True Patriot Love - Ontario’s Healthcare Meltdown： Why the System Broke

00:00:00.000 Recently, Shelley Spence, the Auditor General of Ontario, had a damning report about healthcare in the province with some shocking numbers, including some allegations of $1 billion in potential overcharges by OHIP and even some doctors who were billing for 24 or more hours of service in a single day.

00:00:25.460 To talk more about this and some of the issues facing healthcare in the province, across the country, the man himself, Paul Micucci.

00:00:31.420 Paul, how are you?

00:00:32.060 Good, Jim. How are you doing?

00:00:33.020 Good. Happy holidays.

00:00:33.880 Yeah, you too, brother.

00:00:36.500 You know, I'm a law-abiding Canadian, and like a lot of Canadians, we follow the rules.

00:00:41.120 I just, it sends my hackles up to think someone could bill 500 patients in a day, 59 doctors could bill 24 more hours of practice in a day to the taxpayer.

00:00:54.260 When we know that the healthcare system's at its breaking point, it's so unfair, they can't get away with this, Paul.

00:01:01.200 Well, and the interesting thing, you know, and we're going to get into some more details on it, but the 59 was in 2023.

00:01:08.600 So the 59 doctors that were billing 24 hours or more was in 23.

00:01:13.740 Guess what, Jim?

00:01:14.760 It grew to 82 by 25.

00:01:17.700 Really?

00:01:18.280 Of course.

00:01:18.820 There's no audits, no oversight, and they don't have to repay the money.

00:01:25.480 You know what?

00:01:26.320 But hold on, before you, I just wanted to-

00:01:28.640 Please.

00:01:29.160 Because this has kind of spiraled into a huge discussion over the last 24 hours.

00:01:33.380 So when we started prepping this show, we were really prepping it based on the Auditor General of Ontario's report.

00:01:39.660 A very in-depth report.

00:01:40.980 Yeah, of overbillings.

00:01:42.120 And I spent, like, you know, going through it with Christoph and the team and you, you know, hours going through it.

00:01:48.160 And, you know, we had a show built.

00:01:50.280 And then all of a sudden, you know, this next report comes out saying we're 6 million doctors short.

00:01:55.780 And the lady that did it did a really good job. 1.00

00:01:58.900 The doctor that did it did a really good job trying to figure out a set of principles to deal with being short doctors.

00:02:06.000 So she'd done a bunch of surveys.

00:02:08.000 She'd solicited a bunch of input, found out what the hot buttons were with people.

00:02:12.220 And, of course, it was lack of doctors.

00:02:14.220 You know, that was the key element.

00:02:16.880 But many more things in that report.

00:02:18.740 But on the heels of that, all of a sudden, we get the news that 50% of our doctors across Canada are going to be retiring in the next five years.

00:02:28.500 That is frightening.

00:02:29.780 Right?

00:02:30.740 50%.

00:02:31.140 So, and then on the next thing that comes out, this is like a 24-hour news cycle or 48-hour news cycle maybe.

00:02:38.860 The next one that comes out is the federal government now is going to approve foreign doctors and accept their credentials.

00:02:46.600 So they've opened up a new immigration system to bring foreign doctors in, which, you know, Nir and I do a show on immigration.

00:02:55.000 And we've talked about it before.

00:02:56.780 And the interesting part is we've talked about how hard it is to get doctors in on the show.

00:03:02.100 Now they're going to open it up and let doctors in. 0.64

00:03:05.400 So, but it's too late.

00:03:07.060 So it's, you know, the horses left the barn, quite frankly.

00:03:11.220 The problems are out there. 0.95

00:03:12.780 So, you know, you look at this and it's a smorgasbord of just crap now, the system, because quite frankly, you got overbilling.

00:03:21.920 You got shortages. 0.57

00:03:23.060 You got, I don't know what to think, Jim.

00:03:24.840 I don't even, honestly, I look at the stats because I'm an accountant by trade.

00:03:28.620 And I say to myself, okay, you know, Ontario has 459 patients per doctor.

00:03:37.240 Correct.

00:03:37.840 Right.

00:03:38.120 And Quebec has about 400.

00:03:39.960 Right.

00:03:40.500 You know, three high threes.

00:03:41.800 We did that show on Quebec, which was a great show.

00:03:44.560 And I thought they were on to something.

00:03:46.300 I think you and I both agreed.

00:03:48.040 They had some principles, but it wasn't there yet.

00:03:51.880 So, you know, you look at it and you say, okay, the math doesn't work.

00:03:55.500 Okay.

00:03:55.720 Math doesn't work.

00:03:56.520 There's not enough patients per doctor currently.

00:03:59.240 But yet we need more doctors.

00:04:00.720 But yet we're overbilling.

00:04:02.320 Okay.

00:04:02.820 Now we're going to bring in foreign doctors. 0.69

00:04:06.240 What the heck?

00:04:07.140 Can we not get a strategy here?

00:04:08.800 Can we not put, can we not lay down some track and try to get something that works?

00:04:16.560 Paul, I mean, I don't think there's anyone watching or listening to you right now that

00:04:20.600 doesn't agree that there's something wrong.

00:04:22.780 Well, one of the first things people talk about being Canadian, they talk about this and that

00:04:27.080 and they talk about our healthcare, free healthcare, free healthcare.

00:04:30.140 It's like, it's, it's the envy of the free world, right?

00:04:32.440 Yeah.

00:04:32.740 Like look at our free house.

00:04:34.000 It was, it was, but it can be proper management, proper oversight, proper distribution of funds.

00:04:42.100 It can be again, but someone has to step up.

00:04:45.300 And we were just talking before the show.

00:04:46.760 If Doug Ford stems, stands up there and says, you know what, we are going to find all the

00:04:51.800 people that overbuild and hold them accountable.

00:04:54.480 That could be the end of his political career.

00:04:56.740 Well, yeah, but okay.

00:04:57.560 So now you have an ophthalmologist, right?

00:04:59.820 Who actually billed in 24, $6.7 million.

00:05:05.400 So, you know, he's saying that he was seeing 233 patients per day.

00:05:14.240 That's not possible.

00:05:15.760 That's not humanly possible.

00:05:17.180 No.

00:05:17.640 I go to my eye doctor.

00:05:19.360 What's that?

00:05:19.800 Every minute?

00:05:20.700 That's crazy.

00:05:22.180 It's not even.

00:05:23.040 You're lucky if you can get through your appointment in 30 minutes.

00:05:25.480 Well, we had, we had a radio, uh, diagnostic radiology.

00:05:30.060 We had, uh, who billed 3 million, right?

00:05:33.340 Which is very interesting.

00:05:34.720 Uh, is saying that they had 728 patients a day, which I think someone translated before

00:05:39.820 the show, they were seeing a patient every 2.2 minutes.

00:05:43.700 Well, I've had x-rays.

00:05:45.140 I've had an MRI.

00:05:46.540 That's not possible.

00:05:47.920 That it's not physically possible to get your x-ray done or your MRI done in that short

00:05:52.020 of time.

00:05:52.620 I'm with you.

00:05:53.220 But, you know, honestly, we have, we have GPs that are billing $2 million and they're

00:06:01.560 saying they're seeing, well, 731 patients in a day.

00:06:07.000 We are so regulated in Canada, in Ontario, across the country for everything that if something

00:06:13.060 seems untoward, a red flag comes up, whether it's transportation, uh, business, Bay street,

00:06:21.360 broadcasting, there's a red flag that comes up and someone reaches out to go, Hey, this

00:06:26.320 doesn't seem right.

00:06:27.540 How is it possible that a red flag hasn't come up with this?

00:06:31.120 There are no red flags, but they shut them off.

00:06:34.120 So the red flags, the audit process got shut off years ago.

00:06:38.160 It's an honor system.

00:06:39.660 And there's no monitoring, no analytics looking at these billings.

00:06:44.580 So obviously 95% of the doctors are adhering to the honor system and 5% realize, well, if

00:06:50.920 no one's going to check, I can just do what I want.

00:06:52.940 And they are.

00:06:53.900 Well, and I think the number's higher, unfortunately, Jim.

00:06:56.320 I don't think it's 595.

00:06:57.720 I think it might be quite a bit higher.

00:07:01.180 So, so because quite frankly, when you look at the numbers and again, the number of patients

00:07:06.040 per doctor and you look at the billings, you know, and this is where, pardon me, the provinces

00:07:11.300 and, um, uh, the provinces and the country, Canada has put way more money into healthcare.

00:07:21.760 Oh, so we've opted to the point where we're in the top five, you know, I've talked about

00:07:26.240 this on previous shows.

00:07:27.780 We're in the top five in healthcare spending.

00:07:31.000 We exceed a lot of other countries.

00:07:33.260 And you look at, like you were mentioning before, Denmark, Denmark.

00:07:36.460 Yeah.

00:07:36.700 Yeah.

00:07:37.100 You know, we're, we're below them, but we're not far below them, but they have way more

00:07:42.840 doctors than we do.

00:07:45.300 They have almost double the number of doctors per thousand people.

00:07:48.100 And they don't have these eight months before I see a specialist or nine months.

00:07:51.460 Let's get my hip replaced. 1.00

00:07:53.140 But, but when we looked, we went and looked, they also have an audit process.

00:07:59.380 So, so let's say, you know, um, if we go through and we take a look at the countries that we

00:08:05.500 went through and we looked at probably about six or seven countries and they all have audit

00:08:11.000 processes.

00:08:11.600 They have AI analytics.

00:08:13.340 Like in this day and age.

00:08:14.480 You were mentioning Australia particularly had a really good system.

00:08:17.220 Well, Australia.

00:08:18.100 So here it is here.

00:08:18.900 They have an AI provided, uh, provider, uh, powered, uh, Medicare fraud analytics, real

00:08:26.740 time risk scoring for providers.

00:08:29.080 So if you build so much, you go into a matrix and that matrix pops up and they send a letter

00:08:34.820 to you and you have to validate your billings.

00:08:37.160 That's almost instantaneously, Jim.

00:08:39.420 So say your billing is 450.

00:08:41.100 It consistently, all of a sudden it spikes at 1.8 million.

00:08:43.880 And you're like, Whoa, that should raise a red flag.

00:08:46.620 Yeah.

00:08:46.880 Well, it should on a monthly basis.

00:08:48.300 Right.

00:08:48.960 If you're, you know, if you're 24 month average, if you go above it, it should say, ask why

00:08:53.800 you went above it.

00:08:55.020 Yeah.

00:08:55.160 What happened?

00:08:55.800 What happened?

00:08:56.420 You know, what, what was the thing?

00:08:58.060 So, and the interesting thing is what we had, quite frankly, we, I don't know if you remember

00:09:03.040 this, but I got a couple of these letters, uh, years ago and they, this was, oh God, I probably

00:09:08.680 was in my forties.

00:09:10.380 Um, and it said, were you at the doctor on such and such a date?

00:09:15.280 And it was a check the box.

00:09:16.660 I never got that letter, but you did.

00:09:18.140 Eh?

00:09:18.420 Yeah.

00:09:18.640 And you took it and you checked the box and it was pre paid postage.

00:09:22.580 Okay.

00:09:22.980 You put it back in the mail and said, and that was our audit process.

00:09:25.720 Right.

00:09:26.240 Okay.

00:09:26.780 So that was, and we did do it for a while.

00:09:28.500 And then we shut it down, went to the honored system.

00:09:31.360 And then we have a, if something does pop up now, if someone's doing it and it does

00:09:34.920 raise a red flag, we have a tribunal, you know, for the provinces that's, they sit down

00:09:41.000 with the doctors, the doctors in Ontario don't have any requirement to pay the money back.

00:09:45.640 So if they overbilled and they're found to have overbilled, there is no requirement.

00:09:49.960 They pay the money back.

00:09:51.660 So why even have a tribunal?

00:09:53.700 They, they, on their honor system settle.

00:09:56.400 Well, so if I owe 3 million and I give you 50, then I'm settled.

00:10:02.740 Is that considered okay as close?

00:10:04.780 If you're okay.

00:10:05.660 Not if I'm okay.

00:10:06.740 Not if I'm the doctor.

00:10:07.840 Not if the government, if, if the doctor's okay and he's okay to settle that amount, then

00:10:12.420 it works.

00:10:13.400 Why would you ever stop cheating if you can get away with it every year?

00:10:16.520 Well, that's, that's the issue.

00:10:17.920 So in New Zealand, they have a nationally integrated patient and billing system with

00:10:23.460 flags, anomalies, that flags, anomalies instantly.

00:10:27.660 They have an automated fraud detection in the UK and digital documentation standards.

00:10:33.860 Well, wouldn't that make sense?

00:10:34.860 Wouldn't it make sense is when you went in and swiped your health card, if both you and

00:10:40.640 the doctor were aware, so, and it was registered, so that would be registered.

00:10:46.360 So you'd get an email and saying, you visit the doctor on this day.

00:10:49.380 Yeah.

00:10:49.700 Like, isn't that easy to do?

00:10:51.280 And you hit confirm.

00:10:52.440 Yeah.

00:10:52.700 Just, yeah, I did.

00:10:53.760 Yeah.

00:10:54.220 And then that visit gets validated.

00:10:57.000 We have confirmations from everything.

00:10:59.960 We do for every single thing.

00:11:02.380 I have an email confirmation.

00:11:03.640 I, I, it's so, here's my thing at the end of the day, beyond all the numbers.

00:11:08.960 Yeah.

00:11:09.640 Canadians believe in fairness.

00:11:12.360 We do.

00:11:13.380 We look, I'll pay my taxes.

00:11:15.540 I'll go the extra mile.

00:11:17.080 Yep.

00:11:17.700 But to find out there are doctors abusing the system, abusing the honor system, over billing 0.79

00:11:23.160 so that you can't hire more doctors and more nurses and more radiologists that offends

00:11:28.240 me and then, and something, this is where the government, you say, well, we don't want

00:11:32.760 more government.

00:11:33.420 Well, there's sometimes you do need the government and you do need oversight.

00:11:36.380 And this is one of them.

00:11:37.840 Well, and you know, it's interesting because I say this on a lot of shows, Jim, you know,

00:11:42.680 given where we are, given where the status of the country and financially where we are

00:11:47.920 and, you know, with the U S and tariffs and everything going on, we are at the point

00:11:53.180 where we can't keep doing these things.

00:11:55.560 So what's, what's happening, what you're seeing, and this is very interesting.

00:11:58.880 You know, the, how you look at the last 24 hours, I think people are kind of getting

00:12:03.120 that now, like, okay, this might've been status quo.

00:12:05.780 I was kind of monkeying around with this.

00:12:07.600 Everyone was doing good.

00:12:08.700 We were all killing it.

00:12:10.040 Well, now we're not right.

00:12:12.500 And a lot of the truth is coming out.

00:12:14.340 So now people are starting to say, well, time out now, right?

00:12:16.920 Yes.

00:12:17.280 You know, not only do people not have doctors now we can't afford as a country to do this

00:12:23.220 anymore.

00:12:24.340 So, so interesting.

00:12:25.760 And I thought it was kind of oddly played in the report that came out.

00:12:31.400 All of a sudden we're now hearing that the doctors are retiring.

00:12:36.540 I'm like, oh, that's kind of weird.

00:12:38.060 Like, is that just happen chance?

00:12:40.160 Or was that like saying now, okay, you know, we're not probably going to get our way on a

00:12:46.040 bunch of this stuff.

00:12:48.000 So that's a great question.

00:12:49.600 Whether it's coincidental or intentional, I don't know, you know, I hope it's not, but

00:12:54.220 quite frankly, it, it, it did raise a lot of red flags when I saw it.

00:12:59.580 I was like, oh, this is very odd.

00:13:00.600 And within a 24 hour news cycle, we've had overbilling.

00:13:04.020 We've had, uh, you know, the stats studies on lack of doctors, and now we have retiring

00:13:09.960 doctors.

00:13:10.420 So we have all this in a short period of time.

00:13:12.940 It's like, okay, come on.

00:13:14.420 So how do we, you know, how do we overcome all these things?

00:13:17.940 We got to get a system in place.

00:13:20.360 We need to get, and we should be able to listen.

00:13:22.820 We're very technologically savvy.

00:13:24.500 We're a very smart country.

00:13:25.940 We should be able to quickly.

00:13:27.620 We're not a huge country.

00:13:28.980 We should be able to quickly get health cards that have the capability issued to everyone

00:13:34.520 that we can validate visitation to the doctor.

00:13:38.200 Every time I go to the, I've had to go to the hospital or doctor.

00:13:40.880 They first thing they do is they swipe my information.

00:13:43.600 Yeah, they do.

00:13:44.340 But it doesn't, where does it go?

00:13:45.480 I just assume it goes in their database to indicate that I went.

00:13:49.940 Well, it goes into their database, and then they create a billing form.

00:13:53.640 And apparently, from what I'm hearing, the number of codes for billing in Canada are outrageous

00:14:00.680 across the country.

00:14:01.380 With a variety of codes?

00:14:02.420 Oh, yeah. 0.92

00:14:02.700 It's silly. 0.65

00:14:03.400 It's wacky doodle. 0.98

00:14:04.800 Apparently, it's so crazy.

00:14:06.040 This was the Quebec.

00:14:06.780 Remember the Quebec group?

00:14:08.320 Yeah.

00:14:08.440 They complain.

00:14:09.300 They're like, you know, it takes me five hours to bill because I have 93 different subcodes. 0.59

00:14:14.760 Which is ridiculous. 0.91

00:14:15.820 Which is ridiculous. 0.97

00:14:16.740 So they were trying to get that sort of fine-tuned. 0.67

00:14:20.580 But, you know, here's the other thing.

00:14:21.840 So, and I wanted to go on this, too.

00:14:24.660 Okay, foreign doctors.

00:14:26.440 And you picked it up at the community show.

00:14:28.420 You know, we remember our lifetime getting in a cab.

00:14:31.020 I think everyone had this experience.

00:14:32.700 Hey, you know, where are you from?

00:14:34.480 I'm from.

00:14:35.100 What do you do back home?

00:14:36.380 I'm a doctor.

00:14:37.360 Oh.

00:14:38.200 Okay, great.

00:14:38.940 And this went on for years.

00:14:40.100 Pure later delivery, like it's everywhere.

00:14:41.820 Yeah, I remember having these discussions.

00:14:43.820 It was probably a decade ago.

00:14:46.520 They were more prevalent.

00:14:47.840 Like you had a ton of them.

00:14:49.080 Every person that was driving you in a cab or an Uber or whatever, quite frankly, was a doctor from somewhere or something.

00:14:56.280 So, you know, you used to have a lot of those conversations.

00:14:59.400 But now we're going to open it up.

00:15:00.760 And we're going to bring more doctors in.

00:15:02.000 Which, listen, I'm all for.

00:15:03.480 Mm-hmm.

00:15:03.740 How about starting to focus again on our own population?

00:15:09.320 Sure.

00:15:09.840 Like, so we have a bunch of kids here.

00:15:11.180 And I know, you know, from my family, I know, listening to the kids, how hard it is to get into medical school.

00:15:17.680 Brutally hard.

00:15:18.440 Brutally hard.

00:15:19.160 Yeah.

00:15:19.260 So we must, you know, and this is kind of the interesting thing.

00:15:23.740 And the health ministers, you know, whether it be the federal health minister or whether it be the provincial health ministers, guys, right?

00:15:31.280 And you must be driving to work.

00:15:33.320 So I can imagine you're driving to work and you're saying, okay, what are my top 10 issues in my portfolio today?

00:15:39.580 Number of doctors.

00:15:41.520 Hmm.

00:15:42.820 I think I'm going to put a schedule together to figure out when the doctor is going to retire and what my attrition on doctors is going to be.

00:15:49.120 They do it for everything else.

00:15:50.440 Well, obviously, but they didn't do it for this because all of a sudden, you know, yesterday we're getting this news that in five years, 50% are going to retire.

00:15:59.360 So I'm like, how did we miss this again?

00:16:02.500 You know, well, and kind of the same thing.

00:16:05.380 In this overbilling report, we had to write off $1.4 billion in PPE.

00:16:13.300 Billion.

00:16:14.500 $1.4 billion that the healthcare system can't afford to write off.

00:16:18.880 Right.

00:16:19.320 So all of a sudden, well, I guess we junked it.

00:16:21.780 I guess we threw it.

00:16:22.440 I guess it was stale dated.

00:16:23.520 I guess we decided to, you know, it gets put into a landfill somewhere.

00:16:28.100 How many nurses, how many radiologists, how many doctors with $1.4 billion?

00:16:34.400 Well, that makes no sense to me.

00:16:36.340 And the accountability of it, who are we holding accountable for that?

00:16:40.020 So as we're, you know, as we're driving to work and we're saying to myself, you know, my portfolio is health.

00:16:46.460 You know, I better make sure there's enough doctors today and in five years.

00:16:54.200 I better make sure that that inventory of PPE is kept current.

00:16:58.440 Like, there's not that many things on your radar.

00:17:00.960 Like, quite frankly, come on.

00:17:02.400 The checklist has to be like 50 things.

00:17:05.000 And you have a staff to do it.

00:17:06.580 So I know Cordelucci Vaughan Hospital in Vaughan, Ontario, just opened a medical school dedicated to family doctors.

00:17:14.460 Oh, great.

00:17:15.200 Which is great.

00:17:16.040 Yeah, it's awesome.

00:17:16.780 But unfortunately, it just started.

00:17:18.760 So you have a Bachelor of Science.

00:17:20.860 You go into that med school.

00:17:22.820 Well, that's years before you get into the queue.

00:17:25.280 Yeah.

00:17:25.700 Eight.

00:17:26.340 Right.

00:17:26.940 Yeah.

00:17:27.560 So the thought is you could do your internship right at Cordelucci Vaughan Hospital.

00:17:32.680 Do your internship and then go into practice.

00:17:35.540 But, yeah, they're starting behind the eight ball, bringing in doctors when they talked about this 25 years ago.

00:17:42.220 They knew they had an issue.

00:17:44.360 Starting to expand med schools dedicated to family doctors.

00:17:47.860 They knew there was an issue decades ago.

00:17:50.080 But now they're playing catch it.

00:17:51.360 But like you say, they don't just like two years from now start practicing.

00:17:55.660 It'll take years.

00:17:58.180 No billing systems.

00:17:59.640 No accountability for the number of doctors and when the attrition's happening.

00:18:05.980 No audit processes.

00:18:07.680 Jim, we're a developed country.

00:18:10.040 Oh, my.

00:18:10.640 Are we?

00:18:11.660 Paul, we were proud of health care.

00:18:13.380 To your point earlier, we were proud of our health care system.

00:18:16.300 We were.

00:18:16.800 We bragged about it.

00:18:17.860 We bragged about it.

00:18:18.440 We traveled around the world and said, we pay a lot of taxes, but we have a great health care system.

00:18:22.780 Well, but, you know, it's funny.

00:18:25.060 You know, you talk about this and I brought it up on other shows.

00:18:27.360 I remember as a kid, because, you know, living downtown, you know, we grew up in Little Italy and, you know, work down there.

00:18:38.120 I remember, you know, they always say, don't get hurt in the summer.

00:18:41.680 So we used to have this conversation because there are no doctors.

00:18:44.880 They're on vacation.

00:18:45.580 Yeah.

00:18:45.760 So basically, so in the month of August, everyone would kind of make a joke.

00:18:49.760 Don't go to a hospital in the month of August.

00:18:51.440 So if someone kind of did, everyone was like, oh, my goodness, poor person, you know, they're going to go to the hospital today.

00:18:56.580 Oh, you know, it's August and there's definitely not going to be any doctors.

00:18:59.420 Right.

00:18:59.720 Right.

00:19:00.260 So we always kind of joked about it.

00:19:01.680 And there were times of the year we knew there were going to be no one in the hospitals.

00:19:06.280 And we kind of just, but the population was low.

00:19:09.700 Yes.

00:19:09.940 And we all had family doctors that we kind of knew.

00:19:12.360 Yeah.

00:19:12.760 You know, and they were old guys that we kind of.

00:19:14.840 And they served your family for decades.

00:19:17.120 The family knew them.

00:19:18.240 Everyone knew them.

00:19:18.840 They were trusted.

00:19:19.660 You know, we had this great relationship.

00:19:21.360 And then all of a sudden, boom, that exploded.

00:19:23.780 If you think about it, we got a lot of clinics.

00:19:26.160 So we went to clinic health care.

00:19:28.600 And then, yeah, which I, you know, I have a family doctor, but it is through a clinic.

00:19:34.400 And quite frankly, it seems like that was the downfall.

00:19:39.680 It seems like when we got there, everything kind of fell apart, which is when you look at what happened in Quebec, they kind of, that's where they said things fell apart.

00:19:49.480 Right.

00:19:49.760 What happened was there was a bunch of closed clinics that weren't open to the public.

00:19:55.900 And then what happened was over time, there were more and more and more.

00:20:00.100 And then 2 million Quebecers were then kind of excluded.

00:20:04.620 They were kind of left out in the cold to go to the hospital or go to a limited number of open clinics.

00:20:10.700 And then it just evaporated on them.

00:20:13.720 And, you know, billing, the Ontario numbers, you know, I don't know, billing-wise, there hasn't been a report in Quebec that I've seen or read.

00:20:22.160 But, you know, the Quebec numbers are very close as far as spend per cap.

00:20:27.560 Right.

00:20:28.240 Ontario.

00:20:28.900 So I assume some of the billing issues probably spill over there because the numbers are close, right?

00:20:35.080 My family doctor is part of a health team.

00:20:37.100 I think there's five or six family doctors in a shared office to reduce office costs, insurance costs, and administrative costs because that sucks a lot of their money. 0.98

00:20:45.780 Then they also have malpractice insurance.

00:20:48.180 So that's pretty common for a lot of family doctors I know now is it's five or six family doctors in a health team.

00:20:55.200 And in the case, like, hey, I got to see my doctor and, you know, Dr. Kristoff isn't available.

00:21:01.040 I'll see Dr. Paul and they'll be able to take care of me.

00:21:04.480 And, but they can only see so many people in a day.

00:21:08.000 And I know there's also a clinic in Newmarket that's opened up.

00:21:13.220 And a lot of people who don't have a doctor or need to go somewhere quick, they go see this physician in the clinic and they go, no, you need to go to Southlake.

00:21:20.840 You need to go to St. Mike's.

00:21:22.520 You need to go to this hospital.

00:21:23.680 And I don't see any problem with bringing in these foreign doctors, qualifying them and opening up clinics.

00:21:30.740 There are so many problems in so many communities in this country, Paul, who don't have any family doctor.

00:21:36.260 And there's actually a story that came out that there's some small town communities are giving bonuses to entice you to move to their area to practice.

00:21:44.680 Yeah.

00:21:45.120 And I'm just going to add a little bit onto that.

00:21:47.360 Well, increasing our training and colleges for Canadian citizens.

00:21:52.420 So I'm going to say, so as a stopgap, I think it's a great stopgap to bring in foreign doctors, make sure they're qualified.

00:21:59.040 And open it up to more Canadians.

00:22:00.500 And open it up to more Canadians.

00:22:02.060 Yes.

00:22:02.480 I couldn't agree more.

00:22:03.800 So, because, you know, you think about, we have this conversation all the time.

00:22:06.500 We have a bunch of disenchanted youth who are sitting around, who are overeducated right now.

00:22:12.480 With nowhere to go.

00:22:13.520 With nowhere to go.

00:22:14.340 But yet we have a shortage of doctors.

00:22:17.280 It makes no sense.

00:22:18.260 The comment, it doesn't make any sense.

00:22:20.020 So our healthcare providers, we're in short need of.

00:22:22.660 And quite frankly, it looks like we're going to be even more.

00:22:26.500 So, to me, it seems like a perfect fit.

00:22:28.300 It seems like a logical.

00:22:29.620 But again, to your point, no one wants to touch this hot potato.

00:22:34.160 No.

00:22:34.520 So here's the thing.

00:22:35.780 Here's my recommendation, how to touch this hot potato.

00:22:38.400 Okay.

00:22:38.740 Premier Micucci, tell me.

00:22:40.060 No, no, I don't want to do that.

00:22:42.440 Sorry.

00:22:43.000 Sorry.

00:22:43.180 So, go to the other countries, look at the models, number one, to right size the billing system.

00:22:52.480 So I think the first thing you've got to do quickly is you've got to go somewhere and you've got to say to someone,

00:22:56.560 do you have a system and how do you bill and does this work and does it prevent all this craziness?

00:23:01.660 So let's get the craziness out of the system.

00:23:03.460 Right.

00:23:03.600 Because these crazies, quite frankly, you know, it worries me, quite frankly, that some of these people and the numbers in this billing report are even practicing on people.

00:23:13.180 Absolutely.

00:23:13.880 Yeah.

00:23:14.120 Because what is their standard of care?

00:23:15.640 Well, what's their standard of care?

00:23:17.360 And if you're willing to do this to the health care system, you know, I kind of question some of your ethics.

00:23:23.520 Right.

00:23:23.760 So let's put that aside.

00:23:26.000 Right.

00:23:26.420 You know, those people have to be dealt with, but they'll be not dealt with directly.

00:23:30.700 They'll be dealt with by fixing the billing system.

00:23:34.360 Go to the colleges, take some of the money that you've allocated through the 25 budget.

00:23:39.040 You've got all these major projects.

00:23:40.680 Rather than let's do this for a minute.

00:23:42.620 Rather than a major, because all the major projects we hear about, mines, refineries.

00:23:48.440 Yeah.

00:23:48.620 So we talk about all these things, right?

00:23:50.820 Military.

00:23:52.840 Let's make the overhaul of our health care system a major project.

00:23:57.880 Absolutely.

00:23:58.640 Why did we not ever say that?

00:24:00.720 I don't know.

00:24:01.720 Well, let's say it.

00:24:02.940 Let's start to say it.

00:24:03.940 Let's just say this is broken.

00:24:05.320 It's a mess.

00:24:06.300 Let's all kind of look at each other and say, we really screwed this up.

00:24:09.420 And every province, we're going to build something.

00:24:11.660 May a copa.

00:24:12.300 Let's figure it out.

00:24:13.380 Right.

00:24:13.620 Let's get over it.

00:24:14.400 It is a disaster right now.

00:24:16.960 Let's one by one kind of put the building blocks back.

00:24:20.500 And let's not do it individually.

00:24:22.380 Let's not go across all the provinces, territories, and try to make our own concept.

00:24:27.500 Because, you know, we've tried that before.

00:24:29.260 It doesn't work.

00:24:30.340 The money gets transferred from the federal government.

00:24:32.660 Yep.

00:24:33.640 So let's try to do it.

00:24:34.980 But let's go and actually get that in play.

00:24:38.740 Then the second thing is, as we get that in play, let's get our training centers for our Canadian citizens.

00:24:45.060 Let's get that working now. 0.51

00:24:46.080 So let's figure out how many doctors are going to retire.

00:24:50.360 Go to them.

00:24:51.060 Just say, when is your end date?

00:24:52.980 And do the math.

00:24:54.120 Yeah.

00:24:54.340 When's your end date?

00:24:55.140 When is the last time?

00:24:56.080 When are you closing your practice and you're disappearing from Timmins?

00:25:00.980 Well, Toronto Police Service, Chief Demki, they just had a whole hiring increase because they looked at the attrition for the amount of police officers.

00:25:09.420 And they say, we need to hire this many officers just to break even.

00:25:12.860 Well, they have the same problem in health care.

00:25:14.780 So let's get on it, figure it out, get to the colleges and universities and figure out.

00:25:22.180 Nurses, we haven't even talked about.

00:25:23.680 No.

00:25:24.200 Right?

00:25:24.600 So the nurses, you know, quite frankly, I think when we hear about the overworked health care system, I think we're really, for the most part, talking about those poor nurses who are run off their feet, quite frankly, trying to just patch it all together one by one.

00:25:38.520 And they don't make anything close to a doctor, Paul.

00:25:40.640 No, cripes.

00:25:41.380 Well, they don't, these numbers, cripes, you know, these numbers, they don't even come, they don't even get in a lifetime.

00:25:46.680 So the nurse can't overbill.

00:25:49.300 The nurse can't bill for no service. 1.00

00:25:51.640 The nurse has a set wage that's negotiated on, and that's what they make. 1.00

00:25:57.760 Right.

00:25:58.380 And they work ridiculous hours. 0.60

00:26:00.740 And the mental and physical burnout for the nurses in this country, it's frightening.

00:26:05.100 And then, Jimmy, the final pillar, which we haven't even talked about, we're going to talk about on another show, let's dig into our administration of our health care.

00:26:13.940 Right?

00:26:14.540 Yeah.

00:26:14.660 So we just got to get that right size.

00:26:16.060 Because part of, you know, when we talk about billings and we talk about doctors, we talk about nurses, the administration and the infrastructure of our health care, it needs work.

00:26:25.960 It could be more streamlined and more efficient.

00:26:28.800 It could be way better.

00:26:30.120 Right?

00:26:30.480 Absolutely.

00:26:30.800 Our buildings, our technology, like all that stuff just is lacking.

00:26:35.100 And it's not for funds.

00:26:37.460 So let's be sure.

00:26:38.300 Because everyone, you know, the one thing people say to them all the time is, we need to put more money into health care.

00:26:42.620 Well, you know, even the premier of our province here in Ontario, you know, he said it several times.

00:26:48.000 He says, listen.

00:26:49.140 And he sits there with this kind of beleaguered look.

00:26:52.320 He says, you know, I just put 20 more billion into it when I got in.

00:26:56.600 What do you want me to do now?

00:26:58.380 Right?

00:26:58.880 So you tell me in all your years.

00:27:01.380 Like schools, do they have to come in and take it over?

00:27:03.800 In business, in all your years, you've met so many uber successful people.

00:27:08.420 The one thing they all have in common, I know from the ones I've dealt with, they're not so arrogant that they don't see a good idea and look at it and try to implement it or try to be better and get better and ask for help.

00:27:21.560 And we have to get by this national arrogance about health care that we have the best health care and look at Denmark and Australia and other countries and see what they do.

00:27:33.320 And like, you know what, we could be better here and here and here, more efficient, have more access, more doctors.

00:27:40.380 Until we get through that, Paul, until as a country, we, as a national mindset, don't automatically try to throw someone in an office because they bring up the idea that we need to maybe tweak and revamp and improve our health care.

00:27:55.720 How can it change?

00:27:57.240 Because right now politicians are afraid to do anything like that.

00:28:00.260 So, and that's where, you know, I really think you got to start in small, small chunks.

00:28:05.360 Yeah.

00:28:05.560 So you start with the billing.

00:28:07.140 You know, you have to start being very blunt with people and explaining to them, our health care index is like 30th in the world.

00:28:15.420 We're like very low.

00:28:17.120 So when you look at all the parameters that they make, look at all the parameters of health care, they rank against other countries. 0.79

00:28:22.860 We're in the bottom quartile right now of developed countries.

00:28:26.580 We're in the top quartile for spend.

00:28:30.900 So the two don't equate.

00:28:33.240 So how do we bring it closer together?

00:28:35.420 And then you have to, you just have to keep sending that message and keep sending that message.

00:28:39.520 And then you get one by one, you know, you start tackling the pillars of this problem.

00:28:44.680 It's become such a third rail politically in this country that no premier and no prime minister, no politician is willing to stand up in front of everyone and confront some of these issues.

00:28:56.000 So it just, it keeps rolling over and rolling over and they do little dribs and drabs to say, oh, we're going to have some more family physicians and we're going to bring in a little bit of this and that.

00:29:07.100 But the problem isn't getting smaller.

00:29:09.360 No, no, it's getting worse.

00:29:10.700 And quite frankly, it's going to get worse if they don't tackle it, as you can see.

00:29:14.280 And the numbers, I get back to how I'm upset.

00:29:18.620 I don't begrudge anyone making a fair wage, especially as a heart surgeon and a neurologist and radiologist and what they do.

00:29:26.760 But when you're overbilling and you're saying you're billing 500 patients in a day, that's an insult to Canadians, an insult.

00:29:34.780 It is.

00:29:35.280 It is.

00:29:35.660 And we got to fix it.

00:29:36.740 Absolutely.

00:29:37.680 Paul?

00:29:38.380 Thanks, Jim.

00:29:38.980 He's always got the answers.

00:29:39.940 Listen to him.

00:29:44.280 Listen to him.

True Patriot Love - December 12, 2025

Ontario’s Healthcare Meltdown： Why the System Broke

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