Health minister’s berating of suffering patients was downright cruel

Federal Health Minister Mark Holland, seen at a Feb. 28 press conference on Parliament Hill, last week told patients who have been waiting months for surgeries and to see specialists that they should “be patient.” PHOTO BY ADRIAN WYLD / THE CANADIAN PRESS
Desperate Canadians criticized for considering health care outside Canada

Here’s my piece about the hypocrisy of politicians berating patients, who consider care out of country when they cannot access care in Canada. Published in National Post Mar 13, 2024. Enjoy!


An Ipsos poll for Global News revealed last week that 42 per cent of Canadians would personally pay to travel to the United States for health care, if necessary. This is a 10 percentage point increase from 2023.

Federal Health Minister Mark Holland promptly scolded the 42 per cent.

“Going and paying your way out of your circumstances creates a terrible malady for our system. Because what it means is that private carriers will take the cases that are the most profitable ones, leaving the public system eviscerated,” Holland said at a media conference. “And that is a circumstance we cannot allow.”

Holland asked Canadians “to be patient.” He said we will “get through these health workforce issues.” It is not clear how “workforce issues” explain why 6.5 million Canadians cannot find a family physician.

Leaving aside Holland’s woolly thinking, his comments just seem heartless and cruel. Canadians do not seek care outside Canada on a lark. They’re desperate.

Canadians are underinsured. Canadian governments nationalized medical insurance companies between 1968-1972. With nowhere else to go, patients must moulder in queues with a median wait of 27.7 weeks to see a specialist.

Having nationalized private medical insurance companies and then put people into waiting lines, politicians berate the desperate few who step out of line and flee south for care.

Minister Holland echoes what elites have been saying for decades. In the 1990s, the associate deputy minister of health in B.C. was asked how she felt about patients on waiting lists looking for care in the U.S. She said, “If we could stop them at the border, we would.”

The hypocrisy becomes especially rank when we consider how many of our elected elites have been escaping Canada for care themselves for decades.

Robert Bourassa, then premier of Quebec, had melanoma surgery in Bethesda, Md., in 1993. Danny Williams, then premier of Newfoundland and Labrador, had heart surgery in Miami, Fla., in 2010.  Former Liberal member of Parliament, Belinda Stronach, had breast cancer surgery in California. The late Sen. Ed Lawson, former Canadian trade unionist, also had surgery in the U.S. Former prime minister Jean Chrétien used government aircraft to fly to the Mayo clinic.

The list of elite medical refugees who flee Canada is long and include many of the same people who refuse to change the medicare status quo.

Speaking on 900 CHML, Sean Simpson of Ipsos suggested Canadian interest in cross-border care simply reflected a “post-pandemic world” in which we began to see that medicare was “threadbare.”

But Canadians were fleeing Canada to find care long before the pandemic. In 2019, the Second Street think-tank used Statistics Canada data to determine that more than 217,500 Canadians had left the country for care in 2017. Hospitals in the U.S. advertise to Canadians, eager to meet growing Canadian demand. Patients can buy books to guide them on their quest for surgery abroad, for example: Medical Tourism – Surgery for Sale! How to Have Surgery Abroad Without It Costing Your Life.

But so what? Tasteless comments and elite hypocrisy make us angry, but if wait times are unavoidable, all we can do is stick together and weather the storm, right?

Wait times are not like natural disasters. They are not random. Wait times are created by professional managers.

Dr. Charles Wright, former vice-president at Vancouver General Hospital and wait-list consultant to the BC Ministry of health, said, “Administrators maintain waiting lists the way airlines overbook. As for urgent patients in pain, the public system will decide when their pain requires care. These are societal decisions. The individual is not able to decide rationally.”

Or as a former deputy minister of health of Ontario puts it, “We have waiting lists for some procedures as a means of better organizing our system.”

In other words, patients would not need to wait at all, if elites chose otherwise.

Minister Holland’s comments of last week betray a deep distrust of patients and their ability to make decisions for themselves. Patients should be patient. They should stand in line; wait for care. But as Canada’s foremost health economist, Bob Evans, has explained, the “rational consumer” is a “highly dubious assumption.”

Canada is changing. Last week’s Ipsos poll also found 63 per cent support for private health-care options. Most Canadians do not mind the Toronto-area Highway 407 toll road if it frees up space on the (public) Highway 401 without making it any worse.

Medicare must reform; the status quo is crumbling. While we wait for reform, let’s stop berating desperate patients, who consider leaving Canada for care when wait times grow too long.

Ontario’s healthcare agreement with Ottawa will not fix broken system

Prime Minister Justin Trudeau, left, and Ontario Premier Doug Ford attend an announcement at Seneca College, in King City, Ont., on Feb. 9. PHOTO BY CHRIS YOUNG/THE CANADIAN PRESS

Ontario’s health-care agreement with Ottawa will not fix broken system

The federal-provincial agreement represents more central planning designed to fix problems created by central planning

Published Feb 13, 2024 in the National Post

Prime Minister Justin Trudeau and Ontario Premier Doug Ford congratulated each other last week on signing a $3.1-billion, three-year health-care agreement, ending two years of haggling.

In December 2022, Trudeau had said there’s “no point putting more money into a broken system.” But by February 2023, Trudeau had forgotten his point and signed a $196.1-billion deal with the provinces. It included side deals with individual provinces to be worked out later, which we saw in Ontario last week.

Trudeau is not the only one who changed his mind. Throughout 2022, the provinces fought for a $28-billion increase in transfer payments, with no strings attached. But they settled for $17 billion, with strings to be sorted out later.

Premier Ford seems pleased that his side deal trimmed Trudeau’s strings down to a three-point plan, centred on primary care and data sharing. Health Minister Jean-Yves Duclos had initially demanded five broad and more substantive deliverables.

In a statement, Trudeau’s office said that, “Universal public health-care is a core part of what it means to be Canadian. It is the idea that no matter where you live or what you earn, you will always be able to get the care you need.”

Notice the language here: an “idea” is not a promise or a guarantee. Actual delivery of care is not part of the deal. Continue reading “Ontario’s healthcare agreement with Ottawa will not fix broken system”

Assisted suicide activists should not be running our MAiD program

Photo credit Macdonald-Laurier Institute.

This article first appeared in the National Post, Dec 23, 2023.

Holidays offer a moment to reassess your time commitments. Here’s a great article from HBR that I reread every few years: Do Your Commitments Match Your Convictions?  (I definitely need to review it this weekend!)

Wishing you all a belated Merry Christmas and a productive and happy New Year!


The federal government chose a right-to-die advocacy group to help implement its medical assistance in dying legislation. It’s a classic case of regulatory capture, otherwise known as letting the foxes guard the henhouse.

In the “Fourth annual report on Medical Assistance in Dying in Canada 2022,” the federal government devoted several paragraphs of praising to the Canadian Association of MAID Assessors and Providers (CAMAP).

“Since its inception in 2017, (CAMAP) has been and continues to be an important venue for information sharing among health-care professionals and other stakeholders involved in MAID,” reads the report.

With $3.3 million in federal funding, “CAMAP has been integral in creating a MAID assessor/provider community of practice, hosts an annual conference to discuss emerging issues related to the delivery of MAID and has developed several guidance materials for health-care professionals.”

Six clinicians in British Columbia formed CAMAP, a national non-profit association, in October 2016. These six right-to-die advocates published clinical guidelines for MAID in 2017, without seriously consulting other physician organizations.

The guidelines educate clinicians on their “professional obligation to (bring) up MAID as a care option for patients, when it is medically relevant and they are likely eligible for MAID.” CAMAP’s guidelines apply to Canada’s 96,000 physicians312,000 nurses and the broader health-care workforce of two-million Canadians, wherever patients are involved.

The rise of CAMAP overlaps with right-to-die advocacy work in Canada. According to Sandra Martin, writing in the Globe and Mail, CAMAP “follow(ed) in the steps of Dying with Dignity,” an advocacy organization started in the 1980s, and “became both a public voice and a de facto tutoring service for doctors, organizing information-swapping and self-help sessions for members.”

Prime Minister Justin Trudeau tapped this “tutoring service” to lead the MAID program. CAMAP appears to follow the steps of Dying with Dignity, because the same people lead both groups. For example, Shanaaz Gokool, a current director of CAMAPserved as CEO of Dying with Dignity from 2016 to 2019.

A founding member and current chair of the board of directors of CAMAP is also a member of Dying with Dignity’s clinician advisory council. One of the advisory council’s co-chairs is also a member of Dying with Dignity’s board of directors, as well as a moderator of the CAMAP MAID Providers Forum. The other advisory council co-chair served on both the boards of CAMAP and Dying with Dignity at the same time.

Overlap between CAMAP and Dying with Dignity includes CAMAP founders, board members (past and present), moderators, research directors and more, showing that a small right-to-die advocacy group birthed a tiny clinical group, which now leads the MAID agenda in Canada. This is a problem because it means that a small group of activists exert outsized control over a program that has serious implications for many Canadians.

George Stigler, a Noble-winning economist, described regulatory capture in the 1960s, showing how government agencies can be captured to serve special interests.

Instead of serving citizens, focused interests can shape governments to serve narrow and select ends. Pharmaceutical companies work hard to write the rules that regulate their industry. Doctors demand government regulations — couched in the name of patient safety — to decrease competition. The list is endless.

Debates about social issues can blind us to basic governance. Anyone who criticizes MAID governance is seen as being opposed to assisted death and is shut out of the debate. At the same time, the world is watching Canada and trying to figure out what is going on with MAID and why we are so different than other jurisdictions offering assisted suicide.

Canada moved from physician assisted suicide being illegal to becoming a world leader in organ donation after assisted death in the space of just six years.

In 2021, Quebec surpassed the Netherlands to lead the world in per capita deaths by assisted suicide, with 5.1 per cent of deaths due to MAID in Quebec, 4.8 per cent in the Netherlands and 2.3 per cent in Belgium. In 2022, Canada extended its lead: MAID now represents 4.1 per cent of all deaths in Canada.

How did this happen so fast? Some point to patients choosing MAID instead of facing Canada’s world-famous wait times for care. Others note a lack of social services. No doubt many factors fuel our passion for MAID, but none of these fully explain the phenomenon. In truth, Canada became world-famous for euthanasia and physician-assisted suicide because we put right-to-die advocates in charge of assisted death.

Regardless of one’s stance on MAID, regulatory capture is a well-known form of corruption. We should expect governments to avoid obvious conflicts of interest. Assuming Canadians want robust and ready access to MAID (which might itself assume too much), at least we should keep the right-to-die foxes out of the regulatory henhouse.