Juno News - April 01, 2024


Majority of Canadians want “major changes” to healthcare system


Episode Stats

Length

13 minutes

Words per Minute

185.04993

Word Count

2,483

Sentence Count

116

Misogynist Sentences

1

Hate Speech Sentences

2


Summary


Transcript

00:00:00.000 I wanted to shift gears here to healthcare, the other hot button issue.
00:00:13.380 Now, this is such an infuriating one for so many people because virtually every Canadian
00:00:18.360 who's had some exposure with the healthcare system has experienced something that didn't
00:00:24.360 work the way it was or the way they thought it was supposed to.
00:00:27.540 Whether it is cases of people being treated in hallways, people who have been on waiting
00:00:32.700 lists for months and months and months to see a specialist, not to mention to actually
00:00:37.320 be treated by that specialist.
00:00:39.560 So we all defend the ideal of the healthcare system in Canada, but not the application of
00:00:45.840 it.
00:00:46.000 So how do we get to that ideal?
00:00:47.760 Or is it that our core expectation is flawed?
00:00:50.880 Well, one of the things that's quite interesting, and I'm actually surprised to see this, is
00:00:54.680 that most Canadians would be open to and welcome major changes to the healthcare system.
00:01:00.400 There was a Leger survey of 2,000 Canadian adults, that's quite a large sample size for
00:01:05.720 a poll of this nature, that found healthcare ranks among the top three priorities for politicians,
00:01:10.520 and that two-thirds of those respondents said they wanted significant changes to the system.
00:01:17.160 Now, these obviously have, in some cases, come up against challenges in the courts.
00:01:23.280 Most recently, the Canby surgical case in British Columbia, which I'm sure we can talk
00:01:28.400 about in this context.
00:01:29.320 But let's just talk about what Canadians want here and what's standing in the way.
00:01:33.200 Joining me is counsel for the Canadian Constitution Foundation, Josh DeHaz.
00:01:37.420 Josh, good to have you back on the show.
00:01:39.260 This is a little bit encouraging.
00:01:40.520 I must say, it was a pleasant surprise to see this, because so often this is treated
00:01:45.040 as just this third rail political issue that you're not allowed to do anything with.
00:01:49.220 Yeah, absolutely.
00:01:50.500 So in one sense, it's really bad news, because Canadians see a healthcare system that's in
00:01:56.120 crisis.
00:01:56.840 But what I did find encouraging is the fact that Canadians are saying they're ready for
00:02:01.520 major change.
00:02:02.340 So like you said, two-thirds say they want major change.
00:02:05.880 And only 5% of people actually say that they want to do the thing that you most often hear
00:02:13.440 in the media, which is, you know, just throw more public funding at this problem, right?
00:02:17.860 So people are presented with those options, more public, just more public funding or some
00:02:23.300 major change.
00:02:23.980 And everyone is basically saying, we want major change.
00:02:27.960 And one really interesting part of this, too, was it was kind of counterintuitive to us at
00:02:33.220 the CCF, but women in particular are saying that they are worried about the healthcare
00:02:38.400 system and want major change.
00:02:40.760 72% of women surveyed said that they think the healthcare system is going to be worse for
00:02:46.220 future generations if we don't get those major changes.
00:02:49.480 And that was a lot higher than men.
00:02:51.340 And we're trying to figure out why that was.
00:02:53.400 But we think the reason might be that women just make a lot more of the healthcare decisions.
00:02:58.520 They do a lot more of the sort of caregiving.
00:03:01.560 And so that might explain why they're more worried about it, simply because they, you
00:03:07.380 know, interact with the system a lot more.
00:03:09.820 You have in this country a relatively small group of activists that care very much about
00:03:15.360 the structure of the system, like Canadian doctors for Medicare, for example.
00:03:19.120 But most Canadians, I feel, care more about outcomes.
00:03:22.260 And you look at some of the priorities that were listed here.
00:03:24.880 46% say they want more family doctors as a top priority.
00:03:30.180 Shorter emergency room wait times was behind that.
00:03:33.020 Shorter times for common surgeries and other treatments.
00:03:35.800 Those have nothing to do with who delivers it, with how they access it.
00:03:39.460 Those are just outcomes.
00:03:40.600 Those are things that people want.
00:03:42.360 And I believe that if you were to put forward a system that says, listen, you're not going
00:03:45.920 to go bankrupt looking for healthcare.
00:03:47.720 That's not what we're pushing here.
00:03:48.980 But you will get a better, quicker product.
00:03:52.840 Canadians would be on board with that.
00:03:55.040 But you have, again, this very small group that stands in the way of that.
00:03:59.020 Yeah, you're completely right.
00:04:00.940 One thing a lot of people I don't think realize is that, you know, a lot of the opposition to
00:04:05.840 any sort of reform or change in the Canadian healthcare system, a lot of that's sort of funded
00:04:10.320 by sort of special interest groups like, you know, healthcare unions.
00:04:13.860 And what the message that a lot of Canadians are not hearing is that, you know, Canada
00:04:19.160 is just one country in the world.
00:04:20.920 And we've chosen to have a very strict restrictions on private payment for healthcare.
00:04:28.260 But, you know, if you look at all of Europe, they have universal healthcare.
00:04:32.220 You don't have to pay with your credit card if you need healthcare, if you're poor, if
00:04:36.020 you're middle class, if you want to access the public system.
00:04:38.700 And most people are getting their healthcare through the public system.
00:04:41.820 But they also have this sort of release valve, which is that they have a private system where
00:04:46.720 if things aren't working, some wealthier people can go and they can pay to get healthcare.
00:04:51.300 And that takes pressure off the public system.
00:04:53.740 And the sort of the proof is in the pudding.
00:04:56.000 You know, if you look at all the rankings that look at outcomes and wait times and even
00:05:00.640 equity, all of the European countries are basically doing better than Canada.
00:05:04.860 So I think we really need to start, you know, pushing back against that, that sacred cow that
00:05:11.440 we can't allow any sort of private payment in Canada.
00:05:14.960 Just to bring the legal context here, I know the CCF had taken up the long, long running
00:05:20.780 Canby case in British Columbia there, which I spoke about, I think it was with, I can't
00:05:25.440 remember if it was with Joanna Barron or Christine Van Gein or both, but when the decision came
00:05:29.340 up, but, but as a bit of a primer there, how does that decision stand in the way of what
00:05:34.840 you and I are talking about and Canadians seem to want here?
00:05:38.600 Well, so British Columbia, like most provinces has some restrictions on, you know, doctors
00:05:45.740 work on offering private surgeries or doctors or, or health insurance.
00:05:50.960 And each province is a little bit different, but the idea is that Canadians supposedly want
00:05:57.440 a government monopoly on healthcare.
00:05:59.060 And so we've got all of these restrictions.
00:06:01.980 And in that particular case, we said, you know, if you're waiting on a waiting list for
00:06:06.220 a surgery and you're in, in physical pain and you could pay to relieve that, but it's
00:06:11.940 just a law standing in the way, you know, an arbitrary law that is supposed to guarantee
00:06:17.200 you, uh, reasonable access to healthcare, but it's actually forcing you to wait on a
00:06:21.260 wait list, uh, that's violating your constitutional rights and that shouldn't be allowed to stand.
00:06:26.700 And, you know, there's a 2005 case that found that to be the case in Quebec, but it doesn't
00:06:32.320 apply in the rest of Canada.
00:06:34.220 So we thought that in British Columbia, we would be successful, but the courts there said,
00:06:39.540 no, this is a reasonable limit on people's charter rights, even though people suffer and in
00:06:45.140 some cases die on waiting lists.
00:06:47.520 And so, uh, right now it's, uh, it's still apparently acceptable to do this in British
00:06:53.300 Columbia.
00:06:54.300 And we don't really know what the status is in the rest of the provinces.
00:06:58.120 So, uh, you know, we're always sort of looking for our next can be case.
00:07:01.880 The fight certainly isn't over.
00:07:03.700 Well, and, and there, I think underscores how the ideology is getting in the way of the
00:07:08.580 outcomes here, because, you know, if someone pays out of pocket to take themselves off a
00:07:12.860 wait list and there's an available doctor and available, uh, surgical center, no one
00:07:18.240 is worse off, like absolutely no.
00:07:20.460 In fact, the public system is better off because one more person has come off that wait list,
00:07:24.680 which helps the person behind them.
00:07:26.240 So I really don't get how you like, it's such an inexplicable decision, just not even looking
00:07:32.880 at the law, just on the logic of it.
00:07:35.240 Yeah, that's right.
00:07:37.240 Yeah.
00:07:38.240 So, uh, I also don't understand that, like you can look at, for example, look at Norway
00:07:43.620 and it's the country that ranks better than any other country in, uh, you know, the OECD
00:07:50.240 for its healthcare outcomes, for its healthcare equity.
00:07:53.500 And it does better on cost than Canada.
00:07:55.720 Canada has a very, very expensive system and, you know, they have only about 10% of people
00:08:01.060 there have private insurance and they get, you know, some specialist appointments quicker.
00:08:06.000 They do get some surgeries quicker, but it's optional and 90% of people are happy with the
00:08:12.080 public system and stay in that system.
00:08:14.360 But just taking that, you know, half million Norwegians out of the public system makes the
00:08:19.700 waiting lists in the public system shorter for everyone.
00:08:22.620 And, you know, Norway can actually do a lot more in their public system because they're
00:08:26.520 not, um, because they don't have to look after 100% of the population all the time.
00:08:32.400 Um, an interesting sort of result from this survey that we did with, uh, second street
00:08:37.580 and, uh, MEI was that Canadians actually rank pharma care extremely low.
00:08:43.080 Their priority it's, it's like ninth out of nine options, only 3% set as their top priority.
00:08:49.800 And that's because Canada can't seem to figure out the basics, like getting you your family
00:08:53.500 doctor or, uh, reasonable ER wait times.
00:08:57.400 Uh, Norway or they, they can afford to actually do pharma care, uh, because they also allow
00:09:04.640 some sort of private money into the system.
00:09:07.640 So I think it's pretty clear at this point that, uh, Canada system isn't working, that
00:09:12.000 it's, you know, filing Canadians constitutional rights.
00:09:15.100 And the survey that we've, we've just done seems to show that the public is kind of had
00:09:19.320 ahead of the, the media and some of the sort of politicians on this particular topic, because
00:09:25.120 Canadians are ready for change.
00:09:26.740 Now, one thing, I mean, maybe I, I'm, I'm a bit of adult, so it's probably easier for
00:09:31.220 you than for me here, but it's navigating this issue of, of what is legal and what is
00:09:36.500 just tradition has been incredibly difficult.
00:09:38.820 I mean, Ontario is a great example of this where you've got a couple of literally private
00:09:43.080 hospitals that are there because they've just been grandfathered in.
00:09:46.520 You have federal regulations, but healthcare is provincial.
00:09:49.880 And, uh, and I think a lot of that jurisdictional, uh, ambiguity is used by politicians that don't
00:09:55.360 want to touch this issue.
00:09:56.960 Provincial leaders will say, oh, well, the federal government handcuffs us on universal
00:10:00.360 healthcare.
00:10:01.360 The federal government will say, oh, well, healthcare is a provincial issue.
00:10:04.160 So at its core, if we wanted to have some progress on this issue, where's the starting
00:10:10.260 point?
00:10:11.260 Is it at federal level with the core, uh, Canada health act, or is it provincial?
00:10:15.580 Yeah, I think it's actually both.
00:10:17.940 Uh, so the Canada health act is not as clear as people think it is.
00:10:22.000 So just for a little bit of background, I'm glad I'm not alone in being utterly confused
00:10:25.760 when I look at it.
00:10:27.300 I was reading about, uh, certain aspects of it last night and it's, it's confusing.
00:10:32.100 So the basic idea behind the Canada health act is that the federal government is going
00:10:36.640 to give provinces money to spend on healthcare, even though healthcare is a provincial jurisdiction.
00:10:43.320 Right.
00:10:44.320 So, uh, but to do so, Canada in exchange for that money wants certain, um, guarantees from
00:10:49.920 the provinces, uh, for example, that, you know, people are not going to be charged user fees
00:10:55.900 or things like that, but there's so much ambiguity in it.
00:10:59.380 Um, one really good example is diagnostic services.
00:11:03.700 So, uh, you know, getting an MRI, most of Canada, you can walk into a private clinic, put down your
00:11:11.380 credit card and get off the public wait list.
00:11:13.940 If you want to, by paying for that MRI, well, one of the places you can't do that is Ontario,
00:11:20.180 unfortunately.
00:11:20.980 So, you know, we're stuck going to get to know, or to Buffalo, if we are, are worried
00:11:26.340 about, uh, being stuck in a wait list.
00:11:28.820 So, yeah, I, so I live at just on that.
00:11:30.660 I live an hour from Port Huron, Michigan, you cross the border and billboards advertising
00:11:34.940 to Canadians, you know, get your MRI, you know, $129 or whatever, you know, go here open
00:11:39.700 24 seven.
00:11:40.700 Yeah, we, we have them, I'm in Toronto and we have them on the subway saying, you know,
00:11:45.260 go to Buffalo for all your surgeries or services.
00:11:47.700 But anyway, the point is that the federal government and the private provinces don't even seem to
00:11:52.060 know whether that is supposed to be covered under the Canada health act and the Trudeau
00:11:56.780 government in 2018 said suddenly, actually, you know, this should be, uh, something that
00:12:02.900 provinces are required to, uh, not only pay for, but stop anyone from buying privately.
00:12:08.480 And so in our opinion, this is contrary to the Canada health act and they started fine
00:12:13.040 in provinces like Quebec and Alberta and British Columbia, just for allowing people to get out
00:12:19.320 of the public wait list line, go to a private clinic and pay to have.
00:12:23.240 The healthcare that they need.
00:12:25.280 So there's a lot of ambiguity and I think you could clarify the Canada health act.
00:12:30.200 Um, you know, I think it allows provinces to do a lot more than they say that it does, but there's
00:12:36.320 no reason why the federal government couldn't clarify the Canada health act and say, look,
00:12:41.800 we're still going to fund universal healthcare.
00:12:43.840 We're still going to give you just as much money, but we're going to let provinces innovate
00:12:48.040 to some degree because the status quo just isn't working.
00:12:51.200 So, you know, if it was, if I, if I was in charge, I'd probably start with just clarifying
00:12:55.280 that Canada health act.
00:12:57.280 Well, yeah, there we go.
00:12:58.360 And obviously, uh, with polling, I mean, the, the cynic in all, all of us says politicians
00:13:03.200 are responsive to polls more than their core convictions sometimes.
00:13:06.200 So if that's the case, your move, a political class, uh, you can read more about this at
00:13:10.560 the ccf.ca, uh, Josh DeHaz, always good to talk to you.
00:13:14.400 Thanks for coming on today.
00:13:15.800 Thanks, Andrew.
00:13:17.080 Thanks for listening to the Andrew Lawton Show.
00:13:19.120 Support the program by donating to True North at www.tnc.news.