Juno News - How can we fix Canada’s failing healthcare system？ Let’s look to Japan

00:00:00.000 Hi, I'm Candice Malcolm, and this is The Candice Malcolm Show. We have a great episode for you

00:00:06.440 today, folks. We will be joined by Colin Craig from Second Street in just a minute. And this

00:00:10.360 episode is brought to you by Unsmoke, our sponsor, but more on them later. So today we're going to

00:00:15.080 focus in on the state of Canadian healthcare. We talk about it from time to time on the show,

00:00:20.300 and it is worth repeating. Just every time I see this headline, this story, it doesn't cease to

00:00:24.900 amaze me. It is shocking. Nearly 75,000 Canadians have died on healthcare waiting lists since 2018.

00:00:31.440 75,000 Canadians have died since 2018. At least 15,474 Canadians died last year while waiting for

00:00:39.000 healthcare. But the actual number is probably double a new study shows. So according to

00:00:43.540 secondstreet.org, when jurisdictions that provide no date accounted for the actual number of Canadians

00:00:48.620 who died is likely closer to 28,000. Folks, this is not normal. This is not okay. I know that Canadians 1.00

00:00:54.040 take great pride in the fact that we have universal coverage for healthcare, that nobody goes uncovered

00:00:58.800 and that nobody goes bankrupt trying to pay for their healthcare. But that doesn't make our healthcare

00:01:03.020 system good, and it is not acceptable in an advanced, wealthy country like Canada for us to continue to

00:01:08.520 place at or near the bottom of every ranking system on the OECD. I mean, look at these stories.

00:01:14.500 Hundreds of people line up to get a family doctor in Kingston. You can see the images from February 2024,

00:01:20.300 or again, back in January 2025, hundreds of Canadians lined up in Brockton, Ontario, in hopes of securing

00:01:28.280 a family doctor. So no, this is not a Soviet era breadline that I'm showing you. It's Canada's

00:01:35.380 equivalent. It's the modern day equivalent. You've got your Canadians out in the snow with their 1.00

00:01:38.800 timmies waiting for the chance to possibly have the privilege of talking to a doctor, talking to a family

00:01:46.180 doctor. That is what things have come to today. And another story from the Fraser Institute show that

00:01:52.560 Canadians are paying more for healthcare, but they're getting less. Canada has fewer doctors,

00:01:57.120 hospital beds, and MRIs among longer wait times in other countries with universal healthcare. So even

00:02:02.580 when you isolate for just other countries that have the same type of healthcare that we do, universal

00:02:06.720 healthcare paid by the government, we are still the worst. Among 31 high-income universal healthcare

00:02:12.320 healthcare countries, Canada ranks among the top third in spenders, but receives average to poor

00:02:17.400 value in return. And so our friend today, Colin Craig, who's doing the episode, is trying to do

00:02:24.000 something about this. He has released a new documentary where he compares Japan's universal healthcare

00:02:30.120 system to Canada's. The documentary is released by secondstreet.org, and you should go check that out.

00:02:36.840 So Colin Craig, he's a public policy advocate and president of secondstreet.org, where he focuses on

00:02:42.880 issues related to healthcare challenges in Canada. Colin, welcome to the show. Thank you for joining us.

00:02:48.080 Well, thanks for having me, Candice.

00:02:50.060 Okay. Well, tell us about this documentary that you have released. What was the purpose of it,

00:02:54.840 and what did you find?

00:02:57.360 Yeah. So we went over to Japan to take a look at their universal healthcare system. It's a very respected

00:03:03.300 universal healthcare system. So, you know, you alluded to this earlier, Candice, but Canadians

00:03:07.720 like having a universal system where everyone's covered. You're not going to get bankrupted if you

00:03:13.160 need something serious, like maybe knee surgery or heart operation or whatever. So Japan does that. 0.99

00:03:20.080 The big difference between them and us is that they provide treatment right away, and obviously that's

00:03:26.140 not happening in Canada. We're literally dying on waiting this for things like heart operations,

00:03:32.040 cataract surgery, whatever. I mean, the stories in this country are awful. I think most people understand that.

00:03:38.420 So we went over to Japan to kind of try and find out, you know, what we could learn from their system.

00:03:45.080 And the biggest difference between them and us is that it comes to the supply of healthcare.

00:03:51.980 So in Japan, they take a totally different approach than Canada.

00:03:56.340 They will welcome people to enter their healthcare sector and provide healthcare.

00:04:02.540 You want to open up a knee clinic or a hospital or whatever. If you have qualified staff, you can do it in Japan.

00:04:10.420 The government says, okay, everyone's covered in the country. And here's how much we pay for different procedures.

00:04:17.400 So if it's a knee surgery, I don't know the number uphand, but just I'll make it. Why not?

00:04:23.600 Let's say it's $10,000. And anyone who enters that market knows that, okay, the government's going to be providing

00:04:30.320 $10,000 per knee surgery. So it's a very welcoming approach.

00:04:35.540 They welcome people to help increase the supply of healthcare.

00:04:39.120 In Canada, like I said, we do the opposite. We have governments putting up roadblocks anytime someone wants to start providing healthcare in this country.

00:04:48.140 So by restricting supply of healthcare, go figure, you end up with long waiting lists like the ones that you just showed.

00:04:55.760 Well, one of the things that's so interesting from the documentary is that they just don't really seem to have real wait times in Japan.

00:05:02.020 And I'm going to play a short trailer from the documentary because you speak to a lot of people, people who work in hospitals, doctors, advocates, all this kind of thing.

00:05:09.400 Most people say, you know, average, you wait like maybe a couple of days or two weeks max when you need a surgery, which, you know, to the Canadian here, it's like, wait, what?

00:05:17.760 How is that even possible?

00:05:19.140 Well, you explore that.

00:05:20.240 So let's play this clip from the documentary Fixing Canada's Healthcare Lessons from Japan.

00:05:26.880 We're in Japan this week to learn more about their universal healthcare system

00:05:30.580 and how they have virtually no healthcare wait times.

00:05:33.720 Come on, let's go find out.

00:05:35.240 The wait time is not very long.

00:05:37.940 Basically, no wait time.

00:05:39.820 Do you have any wait times that are measured in years?

00:05:42.740 Not particularly.

00:05:44.460 How long waiting time while in Canada?

00:05:47.520 Sometimes a year.

00:05:48.860 Sometimes a year?

00:05:49.660 Yeah.

00:05:49.960 A year?

00:05:50.600 Yeah.

00:05:54.100 Really interesting stuff.

00:05:55.360 You can see this sort of Japanese temperament, right?

00:05:57.500 They're trying to be polite, but they're kind of shocked when you tell them about what things are like in Canada.

00:06:02.020 And so can you kind of unpack the reason?

00:06:04.980 Like, why is it that there's so much innovation, there's so many options, there's so many choices in Japan, and yet they're still able to maintain that universal coverage?

00:06:13.120 And people don't really pay that much out of pocket when they have major surgeries or even doctor visits.

00:06:17.820 Yeah, that last doctor in the clip there, he was asking how long the wait times are in Canada, because he couldn't believe it when I said it was a year.

00:06:25.460 Like, they were shocked.

00:06:26.600 People over there were, like, stunned that Canadians would have to wait so long.

00:06:30.020 So to your question about how, the big difference is that in Japan, they welcome people to enter their healthcare sector and start providing care for patients.

00:06:41.540 I mean, this is a novel concept, but they want people to enter.

00:06:45.400 If you have a, you know, qualified staff, obviously, but you can go in and open up a clinic that maybe does knee surgeries, or maybe you open up a hospital.

00:06:52.820 So they openly welcome it, because the government doesn't really care who's providing it, as long as it's, you know, qualified people and that they can help patients.

00:07:03.100 So the government sets the rate for how much they will pay for different procedures and that.

00:07:08.320 And then everyone knows, okay, these are the terms of agreement.

00:07:11.280 If I enter the market, then this is how much I'm going to get compensated for providing these different treatments for patients.

00:07:18.020 So it's much easier.

00:07:19.380 It's very straightforward.

00:07:20.280 In Canada, we find the opposite.

00:07:23.100 We have governments putting up stop signs, red lights, whatever, barricades, whatever you want to call it, to restrict the supply of healthcare.

00:07:31.800 So, Candace, tomorrow, if, let's say, you wanted to open up a, whatever, knee surgical clinic somewhere in Canada and start doing like they do in Japan, where you would, you know, have staff providing knee operations to people, you can't really do that in Canada.

00:07:47.660 Because you would have to come up with some agreement with the government where they kind of go, oh, okay, well, we're going to pay you X amount.

00:07:55.340 Because our system just isn't set up that way.

00:07:57.820 They fund services to patients.

00:08:00.580 Our systems fund, or our governments fund health systems.

00:08:04.840 So they throw money into the system and then hope that patients get a lot of treatment or healthcare services out of it.

00:08:11.960 So a lot of our dollars get grinded down in bureaucracy just because of the structure is so different.

00:08:18.420 So we restrict the supply.

00:08:20.000 You end up with long waiting lists.

00:08:21.480 And if you want to, let's say you want to, don't want to wait in the public system in this country and you want to pay privately.

00:08:28.420 Well, government barriers are there to stop that from happening.

00:08:30.880 And you can't do that in your province with the exception of Quebec.

00:08:34.460 So this is why patients travel to other provinces to pay for treatment.

00:08:38.480 So we've got it all backwards and lo and behold, that's why we have long wait times.

00:08:42.640 Well, 100%.

00:08:43.180 It's like a big government top-down system where government controls everything.

00:08:46.200 And if you try to innovate, like we saw with the Day Clinic in British Columbia, the Cammy Day Clinic, the government will sue you out of existence.

00:08:52.400 So much that it doesn't, it doesn't want competition so much so that it will put you out of business.

00:08:57.740 The documentary is called Fixing Canada's Healthcare Lessons from Japan.

00:09:02.080 I got a few more questions for you.

00:09:03.760 First, I want to take a moment to thank the sponsor of today's episode, which is Unsmoke.

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00:09:44.580 Okay, Colin, I want to ask you, because basically, you know, we've been talking about this for a long time, that other alternative countries exist, right?

00:09:53.400 We always compare ourselves to the Americans. 0.82

00:09:55.280 We always look at the U.S. healthcare system.

00:09:56.720 It makes sense.

00:09:57.340 We share a continent with them.

00:09:58.540 We have similar sorts of populations.

00:10:00.640 And yet, one of the things that you do over at Second Street is look outside of the continent for alternatives.

00:10:07.800 So, you know, we had this report that Switzerland has much better health care, other countries as well.

00:10:14.120 Why hasn't this message gotten through?

00:10:17.060 And even in, you know, Canadian provinces run by conservative governments like Ontario and Alberta, we haven't really seen a lot of innovation.

00:10:25.560 Why do you think that is?

00:10:27.400 Yeah, it's a very good question, because there's so many models we could learn from.

00:10:31.620 So we, you know, this year we just talked about it.

00:10:33.620 We went to Japan.

00:10:34.600 And we also have a video on our site, if anyone's interested, where we look at Sweden's health care system, as well as France's health care system.

00:10:40.680 Europe, in particular, has a lot of better universal health care systems that are delivering better results.

00:10:47.540 So there's a lot to learn from.

00:10:48.880 To your question about why we're not seeing reform happen fast enough in this country.

00:10:54.360 The problem is, I see it, because we do a lot of public opinion research, the public is ready for reform.

00:11:03.420 A lot of our polls show that people are ready for reform.

00:11:07.100 They can see that the past few decades of throwing money at the health care system and hoping something would magically work, they can see that hasn't worked.

00:11:15.440 We are one of the top spenders in the world, as you talked about earlier.

00:11:18.820 We're not getting bang for our buck.

00:11:21.060 So the public is ready for reform.

00:11:22.820 The political class has been very slow to respond.

00:11:25.680 And I think part of the problem is that a lot of people in the political class have long memories, and they're still thinking that this is the debate from 20, 30 years ago, where health care reform was something that politicians just did not want to talk about because it was too controversial.

00:11:41.220 But now the public understands that, you know, there are better systems out there in Europe, countries like Japan, Australia, and others that we could be learning from and copying their policies.

00:11:53.360 So the public understands that it's time for the political class to wake up a little bit.

00:11:57.820 Um, something that was encouraging though, and we do have these encouraging signs in different parts of the country and British Columbia last, uh, in their last election, uh, one party there, the conservatives, uh, campaigned on a pretty bold platform to reform health care.

00:12:13.860 So instead of, you know, as political operatives will say, instead of a shield issue where they're kind of playing defense, they were, they saw it as a sword where they could go out and aggressively campaign on it.

00:12:24.180 Now, you know, I think it could have made communicative things better than that, but at least they were willing to kind of stick their neck out and start talking about it.

00:12:31.740 Um, you know, in Ontario, uh, it's some credit to the government there.

00:12:35.820 They're starting to partner more with non-government providers for health care because it doesn't have to be at all.

00:12:42.080 The services don't have to be delivered by the government.

00:12:44.220 The government can fund them, fund other people to deliver the services to the public, whether it's a nonprofit or for-profit entity.

00:12:51.240 So Ontario's doing that more, I think that's a positive step.

00:12:55.080 We'll have to see how well they've negotiated these contracts.

00:12:57.820 Of course, you use different ways to do it better, but it's, uh, it, it looks like it could be promising.

00:13:03.840 Um, in Quebec and Alberta, Quebec's been doing this for a number of years where they are funding services to patients.

00:13:10.500 This is the fundamental difference I talked about before, where you want to fund services to patients rather than funding assistance.

00:13:17.420 So, uh, Quebec is moving more towards, uh, paying for services to incentivize the system to make sure that we're focused on that.

00:13:25.040 Uh, and Alberta has announced they are shifting in that direction to change how they find healthcare so that more dollars reach services to patients.

00:13:35.180 God began getting caught up in bureaucracy.

00:13:37.140 So there, there's some changes we do need to see a heck of a lot more, uh, so that we can be with these patients suffering in his home trip.

00:13:44.820 One of the things I learned from your documentary, Colin, is that in Japan, they have sort of three different types of hospitals that you can go to.

00:13:51.040 You have the government funded government operated hospitals.

00:13:54.240 You also have nonprofit run hospitals, and then you have privately run hospitals.

00:13:57.780 And no matter where a patient chooses to go, basically the dollars follow the patients.

00:14:03.180 So the subsidy goes wherever you choose, which creates the kind of competition that you would want in any market.

00:14:09.060 And it creates more options because, you know, people have the choice to go to the hospital where they have the best experience.

00:14:15.840 Um, the overarching, uh, rules are that every single, uh, healthcare professional needs to be certified by the Japanese government.

00:14:22.320 So it's not like they're just letting anyone go in and perform surgeries.

00:14:25.420 You still have to have the same kind of medical license that you would have in Canada.

00:14:29.520 This just seems like such common sense and such a wonderful way to manage, uh, a system.

00:14:34.800 Um, do you see a possibility for anything like that ever happening in Canada?

00:14:38.760 Uh, yes.

00:14:39.600 I mean, it, it's a little bit similar to what I was just talking about, what Alberta is doing and, um, uh, Quebec where the government, if think about it, they've taken ideology out of healthcare.

00:14:50.880 Um, because most patients don't care if you're getting surgery in a private, a nonprofit or a government facility.

00:14:58.760 You don't care if the nurse who's helping out with the surgery, if she's in the United States or not, no one cares about any of that stuff.

00:15:04.700 If you're a patient, you want the surgery done, right?

00:15:08.040 That's probably your top concern.

00:15:10.400 You don't want to wait alone time for it either.

00:15:13.120 Right.

00:15:13.340 So you want to get good, good, uh, service or fast amount of time.

00:15:17.820 And when you're walking out of the surgical room or whatever, you don't want to face a big bill.

00:15:23.860 I think these are the three things that Canadians are much concerned about now, but that's kind of how they approach it in Japan, right?

00:15:29.580 It doesn't matter if it's a non-profit or for-profit, they'll fund, the money follows the patient, the patient decides which facility works best for them.

00:15:37.220 So with Alberta shifting to this model where they are funding, uh, services, there's nothing stopping them from saying, well, yeah, you could get that service done in a private clinic or a non-profit or whatever.

00:15:49.420 Uh, so we'll see how all-profit ultimately rolls things out, but, uh, uh, uh, it, it, once you start to change how you're funding healthcare, it makes it a lot easier to start taking ideology out of healthcare and really putting patients right at the center of the system.

00:16:05.280 Oh, what a, what a novel concept taking, uh, politics and ideology out of healthcare.

00:16:09.820 I wanted to show this graph from the Fraser Institute.

00:16:12.400 It, uh, shows that the, um, medium weight healthcare wait time has hit 30 weeks, the longest of recording time.

00:16:18.220 So in 2024 physicians across Canada reported average wait times of 30 weeks, uh, between the referral from a GP to the receipt of, uh, treatment up from 27 weeks.

00:16:28.980 And so you can see from this graph folks, how much things have grown.

00:16:32.100 So the blue line shows 1993 wait times, uh, you know, averages were much shorter, actually, it's sort of more like what Colin experienced in Japan that you can get a surgery done in a couple of weeks.

00:16:42.840 Um, now it is nothing like that.

00:16:44.980 So in a place like Prince Edward Island, you might wait as long as 77 weeks for a surgery, uh, New Brunswick, 70 weeks, uh, you know, even the fastest province, Ontario, you were still waiting on average.

00:16:57.180 23 and a half weeks, British Columbia, 29 weeks, Alberta, 40 weeks, 38 weeks.

00:17:03.420 I mean, this is, this is not good folks.

00:17:05.640 If you are in pain and suffering, uh, you would want to see treatment a lot faster.

00:17:10.200 Some good news though, that I'll, I'll finish the interview on con, which is that young Canadians, uh, have more support for changes and innovations in the system.

00:17:17.680 Young Canadians support private healthcare.

00:17:20.240 So according to a research company poll done in May of 2025, 36% of Canadians now believe that the healthcare system should be operated in the private sector.

00:17:29.780 Nearly half disagree.

00:17:31.220 Um, but Canadians aged 18 to 34 had the highest rate, um, saying that they would, uh, approve of, um, private healthcare.

00:17:39.460 So, uh, what do you make of that?

00:17:41.260 Yeah, I think young people can see too, the system is not working.

00:17:45.220 And, you know, like I said at the top, Candace, the good news is that Canadians like this idea of universality.

00:17:52.060 And we can see that we can keep that.

00:17:54.460 We can look to Sweden and Japan and France and all these other countries that have a universal system where everyone's covered.

00:18:00.580 Uh, and, uh, you can get to, by the way, I think that would kill TI people are seeing the ideology in healthcare.

00:18:07.920 It's a lot more, as we talked about Japan, people are getting in right away.

00:18:13.120 People are not, they looked at me strange when I was over there and I was talking about people dying on waiting lists.

00:18:18.800 Like they cannot believe what is going on in this country.

00:18:21.640 And there's, there's one, I'll say this and then I'll, I'll finish.

00:18:24.100 But this one medical director of the hospital at Osaka, we were talking and I was explaining like our system and the suffering and the government bans on access to healthcare and kind of sat back in its chair and said, oh, I see why you came here.

00:18:37.120 Like it just kind of crystallized from, but yeah, it doesn't have to be as bad as it is in this country.

00:18:43.780 Well, a hundred percent folks go check out the documentary.

00:18:46.340 It's called Fixing Canada's Healthcare Lessons from Japan. 0.96

00:18:49.880 That is Colin Craig from Second Street.

00:18:51.840 Thank you so much for joining us, Colin.

00:18:53.020 Thanks a lot, Candice.

00:18:54.280 Always appreciate the conversation.

00:18:56.000 All right, folks.

00:18:56.580 Have a great afternoon.

00:18:57.920 Back again tomorrow.

00:18:59.060 Thank you so much.

00:18:59.760 I'm Candice Malcolm.

00:19:00.340 This is the Candice Malcolm Show.

00:19:01.140 Thank you and God bless.

Juno News - August 21, 2025

How can we fix Canada’s failing healthcare system？ Let’s look to Japan

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