00:02:57.360Yeah. So we went over to Japan to take a look at their universal healthcare system. It's a very respected
00:03:03.300universal healthcare system. So, you know, you alluded to this earlier, Candice, but Canadians
00:03:07.720like having a universal system where everyone's covered. You're not going to get bankrupted if you
00:03:13.160need something serious, like maybe knee surgery or heart operation or whatever. So Japan does that.
00:03:20.080The big difference between them and us is that they provide treatment right away, and obviously that's
00:03:26.140not happening in Canada. We're literally dying on waiting this for things like heart operations,
00:03:32.040cataract surgery, whatever. I mean, the stories in this country are awful. I think most people understand that.
00:03:38.420So we went over to Japan to kind of try and find out, you know, what we could learn from their system.
00:03:45.080And the biggest difference between them and us is that it comes to the supply of healthcare.
00:03:51.980So in Japan, they take a totally different approach than Canada.
00:03:56.340They will welcome people to enter their healthcare sector and provide healthcare.
00:04:02.540You want to open up a knee clinic or a hospital or whatever. If you have qualified staff, you can do it in Japan.
00:04:10.420The government says, okay, everyone's covered in the country. And here's how much we pay for different procedures.
00:04:17.400So if it's a knee surgery, I don't know the number uphand, but just I'll make it. Why not?
00:04:23.600Let'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.
00:04:35.540They welcome people to help increase the supply of healthcare.
00:04:39.120In Canada, like I said, we do the opposite. We have governments putting up roadblocks anytime someone wants to start providing healthcare in this country.
00:04:48.140So by restricting supply of healthcare, go figure, you end up with long waiting lists like the ones that you just showed.
00:04:55.760Well, 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.
00:05:02.020And 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.
00:05:09.400Most 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?
00:05:55.360You can see this sort of Japanese temperament, right?
00:05:57.500They're trying to be polite, but they're kind of shocked when you tell them about what things are like in Canada.
00:06:02.020And so can you kind of unpack the reason?
00:06:04.980Like, 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?
00:06:13.120And people don't really pay that much out of pocket when they have major surgeries or even doctor visits.
00:06:17.820Yeah, 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.
00:06:26.600People over there were, like, stunned that Canadians would have to wait so long.
00:06:30.020So 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.
00:06:41.540I mean, this is a novel concept, but they want people to enter.
00:06:45.400If 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.
00:06:52.820So 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.
00:07:03.100So the government sets the rate for how much they will pay for different procedures and that.
00:07:08.320And then everyone knows, okay, these are the terms of agreement.
00:07:11.280If I enter the market, then this is how much I'm going to get compensated for providing these different treatments for patients.
00:07:23.100We have governments putting up stop signs, red lights, whatever, barricades, whatever you want to call it, to restrict the supply of healthcare.
00:07:31.800So, 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.
00:07:47.660Because 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.
00:07:55.340Because our system just isn't set up that way.
00:08:43.180It's like a big government top-down system where government controls everything.
00:08:46.200And 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.
00:08:52.400So much that it doesn't, it doesn't want competition so much so that it will put you out of business.
00:08:57.740The documentary is called Fixing Canada's Healthcare Lessons from Japan.
00:09:03.760First, I want to take a moment to thank the sponsor of today's episode, which is Unsmoke.
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00:09:44.580Okay, 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?
00:09:53.400We always compare ourselves to the Americans.
00:09:55.280We always look at the U.S. healthcare system.
00:10:00.640And yet, one of the things that you do over at Second Street is look outside of the continent for alternatives.
00:10:07.800So, you know, we had this report that Switzerland has much better health care, other countries as well.
00:10:14.120Why hasn't this message gotten through?
00:10:17.060And even in, you know, Canadian provinces run by conservative governments like Ontario and Alberta, we haven't really seen a lot of innovation.
00:10:34.600And 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.
00:10:40.680Europe, in particular, has a lot of better universal health care systems that are delivering better results.
00:10:48.880To your question about why we're not seeing reform happen fast enough in this country.
00:10:54.360The problem is, I see it, because we do a lot of public opinion research, the public is ready for reform.
00:11:03.420A lot of our polls show that people are ready for reform.
00:11:07.100They 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.
00:11:15.440We are one of the top spenders in the world, as you talked about earlier.
00:11:22.820The political class has been very slow to respond.
00:11:25.680And 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.
00:11:41.220But 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.
00:11:53.360So the public understands that it's time for the political class to wake up a little bit.
00:11:57.820Um, 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.
00:12:13.860So 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.
00:12:24.180Now, 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.
00:12:31.740Um, you know, in Ontario, uh, it's some credit to the government there.
00:12:35.820They're starting to partner more with non-government providers for health care because it doesn't have to be at all.
00:12:42.080The services don't have to be delivered by the government.
00:12:44.220The government can fund them, fund other people to deliver the services to the public, whether it's a nonprofit or for-profit entity.
00:12:51.240So Ontario's doing that more, I think that's a positive step.
00:12:55.080We'll have to see how well they've negotiated these contracts.
00:12:57.820Of course, you use different ways to do it better, but it's, uh, it, it looks like it could be promising.
00:13:03.840Um, in Quebec and Alberta, Quebec's been doing this for a number of years where they are funding services to patients.
00:13:10.500This is the fundamental difference I talked about before, where you want to fund services to patients rather than funding assistance.
00:13:17.420So, uh, Quebec is moving more towards, uh, paying for services to incentivize the system to make sure that we're focused on that.
00:13:25.040Uh, and Alberta has announced they are shifting in that direction to change how they find healthcare so that more dollars reach services to patients.
00:13:35.180God began getting caught up in bureaucracy.
00:13:37.140So 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.
00:13:44.820One 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.
00:13:51.040You have the government funded government operated hospitals.
00:13:54.240You also have nonprofit run hospitals, and then you have privately run hospitals.
00:13:57.780And no matter where a patient chooses to go, basically the dollars follow the patients.
00:14:03.180So the subsidy goes wherever you choose, which creates the kind of competition that you would want in any market.
00:14:09.060And it creates more options because, you know, people have the choice to go to the hospital where they have the best experience.
00:14:15.840Um, the overarching, uh, rules are that every single, uh, healthcare professional needs to be certified by the Japanese government.
00:14:22.320So it's not like they're just letting anyone go in and perform surgeries.
00:14:25.420You still have to have the same kind of medical license that you would have in Canada.
00:14:29.520This just seems like such common sense and such a wonderful way to manage, uh, a system.
00:14:34.800Um, do you see a possibility for anything like that ever happening in Canada?
00:14:39.600I 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.
00:14:50.880Um, because most patients don't care if you're getting surgery in a private, a nonprofit or a government facility.
00:14:58.760You 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.
00:15:04.700If you're a patient, you want the surgery done, right?
00:15:13.340So you want to get good, good, uh, service or fast amount of time.
00:15:17.820And when you're walking out of the surgical room or whatever, you don't want to face a big bill.
00:15:23.860I 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?
00:15:29.580It 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.
00:15:37.220So 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.
00:15:49.420Uh, 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.
00:16:05.280Oh, what a, what a novel concept taking, uh, politics and ideology out of healthcare.
00:16:09.820I wanted to show this graph from the Fraser Institute.
00:16:12.400It, uh, shows that the, um, medium weight healthcare wait time has hit 30 weeks, the longest of recording time.
00:16:18.220So 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.
00:16:28.980And so you can see from this graph folks, how much things have grown.
00:16:32.100So 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.
00:16:44.980So 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.
00:16:57.18023 and a half weeks, British Columbia, 29 weeks, Alberta, 40 weeks, 38 weeks.
00:17:03.420I mean, this is, this is not good folks.
00:17:05.640If you are in pain and suffering, uh, you would want to see treatment a lot faster.
00:17:10.200Some 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.
00:17:17.680Young Canadians support private healthcare.
00:17:20.240So 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.
00:17:54.460We can look to Sweden and Japan and France and all these other countries that have a universal system where everyone's covered.
00:18:00.580Uh, and, uh, you can get to, by the way, I think that would kill TI people are seeing the ideology in healthcare.
00:18:07.920It's a lot more, as we talked about Japan, people are getting in right away.
00:18:13.120People are not, they looked at me strange when I was over there and I was talking about people dying on waiting lists.
00:18:18.800Like they cannot believe what is going on in this country.
00:18:21.640And there's, there's one, I'll say this and then I'll, I'll finish.
00:18:24.100But 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.
00:18:37.120Like it just kind of crystallized from, but yeah, it doesn't have to be as bad as it is in this country.
00:18:43.780Well, a hundred percent folks go check out the documentary.
00:18:46.340It's called Fixing Canada's Healthcare Lessons from Japan.
00:18:49.880That is Colin Craig from Second Street.
00:18:51.840Thank you so much for joining us, Colin.