Juno News - Majority of Canadians want “major changes” to healthcare system

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 0.97

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. 0.75

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. 1.00

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.

Juno News - April 01, 2024

Majority of Canadians want “major changes” to healthcare system

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