Year-end interviews with politicians are often fluffy affairs. Leaders tend to pick friendly journalists and sit down for fireside chats where they will pat themselves on the back for their accomplishments over the year and make broad promises for the new year. Prime Minister Justin Trudeau’s CBC year-end interview with Rosemary Barton was an exception, and was surprising on two fronts.
First, Barton asked pointed questions and didn’t let the prime minister get away with short answers. She asked tough follow-ups and made Trudeau expand on his answers. Barton has been accused of being soft on the Liberal Party, but that wasn’t evident in the interview.
Secondly, Trudeau made a statement on Canada’s health-care system that was quite surprising.
When pressed by Barton on his reticence in increasing health-care transfers to the provinces, Trudeau said, “If I were to send people all the money they need in the provinces, there is no guarantee that folks would be waiting less time in the hospitals. There is no point putting more money into a broken system.”
Canada’s health-care system has long been considered a sacred cow. We have woven the system into our national identity and have claimed it is among the best systems in the world. Politicians offering solutions to health-care challenges beyond pouring more funding into the system are usually shouted down and accused of wanting to Americanize Canada’s hallowed system.
To declare the Canadian health-care system as broken is nothing short of political blasphemy, and it was shocking to see Trudeau make such a bold statement.
It has been becoming increasingly difficult to defend Canada’s health-care system for even the staunchest supporters of the status quo. Canada’s system has been showing cracks for years, despite spending increases, and the pressures of the COVID-19 pandemic exposed just how weak the system really is. Now with the pandemic behind us, hospitals are still overwhelmed with flu outbreaks that should be easily manageable, and waiting lists for treatment and procedures continue to grow.
The only health-care measure Canada ranks near the top of among OECD nations is spending. Canada spends 12.9 percent of its GDP on health care while the OECD average is 9.7 percent.
When spending increases only lead to poorer performance, it becomes undeniable that the system itself is flawed. The first step in fixing Canada’s system is to admit it is broken, and it’s heartening to see the prime minister doing so.
The big question now though is how does the PM plan to address this problem?
When Trudeau implies that any increase in federal health-care transfers to the provinces will be conditional on improved outcomes, is he inviting premiers to implement systemic reforms or is he hinting at direct federal interference upon provincial jurisdiction of health-care provision?
One common denominator among OECD nations with health-care systems outperforming Canada is an increased level of private involvement. Private hospitals and mixed private/public insurance plans are common in many European and Asian countries offering universal coverage. Mixed systems have allowed countries to be more creative with health-care systems and offers them more flexibility when dealing with unusual events such as pandemics. Nations offering private provision options have had more success in attracting and retaining health-care professionals, while Canada’s rigid system is losing skilled workers at an unsustainable rate.
Premiers in Canada should consider Trudeau’s statements to be an invitation to embrace aspects of the more successful universal health-care models around the world. How can the prime minister oppose increases in private health-care provision or insurance plans when they are proven to improve systemic performance? Isn’t that precisely the condition he was laying upon premiers for increases in transfers?
Justin Trudeau needs a tangible legacy for his term in office. Being the first prime minister to significantly reform the Canada Health Act in generations would certainly entrench him as an innovative national leader. Is that what he is getting at when he declares the system as broken?
Trudeau’s declaration didn’t get as much attention as it should have. Nonetheless, he has opened the door for the nation to seriously start reforming its dysfunctional health-care system. Let’s hope provincial leaders in Canada ensure he follows through with it.
