The Canadian Bitcoiners Podcast - Bitcoin News With a Canadian Spin - Canadian Healthcare - CBP Quick Currents

Episode Date: April 19, 2025

Friends and enemies,This week on Quick Currents, we look at the current state of Canadian healthcare. Why did Canada opt to go Universal, what are the issues with the model today, and how can we fix it?Let's dive in.As always, none of the info is financial advice. Website: ⁠www.CanadianBitcoiners.com⁠Discord:   / discord   A part of the CBP Media Network: ⁠www.twitter.com/CBPMediaNetworkThis show is sponsored by: easyDNS - ⁠⁠www.easydns.com⁠⁠ EasyDNS is the best spot for Anycast DNS, domain name registrations, web and email services. They are fast, reliable and privacy focused. You can even pay for your services with Bitcoin! Apply coupon code 'CBPMEDIA' for 50% off initial purchase. Bull Bitcoin- ⁠⁠https://mission.bullbitcoin.com/cbp⁠⁠ The CBP recommends Bull Bitcoin for all your BTC needs. There's never been a quicker, simpler, way to acquire Bitcoin. Use the link above for $20 bones, and take advantage of all Bull Bitcoin has to offer.

Welcome back everybody to the CBP for another quick current. My name is Joey and today we are going to talk about Canadian health care. Very touchy subject. Lots to say, lots to discuss, some problems, some fixes, some proposed solutions. We'll get into all that. But first the sponsors, EZDNS is the friendly neighborhood registrar you've been looking for. Mark will help you with all your domain service needs. We've obviously used EZDNS a few times. We've registered domains with Mark. We've ported domains that were bought for us or bought somewhere else over to EZDNS. It's all a piece of cake. They have all the virtual private server stuff you'd ever want as a Bitcoiner. Run a Bitcoin node, not sure relay, BTC pay server, whatever floats your boat. They got you covered. And then of course for a couple extra bucks, Domain Sure, the security suite that will leave you protected in a way that you're just not going to find anywhere else.

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a 25% reduction in fees. So we like that, you like it too, go over. Payment visit. Let's hop in. Let's start with the basics here. Canada's healthcare system, it's called Medicare by a lot of people. I've never heard it called that but maybe you have. It's a publicly funded universal healthcare model administered by the provinces and territories with federal funding tied to the Canada Health Act of 1984 which ensures universal access to medically necessary services without direct charges. At the point of care you've never paid for a doctor's appointment

neither have I, there's good in that for sure. The roots of this though trace all the way back to 1966 when the Medical Care Act was passed, building on Saskatchewan's pioneering hospital insurance program from the 40s under premier Tommy Douglas. The catalyst was post-World War II social reforms and a growing belief that health care was a right, not a privilege. You may agree, you may disagree, I don't know. Canadians saw skyrocketing medical costs and unequal access. Rural and low-income folks often went without care. Douglas's vision, though, of universal health care gained traction, promising equity and stability. And by 1971, all provinces had adopted public health insurance. Support was

overwhelming. Polls from the 60s showed over 80% of Canadians favored universal health care, drawn to its promise of fairness and security. But not everyone was on board. Private insurers, obviously, and some physicians opposed it, fearing loss of profits and autonomy. The Canadian Medical Association initially resisted the change with doctors in Saskatchewan staging

a 23-day strike in 1962. That would actually be not that bad a wait time by today's standards but I digress. They argued that the government would erode quality and innovation. Some foreshadowing there perhaps despite this public demand won out and Medicare became a cornerstone of Canadian identity. Fast forward to today and the system is maybe creaking and cracking a little bit under its own weight. We're going to break down some of the data on the biggest issues and see where we come down on all these things.

First we'll talk about wait times. According to the Fraser Institute's 2024 Waiting Your Turn report, the median wait for a specialist treatment after a GP referral was 30 weeks, 222% longer than the 9.3 weeks in 1993. In PEI, it's a staggering 77.4 weeks, over a year and a half. For diagnostics, Canadians wait 6.5 weeks for a CT scan and about 13 weeks for an MRI, far exceeding what physicians deem clinically reasonable. These delays aren't just inconvenient, they worsen health outcomes. Obviously, a 2022 study from insurebbd.ca linked prolonged waits for cancer and heart disease to higher morbidity and mortality. Obviously, access

is another sore spot. The Canadian Institute for Health Information, CIHI, reports that about 12% of Canadians, over 4.5 million people, lack a regular family doctor. In rural areas, it's much worse. None of its access rate is just 24%. This forces patients to emergency rooms, where 90% of patients waited up to 4 hours to see a doctor in 2021-22, compared to only three hours in 17-18. ER overcrowding is now routine with hospitals like Kingston General operating at 120% capacity in 2024.

Doctor shortages are a key driver. Canada has two and a half physicians per 1,000 people, well below the OECD average of 3.5. We actually ranked 29th out of 33 high-income countries for doctors per capita. In 2021, 6,819 family physicians were over 65 years old and nearing retirement, presumably anyway, who knows if they're gonna retire, but you'd be thinking about it. And each of those will leave about a thousand patients without care. Burnout is rampant as well.

Eighty percent of Alberta's primary care physicians are considering leaving due to administrative burdens per a 2024 Business Council of Alberta report. Equipment is another weak link. Canada has 35 percent fewer acute care beds per capita than the US and lags behind countries like Turkey and MRI availability. Turkey. Weights for routine ultrasounds average 4.9 weeks per the Fraser Institute. This underinvestment stems from global budgets that have prioritized cost control over capacity and they have left hospitals stretched thin.

Finally, there are systemic inefficiencies like fragmented electronic medical records and poor coordination between primary and specialty care. These exacerbate delays. Only 22% of Canada's primary care practices can share patient data electronically, compared to 80% in the Netherlands. This is not just a glitch, it is a structural failure of our system. So what can we do? Solutions exist, but they require action quickly and probably against the grain as well. We'll talk about a few of them here and unpack some of the data while we're at it. First, increase the supply of healthcare professionals.

Canada could expand medical school and residency spots as Ontario did in 2024, adding 1000 new training positions, incentivizing practice in underserved areas like loan forgiveness or higher pay, could help address some of the rural shortages. South Korea, with fewer doctors per capita, achieve shorter waits by maximizing consultations,

16 per person annually there versus our 7.6 annually. Second, hope you're sitting down, we could allow for a private tier. Countries like Germany and Switzerland blend public and private systems, which reduces the strain on public hospitals. In Canada, private care is limited to less than 1% of critical services due to the Canada Health Act.

A 2005 Supreme Court ruling in Quebec called bans on private insurance unconstitutional, arguing, quote, access to a waiting list is not access to health care. Permitting private options could ease backlogs, though critics warn of inequity, as they always tend to do. Third, we could boost capacity to match population growth. Canada's population grew about 14% from 2013 to 2023, but specialist density only increased

from 108 to 123 per 1,000 people. Building more hospitals and investing in equipment like MRI machines could close the gap. Ontario's 2024 agreement with the federal government, which injected 46.2 billion over 10 years, aims to do this, but scaling it nationally is key and has been a weak spot since the health act took over. Finally, streamlined operations. Centralized wait list, as suggested by Dr. Kamila Premji, could optimize specialist referrals. Programs like RACE, which stands for rapid access to consultative expertise, and Champlin-based eConsult

have cut wait times by 20 to 30% in pilot regions by improving primary specialty communication. Scaling these nationwide could save billions but would be difficult of course. But if we keep kicking the can down the road the costs both human and economic will be staggering. Health outcomes are already deteriorating. A 2022 study by BBD found that delayed cancer surgeries increased mortality risk by 6 to 8 percent per month of delay. Mental health patients faced weights of up to six months for psychiatry leading to a 30 percent higher risk of hospitalization. Chronic conditions worsened, turning treatable issues into disabilities, and in 2023 a BC teen became paraplegic after a three-year wait

for urgent surgery. Economically, the toll is massive. Fraser Institute's 2022 report estimated wait times cost Canada $3.6 billion in lost wages and productivity, 3,000 or so per patient. With 1.2 million Canadians waiting for procedures in 2024, that's 3% of the population sidelined. The average family of four paid 17,000 in taxes for health care in 2023, yet almost 70% of Canadians

say the system is overstretched per OECD surveys. Long term, the aging population is going to amplify this strain. By 2030, 25% of Canadians will be over 65, doubling the demand for joint replacement and cataract surgeries, which have already seen a 33% non-compliance with recommended wait times. CIHI projects a 20% rise in healthcare spending by 2035, hitting $400 billion annually, or 12% of GDP. Without reform, taxes will skyrocket, or rationing will intensify,

leaving more Canadians in pain or worse. Canada's healthcare system was built on a noble promise, care for all, regardless of means. No one is arguing that, but that promise is fraying. Wait times are the longest in decades, millions of Canadians lack doctors, and our equipment and staffing lag behind peer nations. The data is clear. Doing nothing isn't an option.

Solutions like expanding training, embracing private options, boosting capacity, and streamlining the system could turn the tide, but they demand both courage and compromise. As Bitcoiners we value decentralized systems and individual choice. So maybe it's time to ask, can a one-size-fits-all healthcare model really keep up with Canada's needs? Is it time to rethink what universal means and build a system that delivers care, not just a place in line? What do you think? You guys have me on X or Twitter, you can email the show, leave a comment on the podcast or in the live chat on Monday. And until next time, take care.