Juno News - Is Ottawa to blame for Canada’s failing health care system？

00:00:00.000 Let's talk about another issue where certainly the legal issues have not been solved by the

00:00:15.720 court. So we perhaps have to look for political solutions. And healthcare is a tremendous example

00:00:21.020 of that. Healthcare choice. It's not really something we have universally available to

00:00:25.400 Canadians. If you are in Quebec, you have that option because the Supreme Court has decided you

00:00:30.720 do, but only in Quebec, not if you live in another province, certainly not in British Columbia. We view

00:00:37.020 healthcare rightfully so as a provincial issue, but there was a piece from Colin Craig, who's the

00:00:42.100 president of secondstreet.org that says we need to put some of the blame on federal gatekeepers as

00:00:48.140 well. He says we should demand healthcare choice from federal political leaders. Colin Craig joins

00:00:54.320 me now. Always good to talk to you, Colin. So yeah, let's just explain the basics here. Why is this

00:00:59.800 an issue that is federal? Well, it's a reality that the federal government gives provincial governments

00:01:06.940 billions of dollars every single year for healthcare. It is a minority position. So when you

00:01:13.960 go to a hospital and you get care or you visit your family doctor, the bulk of the bill is paid for by

00:01:21.100 the provincial government using tax dollars. But they still receive a decent portion. I don't know

00:01:27.120 the exact percentage offhand, but they still receive a decent enough portion that they certainly want

00:01:33.220 to keep Ottawa happy because they don't want to lose those dollars. And so sometimes when provincial

00:01:38.480 governments go to do things that Ottawa doesn't like, they threaten or they actually come in with

00:01:42.760 funding cuts in terms of how much they're giving for healthcare. So that's how Ottawa is tied into

00:01:47.260 this. And it's done through the Canada Health Act, which is basically a funding mechanism

00:01:52.500 in terms of how Ottawa agrees to give provincial governments money for healthcare.

00:01:57.820 So one of the things that I find just so baffling here, and again, we just had Marty Moore on to do

00:02:02.800 the legal stuff. So you and I don't have to go down the legal road, but the Supreme Court has said,

00:02:07.460 yeah, access to a wait list is not access to healthcare. They've said that you should have the

00:02:11.720 right if you have the means available to go and do something else. They've just said this is the case

00:02:15.360 only in one province alone. You know, it would arguably be more of an easy pill to swallow

00:02:21.560 if they had said no across the board. But in this case, someone in British Columbia can't go to the

00:02:26.800 Camby Clinic, but someone in Quebec can go wherever they want to go.

00:02:30.500 Yeah. And just make a distinction for your listeners, because this can get a bit confusing

00:02:35.520 sometimes. And what people don't always pick up on is that it's getting private or non-government

00:02:41.420 care locally. This is the sticking point. As a Calgarian, if I need a hip operation,

00:02:47.700 I cannot pay in Calgary or anywhere else in Alberta. I can fly to British Columbia and pay

00:02:54.500 to get one there. I can fly to certainly Quebec and other provinces. So you actually have the same

00:03:00.480 problem in BC. Someone in Vancouver cannot pay at a private clinic in Vancouver. They can in Calgary.

00:03:08.500 So you see this happening where people... And it's the same doctors that could have just served

00:03:13.340 the person in their own province if legal. Yeah, it's crazy. No other country on the planet does

00:03:20.380 what Canada does in this regard. It makes no sense in terms of cost. You're increasing cost for

00:03:25.920 patients. You're inconveniencing them at a time that usually this is the last thing they need if

00:03:30.720 you've got chronic pain because they're waiting for hip operation. Like last thing you want to do is

00:03:35.540 jump on an airplane and go somewhere else to get it done. So it makes no sense at all. You know,

00:03:41.180 if you're the federal government, I would point out it's bad for the environment, right? To force

00:03:45.940 people to have to travel even further to get the care that you need. But I certainly wouldn't

00:03:50.260 criticize any patient for doing what they can to improve the health of their bodies.

00:03:56.700 When you talk about this in level-headed terms, you know, I think, wow, you know, this is easy.

00:04:01.360 Why isn't every Canadian getting on board with this? But you bring it into the public realm.

00:04:05.200 Certainly, if a politician were to ever say what you're saying, and as just passionate and mild

00:04:09.160 mannered a way, they're going to have the activists jumping saying they're privatizing healthcare, 0.91

00:04:13.440 American healthcare, you're going to be no longer served. If you're, if you don't have money,

00:04:18.080 people are going to go broke. Like you have all of these doom and gloom scenarios,

00:04:20.960 which how do you push back against that? I mean, how do you tell people that actually,

00:04:25.680 no, it increases care for everyone. Yeah. So, I mean, that's really the debate

00:04:31.980 that dominated 20, 30 years ago. And this is why we didn't see any changes back then. The public has

00:04:38.420 shifted and credit to groups that were around before us. And certainly we've been talking about

00:04:43.940 it for several years now. But reality is, there's not two systems on the planet. It's not just Canada

00:04:49.700 or the US. There are lots of countries that have universal systems like Canada, Norway, Sweden,

00:04:57.420 France, you know, throughout the European Union, Australia, New Zealand. And, you know, many,

00:05:03.540 many reports show that they're doing better than Canada. And the key difference is that they give

00:05:08.000 patients the choice between using their public systems, or using non-government options, whether

00:05:14.360 it's a nonprofit clinic, a private clinic, whatever, patients have that choice. We don't typically

00:05:19.440 have that choice, as we've just discussed in Canada. So, I think more and more Canadians

00:05:24.020 understand that. They're on board with it. The polls show that a large majority of Canadians

00:05:29.700 understand that throwing money at the system is not the solution. We spend a lot of money on healthcare

00:05:35.200 in this country. That's not the problem. The problem is that we don't get good results because

00:05:40.160 of the structure of the system. And giving patients choice, it helps take pressure off of the public

00:05:46.600 system. You know, my bet is if we did that across the country, made it easier, the vast majority of

00:05:52.740 people would still use the public system, and that's fine. But you'd probably have maybe around 10-15%

00:05:58.260 that would use non-government options. I mean, that's kind of been the Swedish experience. And who

00:06:05.400 wouldn't want to take 10 or 15% of pressure off of our healthcare system right now? It'd be, you know,

00:06:11.720 a significant benefit. And combined with other reforms, we could ultimately deliver better care

00:06:17.820 for patients. But the response you get to that is, what happens if 10% or 15% of the doctors

00:06:23.780 decide to leave the public system and go to the private system? Then you've not really helped

00:06:27.920 anything. And what's the answer to that? Yeah, I'm glad you raised that because a lot of people

00:06:31.720 raise that point. And what I always respond with is, well, how does Sweden do it? How does Norway do

00:06:37.660 it? How does Australia do it? I mean, all these other countries that perform better than Canada,

00:06:42.360 they have found a way to do it. And often the solution is that they will cap in the United

00:06:47.600 Kingdom, for example, they cap how much time some in the public system can work in the private system.

00:06:53.260 The second thing to keep in mind is that when you have more employers, you end up with more

00:06:58.940 employees. This is something that the Swedes told us when we were in their country last year talking

00:07:04.280 with people about healthcare. And I thought this is a great way of explaining it. Because when you

00:07:08.940 have a more vibrant healthcare sector, you have more choices for people in the healthcare sector in

00:07:14.800 terms of where they want to work. Right now in Canada, you often have doctors and nurses graduating

00:07:20.740 and they look around and often the option is, well, I work in the government system or I go somewhere

00:07:26.900 else. Well, if they had more choices in Canada, then we could retain more doctors, we could retain

00:07:32.040 more nurses, we wouldn't have the shortages that we have right now. And I know it's not perfectly

00:07:37.400 analogous, but I would also say that we could look at the education system. It's another regulated

00:07:41.920 professional designation to be a teacher. We have private schools. We have not seen this mass exodus of

00:07:48.360 public school teachers to private schools because we also forget that people are motivated by different

00:07:52.720 things. People that go into healthcare are motivated by different things. You may really want to be

00:07:56.620 in a hospital and a family medicine practice and you'll stay in the system because it offers you

00:08:01.060 something. Yeah, I mean, I love that example. We've used it too, Andrew, because it's such a good

00:08:05.880 comparison. You, across Canada, we have choices for parents. You can put your kids in the government run

00:08:12.980 system or you can pay for, you know, private school, independent school, whatever. And the vast majority of

00:08:19.500 Canadians still choose the public system and that's totally fine. But when those do decide, some

00:08:23.920 parents decide on private options, again, they're taking pressure off of those, those public school

00:08:29.000 systems. The point about, you know, choice for, for workers is important. Here's a crazy number that

00:08:36.260 we were able to calculate using some data from the state of Michigan is that there's nearly 2000 nurses

00:08:43.140 who live in Ontario and get up each day for work and they cross the border into Michigan

00:08:49.380 primarily working in the Detroit area. Like that is huge. And we talked to them, we surveyed them.

00:08:56.520 We said, well, why are you doing this? And the number one reason it actually wasn't compensation.

00:09:01.000 It was the availability of work. They had the types of work, like positions that they wanted.

00:09:08.120 But the second reason was compensation and right behind it was working conditions. And many of them

00:09:14.600 noted that they could get these jobs in Michigan. They were the way that they wanted them. They had,

00:09:21.740 they were full time, came with benefits. They came with a predictable schedule. I mean, you,

00:09:28.800 you had a competitive environment in Michigan where they were having employer, employers competing to

00:09:35.300 attract these workers and finding ways to give them the type of work arrangements that they wanted. 0.80

00:09:41.160 Whereas in Ontario, they were looking at it and they're looking at the government system and saying,

00:09:45.560 no, I just don't want to work there. And this has been a problem for a long time. You can't blame

00:09:50.040 the current government. You can't blame even, I don't think the former government, because it's just,

00:09:54.340 it's the problem when you have this monopolistic environment.

00:09:58.240 To be honest, I wonder why, I should, I understand why, but if you really think about it, it's quite

00:10:06.760 surprising provinces haven't seen the opportunity in this, because if you're a provincial government

00:10:11.600 and you can come up with a pitch that you can make to voters, which is you will not pay more in taxes,

00:10:17.420 you will not have any reduction in your care, but you will have this added option. And at the very least,

00:10:23.740 even if you can't afford to use it, there will be fewer people on the wait list ahead of you in the public

00:10:27.480 system to get it because, you know, two or three of those folks will go to the system. You've actually

00:10:32.080 eased the healthcare crisis without having to spend a dollar. And I really don't know why

00:10:39.100 provincial governments have not been the ones to take the lead and call for that.

00:10:43.260 They're, they're concerned about funding cutbacks from Ottawa.

00:10:46.940 But to bring the fight to Ottawa, let us do it. I mean, we see provinces on drug decriminalization

00:10:51.740 saying, not as much anymore, but, you know, saying, hey, give us the right to do this.

00:10:57.740 They could do the same thing provincially if they wanted to expend the political capital doing so.

00:11:02.520 They could. I think it would be wise for patients for them to do this. And the easiest,

00:11:08.520 I think, argument they can make going into Ottawa is, look, Ottawa, you're allowing Quebec to do this.

00:11:14.600 Quebecers get more healthcare rights than anyone else in the country. We need to even the playing

00:11:19.460 field and give all Canadians the same rights that Quebecers have. I think that's the argument that

00:11:24.120 needs to be made if you're in BC, Alberta, wherever. I mean, the BC government obviously isn't going

00:11:29.100 to make that argument, but certainly others could in Ontario, you know, Doug Ford could stand up and

00:11:35.120 make that argument. We don't really look at this through a partisan lens, but the bottom line is

00:11:40.680 it would help patients. And it makes sense for elected officials to do it. The public is behind

00:11:47.640 them. This is like I say, this isn't the debate from 20 years ago. The public has heard, they've seen

00:11:52.240 governments do the same tired old approach of throwing money at the system, hoping something's

00:11:56.980 going to work. It hasn't worked. It's failed. It's time to start looking at what these countries

00:12:02.500 that perform better than Canada, what they do. And then we can start copying them and bring our 0.55

00:12:08.200 standards up. And this is one thing among several changes that could be made to improve results for

00:12:14.600 patients.

00:12:14.900 Colin, Craig, always good to talk to you from secondstreet.org. Thanks so much for coming on

00:12:19.960 today.

00:12:20.600 Thanks for having me, Andrew.

00:12:21.960 Thanks for listening to The Andrew Lawton Show. Support the program by donating to True North

00:12:26.440 at www.tnc.news.

Juno News - May 27, 2024

Is Ottawa to blame for Canada’s failing health care system？

Episode Stats

Summary

Transcript