The Candice Malcolm Show - How can we fix Canada’s failing healthcare system？ Let’s look to Japan

00:00:00.000 Hi, I'm Candice Malcolm, and this is The Candice Malcolm Show.

00:00:05.100 We have a great episode for you today, folks.

00:00:07.080 We will be joined by Colin Craig from Second Street in just a minute.

00:00:10.160 And this episode is brought to you by Unsmoke, our sponsor, but more on them later.

00:00:14.520 So today we're going to focus in on the state of Canadian health care.

00:00:18.500 We talk about it from time to time on the show, and it is worth repeating.

00:00:22.000 Just every time I see this headline, this story, it doesn't cease to amaze me.

00:00:25.280 It is shocking.

00:00:25.860 Nearly 75,000 Canadians have died on health care waiting lists since 2018.

00:00:31.500 75,000 Canadians have died since 2018.

00:00:34.860 At least 15,474 Canadians have died last year while waiting for health care.

00:00:39.780 But the actual number is probably double a new study shows.

00:00:43.120 So according to secondstreet.org, when jurisdictions that provide no date,

00:00:47.400 accounted for the actual number of Canadians who died is likely closer to 28,000.

00:00:51.440 Folks, this is not normal.

00:00:52.480 This is not okay.

00:00:53.120 I know that Canadians take great pride in the fact that we have universal coverage for health care,

00:00:57.640 that nobody goes uncovered, and that nobody goes bankrupt trying to pay for their health care.

00:01:01.780 But that doesn't make our health care system good, and it is not acceptable in an advanced,

00:01:06.220 wealthy country like Canada for us to continue to place at or near the bottom of every ranking system on the OECD.

00:01:13.380 I mean, look at these stories.

00:01:14.560 Hundreds of people line up to get a family doctor in Kingston.

00:01:17.800 So you can see the images from February 2024.

00:01:20.360 Or again, back in January of 2025, hundreds of Canadians lined up in Brockton, Ontario,

00:01:26.620 in hopes of securing a family doctor.

00:01:30.160 So no, this is not a Soviet-era breadline that I'm showing you.

00:01:34.600 It's Canada's equivalent.

00:01:35.880 It's the modern-day equivalent.

00:01:37.220 You've got your Canadians out in the snow with their timmies, 1.00

00:01:39.240 waiting for the chance to possibly have the privilege of talking to a doctor, talking to a family doctor.

00:01:46.520 That is what things have come to today.

00:01:50.060 And another story from the Fraser Institute showed that Canadians are paying more for health care,

00:01:54.840 but they're getting less.

00:01:56.080 Canada has fewer doctors, hospital beds, and MRIs among longer wait times than other countries with universal health care.

00:02:02.260 So even when you isolate for just other countries that have the same type of health care that we do,

00:02:06.460 universal health care paid by the government, we are still the worst.

00:02:10.080 Among 31 high-income universal health care countries, Canada ranks among the top third in spenders,

00:02:15.360 but receives average to poor value in return.

00:02:19.540 And so our friend today, Colin Craig, who's doing the episode, is trying to do something about this.

00:02:25.240 He has released a new documentary where he compares Japan's universal health care system to Canada's.

00:02:32.180 The documentary is released by secondstreet.org, and you should go check that out.

00:02:37.060 So Colin Craig, he's a public policy advocate and president of secondstreet.org,

00:02:41.880 where he focuses on issues related to health care challenges in Canada.

00:02:46.160 Colin, welcome to the show.

00:02:47.060 Thank you for joining us.

00:02:48.160 Well, thanks for having me, Candice.

00:02:50.140 Okay, well, tell us about this documentary that you have released.

00:02:53.740 What was the purpose of it, and what did you find?

00:02:56.900 Some say the bubbles in an Aero truffle piece can take 34 seconds to melt in your mouth.

00:03:01.560 Sometimes the very amount you're stuck at the same red light.

00:03:05.200 Rich, creamy, chocolatey Aero truffle.

00:03:08.060 Feel the Aero bubbles melt.

00:03:10.100 It's mind bubbling.

00:03:12.320 Yeah, so we went over to Japan to take a look at their universal health care system.

00:03:17.140 It's a very respected universal health care system.

00:03:20.180 So, you know, you alluded to this earlier, Candice, but Canadians like having a universal system where everyone's covered.

00:03:26.580 You're not going to get bankrupted if you need something serious, like maybe knee surgery or a heart operation or whatever.

00:03:33.160 So Japan does that.

00:03:34.520 The big difference between them and us is that they provide treatment right away, and obviously that's not happening, and in a T.

00:03:43.020 We're literally dying on waiting this for things like heart operations, cataract surgery, whatever.

00:03:49.280 I mean, the stories in this country are awful.

00:03:51.040 I think most people understand that.

00:03:53.060 So we went over to Japan to kind of try and find out, you know, what we could learn from their system.

00:04:00.460 And the biggest difference between them and us is that it comes to the supply of health care.

00:04:07.100 So in Japan, they take a totally different approach than Canada.

00:04:11.920 They will welcome people to enter their health care sector and provide health care.

00:04:17.440 If you want to open up a knee clinic or a hospital or whatever, if you have qualified staff, you can do it in Japan.

00:04:25.840 The government says, okay, everyone's covered in the country, and here's how much we pay for different procedures.

00:04:33.240 So if it's a knee surgery, I don't know the number uphand, but just I'll make it up.

00:04:38.400 Why not?

00:04:38.800 Let's say it's $10,000.

00:04:39.940 And anyone who enters that market knows that, okay, the government's going to be providing $10,000 per knee surgery.

00:04:48.180 So it's a very welcoming approach.

00:04:50.740 They welcome people to help increase the supply of health care.

00:04:54.620 In Canada, like I said, we do the opposite.

00:04:57.020 We have governments putting up roadblocks anytime someone wants to start providing health care in this country.

00:05:03.180 So by restricting supply of health care, go figure, you end up with long waiting lists like the ones that you just showed.

00:05:10.580 Well, one of the things that's so interesting from the documentary is that they just don't really seem to have real wait times in Japan.

00:05:17.380 I'm going to play a short trailer from the documentary because you speak to a lot of people, people who work in hospitals, doctors, advocates, all this kind of thing.

00:05:24.460 Most people say, you know, average, you wait like maybe a couple of days or two weeks max when you need a surgery, which, you know, to the Canadian here, it's like, wait, what?

00:05:32.980 How is it even possible?

00:05:34.340 Well, you explore that.

00:05:35.440 So let's play this clip from the documentary Fixing Canada's Health Care Lessons from Japan.

00:05:42.020 We're in Japan this week to learn more about their universal health care system and how they have virtually no health care wait times.

00:05:48.900 Come on, let's go find out.

00:05:50.060 The wait time is not very long. Basically, no wait time.

00:05:55.020 Do you have any wait times that are measured in years?

00:05:57.960 Not particularly.

00:05:59.680 How long waiting time while in Canada?

00:06:02.720 Sometimes a year.

00:06:04.260 Sometimes a year?

00:06:04.840 Yeah.

00:06:05.160 A year.

00:06:05.800 Yeah.

00:06:09.280 Really interesting stuff. You can see this sort of Japanese temperament, right?

00:06:12.760 They're trying to be polite, but they're kind of shocked when you tell them about what things are like in Canada.

00:06:17.200 And so can you kind of unpack the reason?

00:06:20.160 Like, why is it that there's so much innovation, there's so many options, there's so many choices in Japan, and yet they're still able to maintain that universal coverage?

00:06:28.320 And people don't really pay that much out of pocket when they have major surgeries or even doctor visits.

00:06:33.000 Yeah, that last doctor in the clip there, he was asking how long the wait times are in Canada, because he couldn't believe it when I said it was a year.

00:06:40.640 Like, they were shocked. People over there were, like, stunned that Canadians would have to wait so long.

00:06:45.220 So to your question about how, the big difference is that in Japan, they welcome people to enter their healthcare sector and start providing care for patients.

00:06:56.720 I mean, this is a novel concept, but they want people to enter.

00:07:00.000 If you have a, you know, qualified staff, obviously, but you can go in and open up a clinic that maybe does knee surgeries, or maybe you open up a hospital, they openly welcome it, because the government doesn't really care who's providing it, as long as it's, you know, qualified people and that they can help patients.

00:07:17.880 So the government sets the rate for how much they will pay for different procedures and that.

00:07:23.620 And then everyone knows, okay, these are the terms of agreement. If I enter the market, then this is how much I'm going to get compensated for providing these different treatments for patients.

00:07:33.220 So it's much easier. It's very straightforward.

00:07:36.300 In Canada, we find the opposite. We have governments putting up stop signs, red lights, whatever, barricades, whatever you want to call it, to restrict the supply of healthcare.

00:07:46.140 So, Candice, tomorrow, if, let's say, you wanted to open up a, whatever, knee surgical clinic somewhere in Canada, and start doing like they do in Japan, where you would, you know, have staff providing knee operations to people, you can't really do that in Canada.

00:08:03.040 Because you would have to come up with some agreement with the government where they kind of go, oh, okay, well, we're going to pay you X amount, because our system just isn't set up that way.

00:08:13.000 They fund services to patients. Our systems fund, or our governments fund health systems.

00:08:20.140 So they throw money into the system and then hope that patients get a lot of treatment or healthcare services out of it.

00:08:27.180 So a lot of our dollars get grinded down in bureaucracy just because of the structure is so different.

00:08:32.880 So we restrict the supply, you end up with long waiting lists.

00:08:36.680 And if you want to, let's say, you want to, don't want to wait in the public system in this country, and you want to pay privately, well, government barriers are there to stop that from happening.

00:08:46.180 You can't do that in your province, with the exception of Quebec.

00:08:49.620 So this is why patients travel to other provinces to pay for treatment.

00:08:53.660 So we've got it all backwards.

00:08:55.060 And lo and behold, that's why we have long wait times.

00:08:57.120 Well, 100%.

00:08:58.360 It's like a big government top-down system where a government controls everything.

00:09:01.400 And if you try to innovate, like we saw with the Day Clinic in British Columbia, the Cammy Day Clinic, the government will sue you out of existence.

00:09:07.920 So much that it doesn't, it doesn't want competition so much so that it will put you out of business.

00:09:12.900 The documentary is called Fixing Canada's Healthcare Lessons from Japan.

00:09:17.260 I got a few more questions for you.

00:09:18.860 First, I want to take a moment to thank the sponsor of today's episode, which is Unsmoke.

00:09:22.980 Look, folks, it is time to modernize Canada's rules on nicotine.

00:09:27.000 Alternatives to cigarettes like heated tobacco vaping products and oral smokeless products don't burn tobacco or produce smoke.

00:09:32.700 They aren't risk-free, but the growing body of scientific evidence shows that they have the potential to be substantially less harmful than actually smoking cigarettes.

00:09:39.680 Despite this, Canadians are banned from access and critical information, and in some cases even banned from these products.

00:09:44.980 Nicotine pouches remain banned in convenience stores, and current laws ban communication about the risks of these products compared to cigarettes.

00:09:51.260 The evidence is here. Tools exist. Canadians should have the freedom to know about them, to be able to learn about them.

00:09:56.400 Please learn more by visiting unsmoke.ca.

00:10:00.160 Okay, Colin, I want to ask you, because basically, you know, we've been talking about this for a long time, that other alternative countries exist, right?

00:10:08.580 We always compare ourselves to the Americans. 0.82

00:10:10.440 We always look at the U.S. healthcare system. It makes sense.

00:10:12.520 We share a continent with them. We have similar sorts of populations.

00:10:15.400 And yet, one of the things that you do over at Second Street is look outside of the continent for alternatives.

00:10:23.500 So, you know, we had this report that Switzerland has much better healthcare, other countries as well.

00:10:29.680 Why hasn't this message gotten through?

00:10:32.240 And even in, you know, Canadian provinces run by conservative governments like Ontario and Alberta,

00:10:38.500 we haven't really seen a lot of innovation.

00:10:40.720 Why do you think that is?

00:10:41.760 Yeah, it's a very good question, because there's so many models we could learn from.

00:10:46.940 So we, you know, this year we just talked about it.

00:10:48.820 We went to Japan.

00:10:49.960 We also have a video on our site, if anyone's interested, where we look at Sweden's healthcare system, as well as France's healthcare system.

00:10:55.880 Europe, in particular, has a lot of better universal healthcare systems that are delivering better results.

00:11:02.800 So there's a lot to learn from.

00:11:04.000 To your question about why we're not seeing reform happen fast enough in this country,

00:11:09.560 the problem as I see it, because we do a lot of public opinion research, the public is ready for reform.

00:11:18.620 A lot of our polls show that people are ready for reform.

00:11:22.280 They can see that the past few decades of throwing money at the healthcare system and hoping something would magically work,

00:11:28.820 they can see that hasn't worked.

00:11:29.940 We are one of the top spenders in the world, as you talked about earlier.

00:11:34.540 We're not getting bang for our buck.

00:11:36.240 So the public is ready for reform.

00:11:38.000 The political class has been very slow to respond.

00:11:40.840 And I think part of the problem is that a lot of people in the political class have long memories,

00:11:45.700 and they're still thinking that this is the debate from 20, 30 years ago where healthcare reform was something that politicians just did not want to talk about because it was too controversial.

00:11:56.400 But now the public understands that, you know, there are better systems out there in Europe, countries like Japan, Australia, and others, that we could be learning from and copying their policies.

00:12:08.780 So the public understands that.

00:12:10.120 I think it's time for the political class to wake up a little bit.

00:12:13.000 Something that was encouraging, though, and we do have these encouraging signs in different parts of the country.

00:12:18.860 In British Columbia, in their last election, one party there, the Conservatives, campaigned on a pretty bold platform to reform healthcare.

00:12:29.200 So instead of, you know, as political operatives will say, instead of a shield issue where they're kind of playing defense,

00:12:34.900 they saw it as a sword where they could go out and aggressively campaign on it.

00:12:39.360 Now, you know, I think it could have made communicative things better than that,

00:12:42.800 but at least they were willing to kind of stick their neck out and start talking about it.

00:12:47.420 You know, in Ontario, some credit to the government there.

00:12:51.100 They're starting to partner more with non-government providers for healthcare.

00:12:54.700 This doesn't have to be, all the services don't have to be delivered by the government.

00:12:59.400 The government can fund them, fund other people to deliver the services to the public,

00:13:03.520 whether it's a non-profit or for-profit entity.

00:13:06.360 So Ontario is doing that more.

00:13:08.060 I think that's a positive step.

00:13:10.280 We'll have to see how well they've negotiated these contracts.

00:13:13.020 Of course, they use different ways to do it better, but it looks like it could be promising.

00:13:19.280 In Quebec and Alberta, Quebec's been doing this for a number of years,

00:13:23.440 where they are funding services to patients.

00:13:25.820 This is the fundamental difference I talked about before,

00:13:28.260 where you want to fund services to patients rather than funding assistance.

00:13:32.560 So Quebec is moving more towards paying for services to incentivize the system

00:13:38.480 to make sure that we're focused on that.

00:13:40.840 And Alberta has announced they are shifting in that direction to change how they find healthcare

00:13:46.200 so that more dollars reach services to patients,

00:13:50.440 God being that are caught up in bureaucracy.

00:13:52.700 So there's some changes.

00:13:54.300 We do need to see a heck of a lot more

00:13:56.080 One of the things I learned from your documentary, Colin,

00:14:02.320 is that in Japan, they have sort of three different types of hospitals that you can go to.

00:14:06.300 You have the government-funded, government-operated hospitals.

00:14:09.340 You also have non-profit-run hospitals.

00:14:11.380 And then you have privately-run hospitals.

00:14:12.860 And no matter where a patient chooses to go, basically the dollars follow the patient.

00:14:18.340 So the subsidy goes wherever you choose, which creates the kind of competition that you would want in any market.

00:14:24.020 And it creates more options because people have the choice to go to the hospital where they have the best experience.

00:14:31.100 The overarching rules are that every single healthcare professional needs to be certified by the Japanese government.

00:14:37.460 So it's not like they're just letting anyone go in and perform surgeries.

00:14:40.500 You still have to have the same kind of medical license that you would have in Canada.

00:14:44.580 This just seems like such common sense and such a wonderful way to manage a system.

00:14:50.180 Do you see a possibility for anything like that ever happening in Canada?

00:14:54.280 Yes.

00:14:54.820 I mean, it's a little bit similar to what I was just talking about, what Alberta's doing and Quebec,

00:15:01.340 where the government, if you think about it, they've taken ideology out of healthcare.

00:15:05.900 Because most patients don't care if you're getting surgery in a private, a non-profit, or a government facility.

00:15:13.940 You don't care if the nurse who's helping out with the surgery, if she's in the United States or not.

00:15:18.020 No one cares about any of that stuff.

00:15:20.120 If you're a patient, you want the surgery done right.

00:15:23.260 That's probably your top concern.

00:15:25.760 You don't want to wait a long time for it either, right?

00:15:28.480 So you want to get a good service, a fast amount of time.

00:15:33.700 And when you're walking out of the surgical room or whatever, you don't want to face a big deal.

00:15:39.040 I think these are the three things that Canadians are much concerned about.

00:15:42.100 Now that's kind of how they approach it in Japan, right?

00:15:44.800 It doesn't matter if it's a non-profit or for-profit.

00:15:47.340 They'll fund, the money follows the patient.

00:15:49.340 The patient decides which facility works best for them.

00:15:52.400 So with Alberta shifting to this model where they are funding services, there's nothing stopping them from saying,

00:16:00.000 well, yeah, you could get that service done in a private, whatever, or a non-profit, whatever.

00:16:05.480 So we'll see how Upward ultimately rolls things out.

00:16:08.920 But once you start to change how you're funding health care,

00:16:13.480 it makes it a lot easier to start taking ideology out of health care

00:16:17.520 and really putting patients right at the center of the system.

00:16:20.460 What a novel concept, taking politics and ideology out of health care.

00:16:24.840 I wanted to show this graph from the Fraser Institute.

00:16:27.720 It shows that the medium health care wait time has hit 30 weeks,

00:16:32.420 the longest of recording time.

00:16:33.440 So in 2024, physicians across Canada reported average wait times of 30 weeks

00:16:37.740 between the referral from a GP to the receipt of treatment up from 27 weeks.

00:16:44.220 And so you can see from this graph, folks, how much things have grown.

00:16:47.200 So the blue line shows 1993 wait times.

00:16:51.080 You know, averages were much shorter.

00:16:52.760 Actually, it's sort of more like what Colin experienced in Japan,

00:16:55.380 that you can get a surgery done in a couple weeks.

00:16:58.380 Now it is nothing like that.

00:17:00.280 So in a place like Prince Edward Island, you might wait as long as 77 weeks for a surgery.

00:17:06.420 New Brunswick, 70 weeks.

00:17:08.120 You know, even the fastest province, Ontario, you were still waiting on average 23 and a half weeks.

00:17:15.080 British Columbia, 29 weeks.

00:17:16.860 Alberta, 40 weeks, 38 weeks.

00:17:18.660 I mean, this is not good, folks.

00:17:20.720 If you are in pain and suffering, you would want to see treatment a lot faster.

00:17:25.440 Some good news, though, that I'll finish the interview on Colin,

00:17:28.240 which is that young Canadians have more support for changes and innovations in the system.

00:17:32.960 Young Canadians support private health care.

00:17:35.540 So according to a research company poll done in May of 2025,

00:17:39.860 36% of Canadians now believe that the health care system

00:17:43.040 should be operated in the private sector.

00:17:45.000 Nearly half disagree.

00:17:46.600 But Canadians aged 18 to 34 had the highest rate saying that they would approve of private health care.

00:17:54.740 So what do you make of that?

00:17:56.420 Yeah, I think young people can see, too, the system is not working.

00:18:00.520 And, you know, like I said at the top, Candice,

00:18:02.220 the good news is that Canadians like this idea of universality.

00:18:07.100 And we can see that we can keep that.

00:18:09.700 We can look to Sweden and Japan and France and all these other countries that have a universal system

00:18:14.660 where everyone's covered and you can get to it right away.

00:18:19.220 I think that would kill TI.

00:18:20.820 But people are seeing the ideology in health care.

00:18:23.360 As we talked about Japan, people are getting in right away.

00:18:28.160 People are not, they looked at me strange when I was over there and I was talking about people dying on waiting lists.

00:18:34.040 Like they cannot believe what is going on in this country.

00:18:36.880 And there's one, I'll say this and then I'll finish,

00:18:39.320 but this one medical director at the hospital at Osaka,

00:18:42.120 we were talking and I was explaining like our system and the suffering

00:18:45.200 and the government bans on access to health care

00:18:47.920 and kind of sat back in its chair and said,

00:18:50.040 oh, I see why you came here.

00:18:52.200 Like it just kind of crystallized for a while.

00:18:55.560 But yeah, it doesn't have to be as bad as it is in this country.

00:18:59.340 Well, 100%, folks, go check out the documentary.

00:19:01.520 It's called Fixing Canada's Health Care Lessons from Japan. 0.96

00:19:05.060 That is Colin Craig from Second Street.

00:19:07.020 Thank you so much for joining us, Colin.

00:19:08.580 Thanks a lot, Candice.

00:19:09.460 Always appreciate the conversation.

00:19:11.180 All right, folks, have a great afternoon.

00:19:13.120 Back again tomorrow.

00:19:14.240 Thank you so much.

00:19:14.960 I'm Candice Malcolm.

00:19:15.540 This is the Candice Malcolm Show.

00:19:16.320 Thank you and God bless.

00:19:17.240 Thank you.

The Candice Malcolm Show - August 21, 2025

How can we fix Canada’s failing healthcare system？ Let’s look to Japan

Episode Stats

Summary

Transcript