Western Standard - Colin Craig of Second Street on an interesting poll they did of Canadians on health care reform

00:00:00.000 So, I mean, just to get right to it, I mean, you know, quite often, as I kind of said earlier

00:00:05.000 in the show before you got on, there's people always say that Canadians don't want any change

00:00:10.200 in their health system. They're afraid of change. They want the status quo. They only want to spend

00:00:13.620 more money on it. But when you've asked Canadians directly, they sound a little more receptive to

00:00:17.900 some reforms than some people would make you believe. Yes, for sure. It seems to be a case

00:00:23.480 where Canadians are ahead of the politicians. And, you know, some of the polling that I've seen over

00:00:27.800 the year suggests that Canadians have been ready for health reform for a long time now. Now, if we

00:00:32.620 had been talking about 20 years ago, I think it was a different topic because, you know, people would

00:00:36.500 talk about things like having private clinics outside of the public system, and it was a lot

00:00:41.440 more taboo. Whereas I think over time, Canadians have had an opportunity to read lots of opinion

00:00:46.660 columns, see lots of interviews, hear lots of discussions about different healthcare systems

00:00:51.700 around the world, and understand that it's not an either or situation. We can have a universal public

00:00:57.280 healthcare system, which is what Canadians like, this idea you can walk into a hospital and, you know,

00:01:02.420 receive some kind of significant procedure and then walk out without facing a big bill. We can keep that

00:01:07.420 option in place, but at the same time, allow patients the choice. So if they don't want to wait a long time

00:01:13.320 to get their knee or hip done, maybe they could go to a private clinic and pay privately. Governments could work 0.55

00:01:19.000 with private clinics to reduce backlogs, all kinds of different reform options. Canadians, I think, are

00:01:23.720 understanding that these things work in other countries that are not called the United States,

00:01:28.860 and, you know, that we could bring them here. And that's really what our poll shows is that

00:01:33.640 Canadians are very much open to health reform, if it can help patients.

00:01:38.080 Yeah, I mean, as you pointed out, not the United States. I mean, speaking of, you know,

00:01:41.140 when we talk about a lot of binary, non-binary stuff, well, our healthcare isn't a binary discussion

00:01:44.900 with systems. There's dozens of systems with a lot of innovative ideas. Some systems stink, some are very

00:01:49.760 good. But we really have shunted our discussion and kind of closed it down for looking anywhere

00:01:54.780 outside of North America. And that's putting us at a disadvantage.

00:01:59.480 Oh, 100%. That's why I say not the United States, tongue-in-cheek, of course, because

00:02:03.580 for so long, opponents of health reform, people who like this sort of pseudo-government monopoly,

00:02:11.040 they don't want to lose any control. So they've effectively tried to position this as

00:02:15.100 Canada's system or the US model. But as you just noted, there's tons and tons of countries around

00:02:21.100 the world with universal healthcare systems. We could be learning from them, understanding how

00:02:25.420 they're delivering better care. And, you know, really, I think that's what we need to do as a

00:02:30.180 country is to start to look at, you know, what's happening in Sweden, on Australia, New Zealand,

00:02:35.380 many other countries around the world that have that universal aspect that Canadians like,

00:02:39.940 but ultimately deliver better results for patients.

00:02:42.360 Well, that word's the key part, because I think that's where a lot of the fear-mongering

00:02:46.200 misunderstanding comes. I mean, nobody's proposing to end the universal aspect of it. Nobody's saying

00:02:51.560 we want to make it where if you don't have cash in hand, you won't get coverage. I mean,

00:02:55.640 most people fully agree they want a system where you never have to sweat paying the bills because

00:03:00.720 you need healthcare. So there'd be universal coverage. It's just changing how it'd be managed and

00:03:04.720 delivered. Yeah, exactly. And, you know, even if someone did want to completely get rid of healthcare as we

00:03:10.260 know it, it's a non-starter politically. There's not a single member of parliament in Ottawa that would

00:03:15.960 stand up and say, let's get rid of it. There's no provincial government in the country, no major

00:03:20.580 political party with any seats that would campaign on this. So politically, it's just not, it's pretty

00:03:27.460 much impossible at the moment. And I would say for the foreseeable future, I don't think it's on

00:03:31.480 anyone's radar. But yeah, like you said, I mean, we can reform the system and make sure that we keep

00:03:36.820 that universal aspect that Canadians absolutely want and find ways to deliver care better. And we

00:03:43.600 threw out a couple ideas in our public opinion research to ask Canadians, well, what do you think

00:03:48.560 about these ideas? So as I mentioned, this idea of, you know, keeping the universal public healthcare

00:03:54.140 system. But if a patient doesn't want to wait, say, a year in chronic pain for their hip operation,

00:04:00.020 will allow them to go to a private clinic where they could pay out of pocket. And a majority of

00:04:04.820 Canadians support that idea, about 51%. So, you know, we've seen that in the past, majority support

00:04:11.680 that. And, you know, I think the public is there, especially when they start to understand what that

00:04:19.100 actually means. I mean, there's ways that other countries have put safeguards in place that, you

00:04:23.960 know, the boogeyman argument is always that, well, everyone's going to leave the public system and go and

00:04:27.740 work at the private system. And obviously, that's not the case, because other countries successfully

00:04:32.320 do this. And they often have some safeguards in place to say, okay, you can't work at the private

00:04:37.280 clinic until you've done X number of hours in the public system each week or whatever.

00:04:42.440 But, you know, one important thing about this is that right now, a lot of surgeons will tell you that

00:04:46.380 they have time on their hands, at least certainly before COVID, when all these backlogs emerged. But

00:04:53.120 they had all this time on their hands, because the governments wouldn't hire them to pay them

00:04:58.100 what would be full-time work for a surgeon, they would only ration out a certain number of hip

00:05:04.060 operations a year. So once the surgeon's done all those, he or she has time to kind of twiddle their

00:05:09.760 thumbs, so to speak. So, you know, there's certainly a lot of capacity within existing time that surgeons

00:05:16.580 have to be able to work in both systems. And ultimately, that would lead to more procedures being done,

00:05:22.040 helping patients, and so forth.

00:05:24.300 Yeah, well, that's where some of the, I mean, that's kind of the lowest you found on reforms,

00:05:27.800 though, is the 51% talking about allowing people perhaps to pay to get in ahead in line. But, you

00:05:32.640 know, I think with more discussion, if people realize and they frame it the right way, you know,

00:05:36.700 they can embrace that. Like, the way I look at it is, okay, I've been told I'll get my knee surgery

00:05:40.500 in six months. But if I let that guy pay cash and get ahead of the line, my surgery would be reduced

00:05:47.580 to four months. So if I could just swallow the envy, yes, he got in tomorrow, but he subsidized

00:05:52.520 my getting in two months faster. Like, I'm winning here. This is okay. And if people could kind of wrap

00:05:59.000 it that way, rather than trying to think of somebody jumping the line, I think you'd see more people

00:06:03.200 realizing this is a better way to go.

00:06:04.840 Yeah, it's an absolutely huge benefit if we did that, because they have patients, other patients

00:06:10.700 would get to move ahead faster in line, it would also increase competition and innovation, you know,

00:06:15.740 when you have two different people doing the same task, well, that increases your chances that maybe

00:06:21.620 one of them will find a better way to do it. And then they can both learn from it. I mean, this is

00:06:25.340 how economies work in every industry, right? You see constant innovation over the years, as new

00:06:30.720 technologies are established and so forth. And, you know, like I said, we got 51% support, I think

00:06:37.080 if we had to maybe rephrase the question a little bit to make it clarify that, you know, it involved

00:06:41.940 keeping the public system, but allowing this on the side, I think that the public, if they fully

00:06:47.020 understood what this is, I think we'd see support to be actually a lot higher. So it is, you know,

00:06:52.080 it's something I'm thinking about the next time we pose this question is to reframe it a bit. But I

00:06:55.940 think certainly the majority of the public is there.

00:06:57.920 Yeah, well, and one of the areas we had a stronger showing of support, perhaps the strongest was 72%

00:07:03.160 support copying that European Union policy that allows patients to visit facilities outside of

00:07:09.720 their provincial borders and get reimbursed later. And I mean, that one, I guess what if a province

00:07:15.100 has to say a specialized clinic that has extra room in it, they can bring people from next door

00:07:19.580 and then get reimbursed from the province later and still gets to faster care, it's sort of that sort

00:07:23.520 of concept? Yeah, it would depend how they implement it here. But I mean, you've done a pretty good job

00:07:29.760 of explaining it. So the way it works in Europe is, let's say you're in Ireland, and you're facing a

00:07:34.840 four month wait for your knee surgery. And when the government would provide it to you, it would cost

00:07:40.760 them, let's say, just to pick a number 5000 euros. Well, what you could do is instead of waiting that

00:07:46.580 four month waiting period, you could maybe go to another EU country like France and pay, let's say,

00:07:51.240 they're charging 4000 or 5000 euros for it. Well, you go there, you pay it, you come back to Ireland,

00:07:57.040 the Irish government reimburses you for what you paid. Now, if you found a better deal, and you paid

00:08:01.920 less, let's say someone went to Estonia, and got their knee surgery done there. Well, then the Irish 1.00

00:08:07.700 government would actually save money because they would pay you that that lower rate, the amount you

00:08:11.300 actually paid. And then the opposite of that, of course, is if you went somewhere and you had to pay

00:08:16.000 more than what your government would normally pay, well, then you would be responsible for the

00:08:19.900 difference. But just having this funding mechanism in place for patients right now, to be able to go

00:08:25.900 abroad and get the care they need instead of spending another year in chronic pain, off work,

00:08:30.580 whatever. Canadians like this idea. And it's a way to get relief for patients immediately to give them

00:08:39.140 that option, it wouldn't be forced to be completely voluntary. Patients would have that option, not

00:08:44.540 everyone's going to take the government up on it. But you know, as we just talked about, when that

00:08:50.160 happens, let's say the government subsidizes someone to go to wherever Tennessee to get their

00:08:54.880 hip done. Well, then they go off of the public waiting list and whoever's behind them in line gets

00:08:59.760 to move up a spot. So I mean, this is this policy is not perfect. But it's one I think that could help

00:09:06.440 immediately reduce waiting lists in Canada. And at the same time, you'd help patients who are decide

00:09:13.800 not to go abroad for surgery, they would all get to move up in a spot in line. So you know, the big

00:09:19.780 question with this policy, Corey is, well, what's the cost? And if you think about it, over a two or

00:09:25.200 three year period, the cost is, there's no real increase, because what you're doing is you're changing

00:09:30.220 the timing of when expenses occur. So instead of paying, say $5,000 to, you know, fix your knee

00:09:37.200 next year, the government would spend $5,000 this year. So over a two year period, the expenses are

00:09:43.260 roughly neutral. Yeah, and I mean, again, you see some of the concerns that come up. And it's fair

00:09:48.280 enough, one of our commenters, Lori Dobby saying, yes, she sees is she or he hates or tell would be

00:09:54.280 if people with money would be able to displace others in a wait list. And we sort of addressed that

00:09:58.660 earlier, if it's shortening the list overall, it won't displace people on the list, it would just

00:10:03.740 mean somebody else. But the waiting list, though, at least, you know, in addressing that, that's the

00:10:08.080 problem. That's where our system is bottlenecked. And maybe if people understand too, like as you're

00:10:12.960 speaking about, that the costs of somebody waiting, if somebody can't go to work, because they're

00:10:18.980 injured or sick, or they're only part time, or they're not as productive. Another thing is they're

00:10:23.060 being medicated quite often pain medication, and that can lead to addiction or long term issues,

00:10:27.260 as well as quality of life. Like we really need to cut those weights and start to examine how we can

00:10:33.420 do it. Yeah. And you know, I agree with your point. And Lori's I think you both made made good points

00:10:38.540 there. Like you said, everyone could benefit because people ahead of you in line who decide

00:10:44.140 to do this, well, they get off of the waiting list. Everyone else gets to move up a spot who's behind

00:10:49.240 them. Lori makes a good point, though, about cost. I mean, that's true. If let's say that you need a

00:10:54.540 whatever $30,000 hip operation somewhere, and you don't have access to being able to pay for that

00:11:00.820 before you get reimbursed, that is the limitation, obviously, of this policy. But what this policy does

00:11:06.460 do is if you think about it right now, who has the money to go abroad for healthcare, because we know

00:11:12.540 hundreds of 1000s of Canadians every single year are flying to other countries, they're driving across the border to

00:11:18.540 the US. People with access to money are able to do this right now. And it's sort of that lower income

00:11:25.180 and lower middle income people that often don't have the funds to be able to do that. This policy

00:11:30.460 changes that it gives them an opportunity to go abroad and get a subsidy, if not full cost coverage

00:11:39.180 for the procedure they require. There's a patient I'll just give this quick anecdote this patient from

00:11:43.180 Manitoba named Max Johnson, Johnson, and the CBC highlight his his story. What happened with him is he

00:11:50.860 needed a knee replacement. And it was going to take I think something like a year or so waiting list in Manitoba,

00:11:56.300 he ended up going to Lithuania. And after he paid for his knee surgery there, he compared that with what the

00:12:04.540 Manitoba government would normally pay to get that procedure done for him. And he calculated that it was about

00:12:10.780 $7,000 less in Lithuania. So if the Manitoba government had been subsidizing people to go to

00:12:16.940 Lithuania for their knee surgeries, the government could actually save money. Patients who may not have

00:12:25.340 whatever amount of money to go abroad, if they had this subsidy in place, they might then be able to

00:12:29.820 start to afford it. So, you know, again, it's not a perfect solution, but it is a policy that could help right now.

00:12:34.860 We're in a crisis, we need to think outside the box. And I think we need to pursue options

00:12:39.100 that may not be 100% right on the money, but maybe you're 90% of the way there. And I think this is

00:12:44.380 one of them. Well, I see you took advantage of you know, when you're doing the poll, the polls are

00:12:48.540 expensive, especially when you get 1500 people like that through, you know, a good polling company.

00:12:53.740 So you want to get all your questions in that you can. But this one's interesting, I think 66%

00:12:57.260 believe that health ministers should have to hold a press conference every year and announce the number

00:13:01.100 of patients who died the previous year due to long waiting lists. And, you know, that's kind of getting

00:13:05.660 outside of talking about the systemic reform. But a nice way to point out like people maybe

00:13:09.500 don't realize just how backlogged the system is. I mean, if you've been fortunate enough not to

00:13:13.180 have health issues, not have to wait for anything in the system, nobody in your family has had a

00:13:17.580 problem, you might not realize how bad it's getting out there. So having these health ministers get up

00:13:22.620 and tell you, by the way, this many people would be alive today if we could have sped up the system,

00:13:27.260 you know, it might add a little fire under some butts. 1.00

00:13:29.500 Yeah, it's, it's, it's a real serious problem right now. And this is a you're right, this question

00:13:35.260 is different from the others in that it's asking, it's, it's driving an accountability in the system.

00:13:40.300 It's a sad fact that every single year, there are patients in this country that die,

00:13:45.580 because the government made them wait too long for healthcare in Canada. Remember,

00:13:51.260 the government has a monopoly on it, you cannot go to a private clinic and get a heart operation in this

00:13:57.180 country because the government won't allow it. So the government has taken complete control over

00:14:01.500 your access to healthcare. And when they essentially force a patient to die in a way because they're not

00:14:09.100 able to get that care they need in time in Canada. Well, that's a pretty serious problem. We've been

00:14:15.820 trying to dig into this information, we do reports every year that are called died on a waiting list

00:14:21.260 reports. And we gather government data on on how this is happening. It's a bit difficult to get the

00:14:27.420 numbers because governments don't track it very well. But it's a very serious problem. And so we've asked

00:14:32.300 this question, well, you know, should health ministers should have to stand up each year and explain to

00:14:37.340 the public how many patients died under their watch because they had to wait too long. And this option

00:14:42.700 is overwhelmingly a popular one with the public, like you said, 66% agree with it. It's just a good

00:14:51.100 accountability measure. I mean, obviously, politicians love to get in front of the cameras 0.70

00:14:55.420 and attract lots of attention when they're building a new hospital, when they're hiring

00:14:59.580 new staff, whatever. They like to get a lot of attention to the good news. This would obviously

00:15:04.220 be an accountability problem in some cases. The public wants to know about it. That's, I think,

00:15:10.220 what that number shows. Yeah. Now, another thing that's interesting when we're talking about

00:15:16.460 private clinics, you know, is the pandemic crisis. I mean, that led to a lot of hospitals

00:15:23.420 basically locking down. A lot of procedures got put off and pushed off because they were

00:15:27.500 trying to quarantine the hospital spaces. And maybe there's a whole, you know, this is kind of going

00:15:31.340 outside of what your poll was asking about. But still, if we had a number of specialized private

00:15:35.260 clinics, whether it was for dialysis or orthopedic surgery or other day surgeries, those areas could have

00:15:41.900 continued to operate while the hospitals were still locked down with vulnerable patients within them.

00:15:47.420 But because we have everything packed into a few giant hospitals, it made us a heck of a lot more

00:15:52.220 vulnerable when a pandemic came around. I'm just saying that there's benefits we could see from,

00:15:57.100 you know, spreading our system out a little more rather than having it packed into one central

00:16:01.100 location like that as well. Yeah, you're 100% bang on. This is a very serious problem, I think,

00:16:06.780 in Canada is that so often, when you need to get your your knee or your hip done, or maybe you're

00:16:12.220 an expectant mother, and you're giving birth, you're going into that hospital building, often it's

00:16:17.820 the same building and complex where you've got people going in because they've got COVID or the flu

00:16:22.780 or some kind of other disease or something that can spread. And sometimes those infections happen,

00:16:31.100 right. And when you keep the healthy people, if you're pregnant, you're healthy, if you need

00:16:36.300 your knee done, you're healthy, you just you have this other problem, right? You're not contagious.

00:16:41.260 So if you had those procedures taking place in private clinics, at least if you had that option,

00:16:45.980 then I think you help could you could help spread some of those viruses and that from being transmitted.

00:16:52.380 Yeah, well, we're kind of, you know, going, I guess, a different route rather than

00:16:55.820 lobbying the politicians, you're talking to the public, because as you said, the public's kind of ahead of

00:17:00.220 the politicians on this one, if they can realize there's an appetite for this among the electorate,

00:17:04.780 maybe they'll be ready to take it on. But I mean, there's clashes that could come with the Canada

00:17:09.020 Health Act. Would it be time to start calling for maybe reforming that act a little to allow

00:17:13.100 a little more flexibility?

00:17:14.860 I think so. Yeah. And I mean, you talked earlier about the funding of health care in this country

00:17:19.900 and how it used to be sort of 50-50. Now it's down to 20 some percent that the federal government's

00:17:24.940 contributing. The vast majority is coming provincially. The great hindrance is that when provincial

00:17:30.380 governments try to experiment a bit, you know, we talked earlier about innovation,

00:17:34.060 when they try to innovate and try things, try doing things differently to try and improve services.

00:17:38.780 Well, if Ottawa doesn't like it, they can come in with the hammer and say, well, we're going to cut

00:17:42.700 your funding. Now, it's only 20 percent, but that's 20 percent that provincial governments need.

00:17:48.540 So, you know, if you did reform the Canada Health Act, I think you could make sure some of the language is

00:17:53.980 clear so that provincial governments have the opportunity to innovate while keeping that

00:18:00.620 universal aspect that, you know, Canadians overwhelmingly like. So, you know, I think

00:18:06.460 there's an opportunity to reform the Health Act. And if you did, you could ultimately improve

00:18:11.660 the outcomes for patients.

00:18:13.660 Well, and we have to start with somewhere, as I said, that the politicians will move when their own

00:18:18.380 electoral butts get on the line. So, you know, you guys are doing good work and getting the public

00:18:23.180 working up on it and, you know, and realizing that we've got to examine new things. You've been

00:18:27.340 doing other things with Second Street before I let you go to, you know, your Survivors of Socialism 0.54

00:18:31.660 series and a number of other things. Do you want to let us know a little bit about the work you do

00:18:35.660 before you go? Sure. Yeah. Like you said, we did a series called Survivors of Socialism, where we

00:18:40.540 talked to Canadians who came from socialist and communist countries. We heard their stories and we also

00:18:46.060 surveyed them to say, you know, are there any policies in Canada that concern you because they remind you of

00:18:50.460 the countries that you fled. And so, yeah, we've got some interesting responses there. People can

00:18:54.700 check that out. We've been doing public opinion research on the oil and gas sector and what

00:19:00.140 Canadians think about developing and exporting more of our resources so that the world can buy from us

00:19:07.420 instead of Russia. And obviously the huge benefit of that is if the world doesn't have to keep money,

00:19:12.700 giving money to Putin for energy, well, then he has fewer dollars to buy tanks and rockets and

00:19:18.620 invade countries like Ukraine and whoever, what other, what other countries that may be on his list

00:19:24.860 to invade next. So we've been doing projects like that. We've got lots of stuff on our website and

00:19:29.820 obviously people can find it at secondstreet.org. Excellent. Well, I always appreciate you coming

00:19:34.940 in. I really liked the poll you did, you know, and getting some of that good information directly

00:19:38.140 from Canadians. So thanks for coming on to talk to us today about it and keep up the good work.

00:19:42.780 Thanks a lot, Corey. Appreciate it. The current Lethbridge feed grain prices are as follows.

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Western Standard - November 03, 2022

Colin Craig of Second Street on an interesting poll they did of Canadians on health care reform

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