Majority of Canadians want “major changes” to healthcare system
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Summary
Healthcare is a hot button issue in Canada, with some arguing that it needs major reform. In this episode, I talk to Josh DeHaz of the Canadian Constitution Foundation about what's standing in the way of reform, and why most Canadians are ready for major change.
Transcript
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I wanted to shift gears here to healthcare, the other hot button issue.
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Now, this is such an infuriating one for so many people because virtually every Canadian
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who's had some exposure with the healthcare system has experienced something that didn't
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work the way it was or the way they thought it was supposed to.
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Whether it is cases of people being treated in hallways, people who have been on waiting
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lists for months and months and months to see a specialist, not to mention to actually
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So we all defend the ideal of the healthcare system in Canada, but not the application of
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Well, one of the things that's quite interesting, and I'm actually surprised to see this, is
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that most Canadians would be open to and welcome major changes to the healthcare system.
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There was a Leger survey of 2,000 Canadian adults, that's quite a large sample size for
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a poll of this nature, that found healthcare ranks among the top three priorities for politicians,
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and that two-thirds of those respondents said they wanted significant changes to the system.
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Now, these obviously have, in some cases, come up against challenges in the courts.
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Most recently, the Canby surgical case in British Columbia, which I'm sure we can talk
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But let's just talk about what Canadians want here and what's standing in the way.
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Joining me is counsel for the Canadian Constitution Foundation, Josh DeHaz.
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I must say, it was a pleasant surprise to see this, because so often this is treated
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as just this third rail political issue that you're not allowed to do anything with.
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So in one sense, it's really bad news, because Canadians see a healthcare system that's in
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But what I did find encouraging is the fact that Canadians are saying they're ready for
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So like you said, two-thirds say they want major change.
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And only 5% of people actually say that they want to do the thing that you most often hear
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in the media, which is, you know, just throw more public funding at this problem, right?
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So people are presented with those options, more public, just more public funding or some
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And everyone is basically saying, we want major change.
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And one really interesting part of this, too, was it was kind of counterintuitive to us at
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the CCF, but women in particular are saying that they are worried about the healthcare
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72% of women surveyed said that they think the healthcare system is going to be worse for
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future generations if we don't get those major changes.
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But we think the reason might be that women just make a lot more of the healthcare decisions.
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And so that might explain why they're more worried about it, simply because they, you
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You have in this country a relatively small group of activists that care very much about
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the structure of the system, like Canadian doctors for Medicare, for example.
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But most Canadians, I feel, care more about outcomes.
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And you look at some of the priorities that were listed here.
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46% say they want more family doctors as a top priority.
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Shorter emergency room wait times was behind that.
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Shorter times for common surgeries and other treatments.
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Those have nothing to do with who delivers it, with how they access it.
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And I believe that if you were to put forward a system that says, listen, you're not going
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But you have, again, this very small group that stands in the way of that.
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One thing a lot of people I don't think realize is that, you know, a lot of the opposition to
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any sort of reform or change in the Canadian healthcare system, a lot of that's sort of funded
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by sort of special interest groups like, you know, healthcare unions.
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And what the message that a lot of Canadians are not hearing is that, you know, Canada
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And we've chosen to have a very strict restrictions on private payment for healthcare.
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But, you know, if you look at all of Europe, they have universal healthcare.
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You don't have to pay with your credit card if you need healthcare, if you're poor, if
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you're middle class, if you want to access the public system.
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And most people are getting their healthcare through the public system.
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But they also have this sort of release valve, which is that they have a private system where
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if things aren't working, some wealthier people can go and they can pay to get healthcare.
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You know, if you look at all the rankings that look at outcomes and wait times and even
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equity, all of the European countries are basically doing better than Canada.
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So I think we really need to start, you know, pushing back against that, that sacred cow that
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we can't allow any sort of private payment in Canada.
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Just to bring the legal context here, I know the CCF had taken up the long, long running
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Canby case in British Columbia there, which I spoke about, I think it was with, I can't
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remember if it was with Joanna Barron or Christine Van Gein or both, but when the decision came
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up, but, but as a bit of a primer there, how does that decision stand in the way of what
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you and I are talking about and Canadians seem to want here?
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Well, so British Columbia, like most provinces has some restrictions on, you know, doctors
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work on offering private surgeries or doctors or, or health insurance.
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And each province is a little bit different, but the idea is that Canadians supposedly want
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And in that particular case, we said, you know, if you're waiting on a waiting list for
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a surgery and you're in, in physical pain and you could pay to relieve that, but it's
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just a law standing in the way, you know, an arbitrary law that is supposed to guarantee
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you, uh, reasonable access to healthcare, but it's actually forcing you to wait on a
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wait list, uh, that's violating your constitutional rights and that shouldn't be allowed to stand.
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And, you know, there's a 2005 case that found that to be the case in Quebec, but it doesn't
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So we thought that in British Columbia, we would be successful, but the courts there said,
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no, this is a reasonable limit on people's charter rights, even though people suffer and in
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And so, uh, right now it's, uh, it's still apparently acceptable to do this in British
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And we don't really know what the status is in the rest of the provinces.
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So, uh, you know, we're always sort of looking for our next can be case.
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Well, and, and there, I think underscores how the ideology is getting in the way of the
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outcomes here, because, you know, if someone pays out of pocket to take themselves off a
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wait list and there's an available doctor and available, uh, surgical center, no one
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In fact, the public system is better off because one more person has come off that wait list,
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So I really don't get how you like, it's such an inexplicable decision, just not even looking
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So, uh, I also don't understand that, like you can look at, for example, look at Norway
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and it's the country that ranks better than any other country in, uh, you know, the OECD
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for its healthcare outcomes, for its healthcare equity.
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Canada has a very, very expensive system and, you know, they have only about 10% of people
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there have private insurance and they get, you know, some specialist appointments quicker.
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They do get some surgeries quicker, but it's optional and 90% of people are happy with the
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But just taking that, you know, half million Norwegians out of the public system makes the
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waiting lists in the public system shorter for everyone.
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And, you know, Norway can actually do a lot more in their public system because they're
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not, um, because they don't have to look after 100% of the population all the time.
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Um, an interesting sort of result from this survey that we did with, uh, second street
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and, uh, MEI was that Canadians actually rank pharma care extremely low.
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Their priority it's, it's like ninth out of nine options, only 3% set as their top priority.
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And that's because Canada can't seem to figure out the basics, like getting you your family
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Uh, Norway or they, they can afford to actually do pharma care, uh, because they also allow
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So I think it's pretty clear at this point that, uh, Canada system isn't working, that
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it's, you know, filing Canadians constitutional rights.
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And the survey that we've, we've just done seems to show that the public is kind of had
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ahead of the, the media and some of the sort of politicians on this particular topic, because
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Now, one thing, I mean, maybe I, I'm, I'm a bit of adult, so it's probably easier for
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you than for me here, but it's navigating this issue of, of what is legal and what is
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I mean, Ontario is a great example of this where you've got a couple of literally private
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hospitals that are there because they've just been grandfathered in.
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You have federal regulations, but healthcare is provincial.
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And, uh, and I think a lot of that jurisdictional, uh, ambiguity is used by politicians that don't
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Provincial leaders will say, oh, well, the federal government handcuffs us on universal
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The federal government will say, oh, well, healthcare is a provincial issue.
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So at its core, if we wanted to have some progress on this issue, where's the starting
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Is it at federal level with the core, uh, Canada health act, or is it provincial?
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Uh, so the Canada health act is not as clear as people think it is.
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So just for a little bit of background, I'm glad I'm not alone in being utterly confused
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I was reading about, uh, certain aspects of it last night and it's, it's confusing.
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So the basic idea behind the Canada health act is that the federal government is going
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to give provinces money to spend on healthcare, even though healthcare is a provincial jurisdiction.
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So, uh, but to do so, Canada in exchange for that money wants certain, um, guarantees from
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the provinces, uh, for example, that, you know, people are not going to be charged user fees
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or things like that, but there's so much ambiguity in it.
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Um, one really good example is diagnostic services.
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So, uh, you know, getting an MRI, most of Canada, you can walk into a private clinic, put down your
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If you want to, by paying for that MRI, well, one of the places you can't do that is Ontario,
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So, you know, we're stuck going to get to know, or to Buffalo, if we are, are worried
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I live an hour from Port Huron, Michigan, you cross the border and billboards advertising
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to Canadians, you know, get your MRI, you know, $129 or whatever, you know, go here open
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Yeah, we, we have them, I'm in Toronto and we have them on the subway saying, you know,
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go to Buffalo for all your surgeries or services.
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But anyway, the point is that the federal government and the private provinces don't even seem to
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know whether that is supposed to be covered under the Canada health act and the Trudeau
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government in 2018 said suddenly, actually, you know, this should be, uh, something that
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provinces are required to, uh, not only pay for, but stop anyone from buying privately.
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And so in our opinion, this is contrary to the Canada health act and they started fine
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in provinces like Quebec and Alberta and British Columbia, just for allowing people to get out
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of the public wait list line, go to a private clinic and pay to have.
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So there's a lot of ambiguity and I think you could clarify the Canada health act.
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Um, you know, I think it allows provinces to do a lot more than they say that it does, but there's
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no reason why the federal government couldn't clarify the Canada health act and say, look,
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we're still going to fund universal healthcare.
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We're still going to give you just as much money, but we're going to let provinces innovate
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to some degree because the status quo just isn't working.
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So, you know, if it was, if I, if I was in charge, I'd probably start with just clarifying
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And obviously, uh, with polling, I mean, the, the cynic in all, all of us says politicians
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are responsive to polls more than their core convictions sometimes.
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So if that's the case, your move, a political class, uh, you can read more about this at
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the ccf.ca, uh, Josh DeHaz, always good to talk to you.
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Thanks for listening to the Andrew Lawton Show.
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Support the program by donating to True North at www.tnc.news.