Juno News - Surge in waitlist numbers highlights need for health care reform

00:00:00.000 Since we're keeping on a little bit of a provincial bent today, I wanted to turn from

00:00:14.280 one area of provincial jurisdiction to another, which is healthcare. Not to say the provinces

00:00:20.540 are always managing this issue as well as they need to be. This is probably no more acutely

00:00:27.280 available and accessible to us than it is with wait times. Now, wait times are not as much

00:00:34.220 an issue as they are. Let me back up. We don't hear the discussion of it as much as we did

00:00:39.900 a few years ago even. There was a real pinch point where there was a crisis, especially

00:00:44.400 in Ontario, of people being treated in hallways. You had hospitals that had to develop hallway

00:00:49.000 medicine protocols. But when we talk about access to healthcare, especially to surgeries,

00:00:55.120 which are very much important for people, they're still in terrible, terrible places. We know

00:01:01.400 there are a number of studies that have pointed to how many Canadians are just taking themselves

00:01:05.660 off the wait list and going and paying out of pocket in the United States or elsewhere in the

00:01:10.460 world. Our friends over at secondstreet.org have been tracking this issue relentlessly and they've

00:01:15.920 found that wait lists have increased by 5% with over 140,000 more Canadians waiting for surgery,

00:01:24.120 diagnostic scans, or specialist deployments. Joining me is the president of secondstreet.org,

00:01:30.060 Colin Craig. Colin, always a pleasure. Thanks for coming on today.

00:01:33.760 Well, thanks for the chat today, Andrew. I appreciate it.

00:01:36.080 So obviously, this is an issue that Canadians, if they don't know about, it's because they're 0.81

00:01:41.520 fortunate enough to be not on the wait list. Any Canadian who's ever tried to navigate the system

00:01:45.460 is well aware of this here. And we're not talking about examples of people that are,

00:01:51.580 you know, being turned away at emergency rooms because they had a heart attack and they're not

00:01:55.140 being treated. But that is also not to say that these are not very crucial things that people in

00:02:00.860 Canada are not able to readily access. Well, that's right. I mean, this, these numbers that

00:02:06.780 we've dug up, we asked every province in the country, pretty straightforward question. How many

00:02:11.900 people in your province are waiting for surgery, a diagnostic scan, or to see a specialist?

00:02:16.460 And there were actually only three provincial governments that could tell us all three of

00:02:21.700 those numbers, Nova Scotia, Quebec, and Alberta. And the other provinces gave us either one of the

00:02:30.100 numbers or two of the numbers. So there's a lot of holes in it. We're looking at 3.1 million people

00:02:35.420 waiting for those important health care services. And you alluded to it in many cases, sadly,

00:02:41.720 those are a lot of people that are suffering. And we tried to be cautious and try to fill in some of

00:02:48.380 those blanks. If you go to our website, you've got this big grid with all the numbers that governments

00:02:52.380 gave us with a lot of holes. And if you fill in the holes to try to look at what that big picture

00:02:57.200 looks like, it's probably about 5.1 million Canadians that are waiting. Or to put this in plain English,

00:03:04.320 about one in eight Canadians are on a wait list right now for health care services.

00:03:08.160 Just to jump on that point, the issues that you had from the provincial government,

00:03:13.380 is that a data collection issue? Or is it a transparency issue? And by that, I mean,

00:03:17.160 do they have the numbers and they're not sharing them? Or are they just not making it a point of

00:03:21.080 finding this data?

00:03:22.860 I think it's partially a data collection problem and, to be blunt, an incompetence problem. If you have a

00:03:31.040 problem, the first thing you need to do is understand how big it is and understand how you're

00:03:36.060 going to get rid of it or attack it, fight it, whatever you want to call it. So if you're going

00:03:40.820 to measure progress against how many people are waiting to see a specialist, well, the first thing

00:03:45.880 you've got to do is figure out, okay, well, how many people are waiting right now to see a specialist

00:03:49.000 and how do we get that number down? And if you can't produce that number as a provincial government,

00:03:53.960 I think that's a problem.

00:03:54.820 So yeah, I think it's a problem in terms of the fact that they just, they don't seem to collect

00:03:59.960 the data centrally in some cases. And in other cases, maybe they're just not even asking the

00:04:05.940 question to find out.

00:04:07.540 Well, and to be more cynical on this, not that I try to be a cheery optimist sometimes, but

00:04:11.900 why would you want to collect the data if you know what it will show? And I think that's probably

00:04:17.120 where we're seeing a little bit of this here. There's no motivation to go in and do an intensive,

00:04:21.220 deep dive into figures that are going to show provinces are not delivering the service they're

00:04:27.120 supposed to.

00:04:28.540 Yeah. Well, that could be part of it. I mean, we've got to remember too, that they can often

00:04:33.040 give us some data, but not others. So they can tell us right across the country, pretty

00:04:36.380 much with the exception of Prince Edward Island, how many people are waiting for surgery.

00:04:41.220 But we got to remember that quite often with healthcare issues, you don't always need surgery.

00:04:46.580 Sometimes you need some kind of other intervention, medication or some kind of other change,

00:04:52.400 physiotherapy, whatever it is. It's often cases where you don't need surgery. And so you've

00:04:57.320 got to meet with a specialist to find out what that course of action is, maybe need a diagnostic

00:05:01.740 scan and so forth. So it's troubling that you can't get those numbers. But like I said, the

00:05:07.120 numbers don't seem to be good. There were some bright spots, though. We saw some positive

00:05:11.200 improvement over the past year in Saskatchewan and Manitoba and Quebec were a couple of the

00:05:16.600 ones that we highlighted where we've seen some good progress in terms of a number of people

00:05:20.620 waiting.

00:05:21.660 I know that the third rail in Canadian politics has always been healthcare. I mean,

00:05:26.180 any discussion about the system yields just this knee-jerk, visceral, emotional reaction

00:05:31.920 from people. We've had mixed court rulings on what you're able to do as far as fee-based

00:05:38.360 services and care. But one thing we know in the case of Quebec is that you have the option

00:05:44.320 to oftentimes go and get a service out of your own pocket. Now, that's not to say that when

00:05:50.400 you're paying as much in taxes as you are for provincial healthcare, that's just. But if

00:05:54.980 you're kind of just looking in self-preservation mode, I get why people do that. So for people

00:05:59.760 outside of Quebec, though, they don't have that opportunity available. So they're either forced

00:06:04.220 to just deal with it or to leave the country, are they not?

00:06:08.860 Yeah, that's basically it. It's a real messy situation. It makes no sense whatsoever. So

00:06:13.380 you're right. If you're living in Montreal and let's say you need to get your hip done,

00:06:17.860 you have a few choices. One of which is you could wait for the government to provide you

00:06:22.180 that hip operation and you get it done. You walk out, you don't face a bill. It's paid for

00:06:27.360 through tax dollars. You also have the option of going to a local clinic in Montreal and get

00:06:34.800 your hip done or maybe in Quebec City or somewhere else. You can pay for that privately and get

00:06:40.480 it done fast and have that option, public system or private option. Then obviously you have

00:06:44.760 a third option, which is to leave the province altogether, maybe go to another country or other

00:06:50.880 province, whatever. So Quebec is unique. The Supreme Court of Canada has given Quebec this unique right.

00:06:58.720 The rest of the country, you don't really have that option. There's a whole bunch of government

00:07:02.480 regulations and barriers that mean that you can't pay, for example, in Vancouver to get your hip

00:07:10.000 operation and you have to travel somewhere else. So quite often you see people from Vancouver fly to

00:07:14.800 Calgary and you often see Calgarians do the same thing. They'll fly to Vancouver and pay for it.

00:07:20.160 There's some interesting things that are happening there where

00:07:24.480 in Calgary is actually a clinic that is enabled. It's a bit wonky, but they've been able to hire

00:07:30.480 surgeons that are not part of the public system whatsoever. And you can actually now pay in

00:07:36.080 Calgary for some private surgery locally. It's weird. It doesn't make any sense. The problem is

00:07:42.720 all these government regulations are gumming up the healthcare system. They're leading to more people

00:07:48.080 depending on the public system rather than some of those people deciding to pay privately. And when

00:07:53.120 that happens, you take pressure off of the public system and you reduce wait times of the public

00:07:58.480 system. And that's why no other developed nation on the country with universal healthcare does what

00:08:03.520 Canada does. They make it easy for patients to have that choice because it's better overall for results.

00:08:08.960 Yeah. And when I want to talk about one of those ideas in a moment, but just on the weird sort of

00:08:13.440 situation you described there in Alberta, one of the things I find so obnoxious about this debate

00:08:18.480 is that we don't really have the system that the universal healthcare activists think we do and kind

00:08:25.760 of pretend we do where it's not this truly 100% public system with nothing private whatsoever because

00:08:32.480 there are these weird loopholes and exceptions. I mean, you know, on one end you have just people that

00:08:38.960 have a friend of a friend who's a doctor that can jump the line that way. But in other cases, you have

00:08:43.920 a lot of clinics that operate in a very weird legal gray area. I've talked to some people. In fact, I did a

00:08:50.960 discussion on this very show and there was a private healthcare clinic in my city that does a

00:08:56.720 combination of private and public healthcare. And I had a lawyer on the same show who was saying,

00:09:00.640 well, I'm not convinced that what they're doing is legal. And the owner of the clinic said, well,

00:09:04.480 yeah, we are. And here's why. But people can't even quite agree with what the law says in some cases

00:09:10.560 on this stuff. And then you further add to this, patients just want a solution. Like patients don't

00:09:16.800 care where it comes from. And one of the points, your colleague, Dom Lucek wrote an op-ed for True

00:09:21.920 North about this. And he said in the European Union, you can go to another EU country, pay out of

00:09:26.720 pocket and then be reimbursed. Now, I'm never a big fan of government spending a lot of money. But my

00:09:33.040 approach to this would be if the government has said that you had a right to this and they were going

00:09:37.680 to pay for it anyway, it shouldn't matter where you got it from. But that is a no go in Canada.

00:09:42.640 Yeah, you're right. I mean, it's sort of like taking the horse blinders off for governments,

00:09:47.680 right? We have this approach in this nation, largely where provincial governments say,

00:09:52.240 okay, this is how we're going to provide healthcare to Canadians. And they're thinking

00:09:56.480 within their own jurisdiction. Whereas what they do in the EU is they take the horse blinders off

00:10:01.760 and they say, well, wait, we can allow patients access to the entirety of Europe and allow them if

00:10:07.440 they want to go to another European country, they can go there, pay for surgery and then get

00:10:12.080 reimbursed by their home government. And it's not whatever they want to spend, it's up to what

00:10:17.280 that government would have spent locally. So if we give an example in Canada, let's say in

00:10:22.880 Ontario there, Andrew, that you need your hip operation. And let's say that the government's

00:10:28.000 going to tell you, well, they'll get to you next year. So in the meantime, you're in chronic pain,

00:10:32.320 you're off work, you're not making any money, you're dependent on the social assistance,

00:10:38.880 whatever. It's a bad situation all around. But if they said to you, Andrew, okay, if we give you

00:10:44.560 this surgery next year, it's going to cost $30,000 for us as a government to give it to you.

00:10:50.160 We're going to give you the option of going somewhere else and you'll have access to $30,000

00:10:55.920 in reimbursement. Well, you might decide, well, look, you know, I've got a cousin in Lithuania. I'd

00:11:01.840 love to see that cousin. I'm going to go over there, see that cousin. And at the same time,

00:11:06.880 I'll get my hip operation because I can get it done for maybe 25,000 Canadian. And, you know,

00:11:13.040 I'll actually save the government some money. Well, you'd have that option. You could recover

00:11:17.280 your cousin's place, whatever, or maybe you go to Tennessee or wherever you would have that option.

00:11:22.000 Suddenly as a patient, you have access to thousands and thousands of places to get that

00:11:26.800 surgery done around the world. And for the government, it's, it's positive because they

00:11:32.720 can get you back to work faster. You can start working again, paying taxes and so forth.

00:11:38.400 They're paying the money say this year instead of next year. And that example of Lithuania,

00:11:43.760 you know, they'd actually save a bit of money. Maybe if you went to Tennessee, it was $30,000

00:11:48.320 or maybe $35,000. If it was $35,000, well, then you're paying that difference between the $30,000 and

00:11:53.520 $35,000. But it's good for the government because it helps, helps them get you the care you need faster.

00:12:00.880 Like, say you get back to work for other patients who decide not to go abroad for surgery. Well,

00:12:05.440 they benefit too, because now Andrew Lawton's not ahead of me in line. He's gone off to somewhere

00:12:10.160 else. I don't want to travel. I want to get my surgery in Ontario. Well, it's still good for me,

00:12:14.080 because now I get to move up a spot in line. So it's good for patients too. It's, it's not a magical

00:12:18.880 solution, but it can help in a time of crisis. We're in a time of crisis. So it's, it's an idea that we

00:12:24.640 think that governments should give a look at here in Canada. We've actually seen some governments kind of do

00:12:29.920 this in Manitoba. They've been sending patients all over the world to Ohio and California, British

00:12:36.320 Columbia, and I believe Alberta as well, sending them to private facilities where they can get their 0.53

00:12:41.840 hips and their knees done and whatever. That was one thing that they did to try and get their backlog 1.00

00:12:46.480 down. And they've had some positive results in Manitoba. The numbers are down about 21% for the

00:12:52.640 surgeries that they provided data for. So I think it's an option that could help.

00:12:56.400 Yeah, very well said. You can read all of this and more over at secondstreet.org. The president,

00:13:03.040 Colin Craig, always good to talk to you, sir. Thanks for coming on today.

00:13:05.840 Thanks for having me, Andrew.

00:13:07.040 Thanks for listening to The Andrew Lawton Show. Support the program by donating to True North

00:13:11.920 at www.tnc.news.

Juno News - January 07, 2024

Surge in waitlist numbers highlights need for health care reform

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