatchewan where you're allowed

00:13:38.980 to purchase them, just not in other provinces. I think Canadians would be blown away to know you

00:13:43.300 get same day MRIs in Germany as a universal access healthcare system public patient. But this is the

00:13:48.420 Canadian experience.

00:13:49.860 We certainly have expanding wait times for diagnostics. In part, this will be population

00:13:53.700 growth. Obviously, it'll be aging of the population. It'll be the public system not

00:13:57.860 keeping up with the investments it needs to be making in spite of spending a lot of money.

00:14:02.180 There's also a reality that over time, medicine is becoming more reliant on diagnostics. Physicians

00:14:06.980 want more information about what's happening and more routine follow-up information. That increased

00:14:11.940 demand is going to drive increased use of services, which unfortunately in a ration system is going to mean

00:14:17.540 more waiting for healthcare.

00:14:18.660 Yeah. Nadim, one thing I've been curious about, how do inconsistencies in provincial

00:14:25.700 data reporting affect the accuracy of a study like this in national comparisons? I know that

00:14:32.100 from reading that Second Street study recently on the amount of Canadians who died on waitlists

00:14:37.220 included the caveat that BC and Quebec provide less timely numbers, so they're viewed as potentially

00:14:44.340 influencing that final number. How do you adjust for that? What's the big difference looking from

00:14:50.500 province to province?

00:14:51.460 Our study uses proprietary data, so we actually survey medical specialists across the country

00:14:56.580 and ask them specifically for their wait times in their practice, which we then aggregate up using

00:15:01.620 the number of procedures actually completed to give us specialty, provincial, and national medians.

00:15:06.500 We have used the same procedure since 1989 when we first began measuring in British Columbia.

00:15:11.380 1993 was our first national measurement, so this is Canada's only comparable, comprehensive,

00:15:16.340 and national measurement of waiting times for medically necessary services. Even if you disagree

00:15:21.060 with the numbers specifically, the consistency of the methodology allows us to very clearly trend

00:15:25.540 growth and reduction, which means even if you don't agree it's 28.6 weeks this year, it is substantially

00:15:31.700 longer than it was just five years ago and much, much longer than it was 30 years ago.

00:15:36.500 Yeah, and speaking of that substantial increase, I mean, what future trends do you anticipate for

00:15:43.060 wait times here, given the 208% increase since 1993?

00:15:47.940 The reality is ours is a healthcare system offering low expectations, cloaked in lofty

00:15:53.460 rhetoric. Nothing is changing on the ground outside of Alberta making some very important reforms.

00:15:58.740 Largely across Canada, the healthcare systems are as they were, and these wait times are not the result of

00:16:03.460 a lack of spending. We have some of the highest expenditures for healthcare in the developed world.

00:16:07.780 They're the result of poor policy choices, and those policy choices are going to drive

00:16:12.180 ever longer waiting times until we resolve them. Let's look internationally. Australia, Sweden,

00:16:18.260 Switzerland, Germany, the Netherlands, higher performing universal access healthcare systems in ours,

00:16:23.380 more timely healthcare, and all of them, 100% of them, have user fees, cost sharing for access to the

00:16:29.300 healthcare system, private competition in the delivery of hospital services, and a private

00:16:34.100 parallel option like exists in Quebec and like is soon going to exist in Alberta, but that doesn't

00:16:39.060 exist anywhere else in this country. So we've chosen the wrong set of policies. Those policies have

00:16:44.100 resulted in very long wait times, and by doing nothing about it, we're just going to get longer wait

00:16:48.900 times next year and the year after. Yeah, and the myth of what we're protecting too, like it's us and

00:16:55.140 the our worldly progressive allies. It's like we are like increasingly out on the on a melting ice

00:17:01.860 flow when it comes to this stubbornness. It is, yeah, it's all those countries you mentioned, it's

00:17:06.340 Japan. And then there's us, where it's like us, Cuba and North Korea are like, you know, from our

00:17:11.540 actual cold dead hands, we're not giving this up. Now, should we just what's the what would be the your

00:17:17.460 recommendation coming out of coming out of this paper? Like, should we just be going down the Alberta

00:17:21.780 route? Should we be following Daniel Smith's lead? Should we be? Is there a specific European

00:17:26.660 nation or Asian nation that offers the path forward? What would you like to see as sort of

00:17:31.460 the director of health policy here with Fraser Institute? The reality is waiting has become a

00:17:36.420 defining characteristic of the Canadian healthcare experience, and it is one of Canada's most solvable

00:17:40.980 healthcare problems. We can fix this. Premier Smith is certainly moving in a great direction, but

00:17:45.860 it's not far enough. Let's look at Switzerland. This is a healthcare system that delivers some of the

00:17:51.060 most timely access to healthcare in the developed world, some of the highest quality universal access

00:17:55.860 healthcare in the developed world, and does it for about the same as we spend. They have a very

00:18:00.420 competitive system. They have private insurance actually delivering the universally accessible

00:18:05.060 insurance product. As an individual, you buy insurance from a mandatory insurer, and that insurer

00:18:10.420 looks after you, not the government. The government just makes sure you have the insurance. There's a

00:18:14.260 competitive hospital sector. There's cost sharing. You have to pay a deductible before your insurance

00:18:18.420 kicks in, and you have to pay user fees after that to another limit before the insurance takes over

00:18:23.140 completely. In Switzerland, patients are not prisoners of the bureaucratic will. They can buy

00:18:27.460 any healthcare services they wish if they simply desire to do so for their own preferences. This is

00:18:33.300 a healthcare system that functions so much better than the Canadian model. Yes, Premier Smith's reforms are

00:18:38.180 moving us in that direction, but we can go much, much further and really solve this waiting times

00:18:43.300 problem. It's notable that Netherlands in the 1990s had a waiting times problem. Nowhere near as bad

00:18:48.180 as ours, but they did have one. They decided to copy the Swiss model, and now they don't have a waiting

00:18:52.980 times problem. In fact, their wait times are now shorter than those in Switzerland who they copied.

00:18:57.860 Wow. So there's the model. It's terrifically important work from the Fraser Institute. I'm going

00:19:02.820 to be sharing this in the show notes. I hope everyone checks it out. Nadim, thank you so much for

00:19:07.300 joining us today. Thanks for having me on the show.

Juno News - December 11, 2025

Canada’s Health-Care System Is Collapsing

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