Shownotes Transcript
Scott Payne spent nearly two decades working undercover as a biker, a neo-Nazi, a drug dealer, and a killer. But his last big mission at the FBI was the wildest of all. I have never had to burn Bibles. I have never had to burn an American flag. And I damn sure was never with a group of people that stole a goat, sacrificed it in a pagan ritual, and drank its blood. And I did all that in about three days with these guys.
Listen to Agent Pale Horse, the second season of White Hot Hate, available now. This is a CBC Podcast. I'm Dr. Brian Goldman. This is White Coat Blackheart. Monday is voting day for Canada's 45th federal general election.
While Trump and tariffs have generated headlines, health care is also an election issue. A new national survey has found Canadians to be deeply frustrated with primary health care in this country. A 72-page report found evidence of what it calls an attachment crisis. In other health news, it's a scenario that doctors have long feared as the national conversation continues around staffing shortages and long wait times in hospitals across the country.
The Canadian Medical Association says it's time for the country to have an honest conversation about private and public health care. A new poll out today suggesting Canadians are much less satisfied with our access to health care than Americans are.
From the 7th to the 10th of April, we interviewed representatives selected by each of the five major political parties on how they would handle three health care issues: the shortage of physicians and nurses, a pan-Canadian license for health care workers, and creeping private pay health care. Note that these interviews were conducted before the party's full health care platforms were released.
You'll hear each party's positions in alphabetical order, beginning with the Bloc Québécois' Luc Thériault. Luc Thériault is running for the Bloc in Quebec's Montcalm riding. He was most recently the party's health critic. Monsieur Thériault's answers in French are being read by White Coat's Samir Chabra.
I started by asking him and the other candidates what they would do about the shortage of physicians, nurses and other health care professionals across Canada. When it comes to personnel or personnel shortages, I'd like to remind you that this doesn't concern the government of Canada.
It concerns the provinces, and the provinces have funding problems. So perhaps we can discuss this another way. What I'm going to say is that the federal government should focus on its responsibilities, and it has no responsibility for providing care. Now, indirectly, we could say that accessibility is a criterion that's already enshrined in the law, except that it depends on how well the provinces are able to provide care.
And yet, there has been chronic underfunding for years, which has led to the results you're talking about. Personally, I'd like to see the federal government take charge of its own responsibilities, and one of them is drug licensing.
In the next 10 years, there are going to be innovative new medicines that patients will need access to. And that means that the licensing process has to be state-of-the-art, which it isn't at present. We're way behind schedule, and there are many roadblocks in getting drugs approved and licensed.
particularly for rare diseases. Hi, my name is Dr. Stephen Ellis. I'm the conservative candidate for Cumberland Colchester, and I've been the conservative health critic for the last two and a half years. I think there's a few different ideas that will make the system better. And Brian, I'll focus mainly on physicians, but as you know, this can be applicable to any healthcare sector. People want a national license.
Second part of it is international medical graduates who have experiences. And some studies out there would suggest there's 20,000 physicians who are in this country who are not practicing as physicians. And the other thing, incredibly sadly, that they've told me that Canada has become known as the graveyard for physicians.
meaning they will never get a license in Canada. And, you know, there's an easy solution to that in the sense, of course, taking those internationally trained physicians and partnering with Canadian physicians in a system that comes under various names, but practice ready assessment program so that their competency can be easily understood by the physician who's working with them. And that doesn't have to be time-based. It needs to be competency-based and
The other thing that we need to understand is something that I've termed the training time burden. As you know, the minimum amount of time right now in most medical schools across the country to become a family doctor after high school is 10 years. And this is, to me, one of the most important things. If we are saying that we are in a crisis, and I think that everybody agrees with that, then we're not going to be able to do anything.
The obligation of anybody who is a stakeholder who has an opportunity to make the system better, the time for planning and talking is over and the time is now for action. I'm Dr. Anne-Marie Zadlik. I'm a family physician of 35 years in Guelph, Ontario, now running as the MP candidate for the Green Party in Guelph. I'll address the shortage of physicians first.
I think there needs to be a top-down, bottom-up approach. We need to take a look at reforming health care entirely in this province. The shortage has been there for a very long time. Many factors have contributed to it. So we are looking at reforming the Canada Health Act and introducing a Primary Care Health Act and a Mental Health and Addictions Act
that would insist that provinces use their Canada health transfers to fortify primary care and to fortify mental health and addiction care. In the province of Ontario, I think what we need to do is set up new teams of primary care prescribers, nurse practitioners, nurses, family physicians,
much like Jane Philpott is already doing in the province, creating primary care homes. In order to do that, everyone in those new primary care clinics needs to be salaried. So it's a different financial model that will entice new physicians who are presently looking for salaried positions to rejoin community-based practices. I also spoke with Kamal Khaira, Liberal Party candidate running in Brampton West in Ontario.
She's a registered nurse and most recently served as Minister of Health. Let me first start by emphasizing the very important fact that in Canada, health care is a right and a right that the Liberal Party of Canada and a Liberal government will always fight and protect and defend at all costs.
Our focus is on protecting our universal health care system, modernizing it, working with provinces and territories to deliver better care faster. And that's precisely why we had put forward a historic plan
$200 billion forward to provinces and territories to rebuild our healthcare system after the COVID-19 pandemic. And we have been very clear, as you know, Brian, with provinces and territories, that these dollars are meant to be spent on key priorities areas, which is around hiring more family doctors, nurse care practitioners, strengthening our primary care healthcare teams,
ending the backlogs that we've seen in our ERs, you know, strengthening our home care and supporting our elders in our long-term care homes. And we make sure that this funding also to the provinces is conditional on results because Canadians deserve to see progress on this issue. I'm Don Davies. I'm the new Democrat candidate for Parliament in Vancouver Kingsway. Well, you know, when I first ran for Parliament in 2008 with Jack Layton, there were 5 million Canadians who didn't have a family doctor.
Today in 2025 the problem is much worse now nearly 7 million Canadians don't have access to a family physician and that's a particular problem because having a family doctor is our entry into our health care system. So the NDP has announced a suite of measures to address this. Our commitment is that every Canadian should have a family doctor by 2030 and
And we would do that by adopting a number of measures. First, we'll increase the federal health transfer to the provinces and territories by 1%. Second, we'll streamline the process for internationally trained physicians to practice in Canada, faster foreign credential recognition.
We need to work with the provinces and regulatory bodies to reduce the administrative burden on doctors that takes time away from patients. And we're also going to implement pan-Canadian licensure to help medical professionals practice where they're needed across the country. That's been a key demand of the Canadian Medical Association and the Canadian Federation of Nurses' Unions.
I think we also need more community-based clinics with the team-based care model. We have to expand the scope of practice of medical professionals such as nurse practitioners and pharmacists that'll take a little bit of the burden off family docs and distribute care among other allied professionals.
And finally, I think we have to train more family doctors, more nurse practitioners, more nurses and allied health professionals. I think overarching everything, Brian, is we have to invest more in prevention and address the social determinants of health. That keeps people away from the doctor's office. Since May of 2023, physicians who are licensed in Nova Scotia, New Brunswick, Prince Edward Island or Newfoundland and Labrador are able to join the Atlantic Physician Registry and practice in any of the Atlantic provinces.
Elsewhere in Canada, doctors and nurses must be licensed in each province or territory in which they wish to work. The Canadian Medical Association has been calling for a pan-Canadian license which would permit physicians to work anywhere in Canada. We asked each candidate for their party's position on that. It's a bit complicated. If you're already short of manpower, can you really afford to have manpower roaming around the country?
I'm not sure that's the solution. There's also a question of fairness. If doctors are trained at McGill, for example, and Quebec pays for it, and the person goes to work in Toronto...
Quebec doesn't benefit from that. So it's something that really needs to be studied. I asked Luc Thériault whether he thinks there could be an opportunity to allow American doctors to practice in Canada. Well, tell that to Donald Trump. Listen, if indeed there are American doctors and doctors from all over the world who want to come and work in our networks, I think they're welcome. Expertise and brains have been lost. There's been an exodus.
So if we can import some healthcare professionals, I've got no problem with that. In fact, it was a problem we never solved. When we talk, for example, about the recognition of diplomas, there are people who emigrate with medical diplomas who are unable to practice. That's a deplorable situation, and it mainly concerns professional orders, so it's not a matter for the federal government. We can have a discussion on health in general, but the Bloc Québécois is responsible for the federal jurisdiction.
I don't sit in the Parliament of the National Assembly of Quebec. I'd have a lot to say about health care if I did. Here is Conservative candidate Dr Stephen Ellis with his party's plan. We've seen quite clearly here in Atlantic Canada that provinces can get on board. Newfoundland, PEI, New Brunswick and Nova Scotia have adopted the ability to have a single licence and to...
use that license amongst those provinces. So again, this comes down to leadership. This is something that we don't often talk about in this country, which is very, very sad because good leadership leads to good results.
and pointing out to folks the folly of how things are being done at the current time and showing a better way, which is incredibly thoughtful, I think. And having had all of those meetings already over the last two years in my role as the shadow critic for health, I think that the opportunity is right there in front of us to make these changes and to make them quickly. And here is Green Party candidate Dr. Anne-Marie Zadlik. I think that's an absolute challenge.
that you break down the interprovincial barriers, so to speak, that prevent physicians from moving easily or nurse practitioners or nurses from province to province to work without having to be re-licensed in that province. We would have a lot more prescribers, nurses, nurse practitioners moving into areas that are extremely resource poor with respect to primary care if the barrier, one of the barriers is removed from transferring to a different province. And one of those is
licensing. Kamal Kara with the Liberals had this to say about national licensure. I think that is such an important part. I mean, you know, when we talk about making sure that there are, we remove barriers around our provincial territorial jurisdictions, we're exactly doing that by tackling it with the Team Canada approach. Working, having
hand in hand with our provinces, with our regulators and the immigration system. And that's precisely why we were able to put forward and invested more than $77 million to speed up credential recognitions, to expand residency positions, to get internationally trained professionals into the workforce. Our Liberal team will create one
Canadian healthcare workforce. As a nurse, I should be able to practice anywhere that I need to. I am an Ontario licensed nurse, but I know right now, in order for me to go to BC or anywhere, there's a whole accreditation system that goes through so that I can get accredited.
We need to remove those barriers. And just before this election, I actually sent a letter to all the health ministers of provinces and territories to ensure that we are all working to break down these barriers together. So one of the key focuses of our reelected Liberal government will be to
eliminating these barriers so that doctors, nurse practitioners, nurses on our healthcare workforce from Ontario can practice anywhere in Alberta to Newfoundland or anywhere they choose. This is a barrier and I think there's a huge opportunities for us to remove those barriers to make sure we're creating a Team Canada approach.
Here's how candidate Don Davies says the NDP would address the issue of a pan-Canadian license. Provinces have the direct responsibility of professional regulation, so it's going to require federal and provincial and territorial governments working together. But because it's been such a clear demand of the Canadian Medical Association and the nurses' professional unions,
I can't see why anybody would want to stand in the way of that. So I think that we just have to roll up our sleeves and get to work working together. We'll be right back.
In the fall of 2001, while Americans were still grappling with the horror of September 11th, envelopes started showing up at media outlets and government buildings filled with a white, lethal powder. Anthrax. But what's strange is if you ask people now what happened with that story, almost no one knows. It's like the whole thing just disappeared. Who mailed those letters? Do you know?
From Wolf Entertainment, USG Audio, and CBC Podcasts, this is Aftermath, the hunt for the anthrax killer. Available now. You're listening to White Coat Blackheart.
On our election show, we asked representatives of the five major parties how they would tackle three specific health care issues selected by us. Last fall, our show did a two-part series on private pay, family medicine and Quebec. We asked all five candidates for their party's position on the private pay issue, beginning with the Bloc Québécois candidate, Luc Thériault. I don't believe it.
I don't think there's that much private use right now. It's a question of financing, because that's what we're talking about. We're talking about problems resulting from chronic underfunding during the pandemic. And it takes money to plug the gap. In Quebec, for example, we were talking earlier about staff shortages. There are operating rooms available, but we don't have the nurses to staff those rooms. This is due to years of chronic underfunding.
Working conditions have deteriorated in the public system. People prefer to work in the private sector because they have control over their schedules and a better quality of life. So all this is also linked to working conditions, fair working conditions, the ability to invest and create living environments that are attractive. I followed up by asking, can the federal government play a role in regulating private pay practices? Yes or no? I think the federal government has nothing to impose.
I don't think the federal government should impose anything, period. Let them take care of their responsibilities first and take care of them properly, which they're not doing right now. Let them respect the pact that was put in place at the beginning of the institution of health insurance.
And yes, they can always say they're holding back money, but that's not the way to improve services. We're talking about problems linked to chronic underfunding. Not to recognize that, in my opinion, is totally delusional. And after that, let's say we ask, can the federal government try to regulate? Basically, the question is, can the federal government decide to give its money based on what it considers to be performance criteria?
My answer to that question is the answer that all provinces will give: no. If you want to do that, we'll reopen the constitution and then change the rules of the game. The federal government has responsibilities. In the early days of Confederation, it decided to take care of things like defense and told people to take care of the world.
At the time, education and health weren't glamorous. In this day and age, health is a major concern for citizens. And now the federal government wants to lecture the provinces when they don't have the financial resources.
Next is Dr. Stephen Ellis with the Conservatives. I mean, we don't talk about that at all, Brian, in the sense that that's not the system that we have in this country. We have a publicly funded system. It's a system that I've grown up in, and it's a system that I know that if we have stakeholders who take what's happening in this country very seriously on behalf of Canadians, that we can actually make a system that works for everybody again. Patients are acting out of desperation today.
because the system is failing them. But I can be very clear with listeners that Conservative government has certainly no ideas around privatizing care in this country. That's a misconception that people often want to say that that's what we want to do as Canada's Conservatives.
As I said, I've been the shadow critic for the last two years. That's not something that we want to do. And perhaps you don't like the answer, but with good leadership, I believe in good relationships, again, that I think Minister Dubé and I have together, that those are problems that we can solve. If people know that help is on the way, that the crisis can be solved, again, with good leadership and good solutions across this country,
then we can extinguish that type of behavior, which I don't think anybody wants to see. But when, when people are desperate, when their health is on the line, when they're waiting, uh, and, and incredibly sadly, Brian, when they're dying in emergency rooms, people start grasping at those straws.
But I don't believe for a second that that's the style of health care that anybody wants in this country. And certainly it's not a style of medicine that Canada's Conservatives would be behind at all. Next comes Dr. Anne-Marie Zadlik of the Green Party.
We are against that, no question. We have a huge number of people in the next number of years that will be housing insecure and food insecure. That group, as it goes past 20%, 30% as a result of tariffs, will not be able to afford to access a family physician if they need to pay for it in any way.
And if the private system that Quebec is describing pays a family physician more to provide that care, why wouldn't most family physicians go into that private system if they're struggling to survive in the public system? And at the moment, we are all struggling to survive in the public system. How would your party use the Canada Health Act?
to deal with private pay family doctors? I think that it has to be something that we stand by as Canadians.
We value our universal health care system, Medicare that's universally accessible to all, that has no private components to it. And I think that has to be enforced through the Canada Health Act. No privatization creep, none whatsoever. It's too easy for provinces to do that. They're looking for answers to the crisis in primary care. But there are other answers that don't allow for privatization. Here is Kamal Kara of the Liberal Party. Look, look.
Liberal Party of Canada will always defend Canada's public universal health care system. We believe strongly that care should be based on need, not on ability to pay. That's why we
oppose absolutely in the strongest terms creeping privatization that and we have been working with provinces and territories to crack down where and to uphold the Canada Health Act where there is evidence of paying out of pocket for medically necessary services that is absolutely unacceptable
But it's happening right now. But it's happening right now and it's growing. That's why we have been working with provinces and territories to uphold the Canada Health Act where there is evidence. And I will tell you, my predecessors before I was a health minister were very actively have been calling out and writing to provinces where we have seen that happen. Absolutely unacceptable. We will always uphold the Canada Health Act.
thinking about critics, your party has been in government since 2015. Why should voters think that what you say you'll do now that you might not have done in the past 10 years that you would do in a new liberal mandate? Well, I will tell you the
the Liberal government is a party that will always defend and protect our healthcare, our universal publicly funded healthcare system. And we certainly have seen, particularly after the pandemic, a lot of gaps that existed within our healthcare system. And we have, as a
party as an evidence-based party a scientific party have always been working alongside our advocates always been working alongside provinces and territories been experts on the ground to make sure we build a system a 21st century system we modernize the way that we look at health care in this country and that's exactly we have delivered on the largest historic investment
and a generation, $200 billion. And that is tied to results. That is around showing results to Canadians that the provinces and territories are accountable to. We are a government that would always protect our universally publicly funded healthcare system and make sure we continue to make it the best system in the world. That is a commitment of our Liberal government and we will always to support Canadians right across this country.
And finally, here is Don Davies on how the NDP would address private pay access to family doctors.
Well, you know, the New Democrats are the party of health care. We invented it in Saskatchewan in the 1940s. We pushed the Liberal government in the 1960s to bring in national Medicare. And so we are strong proponents of public health care, not only because it's the fairest way to deliver care in Canada, Brian, but it's also the most cost effective. So what we would do is this. When Medicare was first established in Canada, the federal government agreed to assume half the costs of
associated by the provinces and territories. But as we know, that has slid over the decades to about 22% today. That's why in the last parliament in the NDP's supply and confidence agreement, we required additional ongoing investments by the federal government in our public healthcare system. So we pushed the federal government to provide an additional $46 billion over 10 years
in public health care funding to the provinces and territories. Now that's fallen far short of what's needed. The premiers have indicated they need about 35% or they want to see the federal government contribute 35% of the costs and I agreed with that proposal when I was health critic. We just simply need to invest more money in our public health care system and enforce the Canada Health Act.
You know, privatization has proved to be by every major study and including in a very major case here in British Columbia that went to the BC Court of Appeal in the Canby surgeries case. After an exhaustive examination, it found that private delivery of service not only increases wait times in our public system, it not only restricts care to those that can pay for it, but it costs more money.
And I think we just have to look south of the border for even more evidence where the United States pays more money per capita for health care and they don't even cover every American citizen. So the new Democrats have said we need robust enforcement of the Canada Health Act. We need to assiduously avoid privatization and we need to invest in our public health care system. And that's what we did last parliament by pushing a historic breakthrough in dental care.
by investing an additional $4.5 billion a year to get 9 million Canadians who never had access to dental care, dental care, and also to get a start on PharmaCare by providing the historic first delivery of diabetes and contraception medications through our public health care system. And every major study that I've seen found that we can save between $4 and $11 billion a year
if we have universal access to pharmaceuticals through our single payer system. So it's not only clinically required, it's not only fair, but it actually will save our system money.
One in four Canadians care for a family member, friend or neighbour. And many are stretched thin caring for loved ones. We wanted to know what the major parties would do to help out caregivers. Here's what Luc Thériault with the Bloc Québécois had to say. We and the Bloc Québécois have tabled Bill C-418, which calls for an in-depth reform of employment insurance.
We're looking to increase the benefit period and review the criteria, particularly the allocation of benefits to caregivers, to make them more flexible. We're also proposing that the tax credit for caregivers be made refundable, which has been requested by many other groups and associations.
Overall, we're looking to increase the employment insurance benefit from 55% to 60%. The 55% figure for insurable income is from a long time ago, and it's only natural that we should raise it for inflation.
There's also the fact that benefits are currently 15 weeks for adult caregivers, 26 weeks for compassionate care benefits, and 35 weeks for caregivers of children. We need to improve what we're offering, and this is a solution that could effectively recognize the contribution of caregivers for all the services they provide when the health care system can't.
Here's Dr. Stephen Ellis with the Conservatives. Yeah, you know, that again, because we have a system that's crumbling at our feet, that's where we have come to, you know, that we know that many folks, of course, after many years of providing that difficult care as family members, that it becomes an untenable position. And we've seen that we can't have enough
of PCAs or PCWs in this country with the ability to care for folks who are sick. We also know that there are not enough long-term care spots and that many people would love to be able to be cared for at home. So continuing to look at those situations. Next comes Dr. Anne-Marie Zadlik of the Green Party. That's a big issue that I'm finding that is very common as I knock on doors.
I'll have a son or a daughter answer the door and talk about the fact that they're not able to work outside the home. They may not be happy with the work they find online, and they have to be there because they're supporting a person who is aging at home. And there are specific parts of our policy that support those caregivers who are providing care.
home-based care, allowing their older family members to age at home. One of the parts of that policy in the Green Party platform is to reinstate tax breaks for people who are renovating their home to bring a family member in and make them comfortable, tax rebates for people who are doing that, and so on.
Would that policy include providing refundable tax credits to unpaid caregivers? Yes, that is part of the plan. Here is Kamal Kara of the Liberal Party. That's an incredibly important question. And I will tell you, caregivers play such an incredible role within our system.
We've seen this particularly come to light, unfortunately, during the COVID-19 pandemic. And we need to make sure that we are focused as a country to work alongside provinces and territories, work alongside advocates and healthcare workers, as well as particularly those caregivers. And that's precisely why we have been able to create a sectoral table on care economy to provide recommendations to the government on the creation of
a national caregiver strategy. This is around supporting not just the unpaid, but also supporting some of the lowest paid workers that we've seen. That also includes making sure that we're supporting, you know, personal support workers that our government was able to put 1.5%,
$7 billion to better support wage improvements. And Don Davies with the NDP had this to say. Well, thanks for asking that, Brian. You know, caregivers across Canada are they're undervalued, they're stretched too thin and they're at a breaking point. I don't think it's a private struggle anymore. It's a national crisis.
The last figures I saw are that one in four Canadians, that's about 10 million people, are caregivers. And a growing number of them are experiencing significant health, social and economic consequences related to their roles. So to address that, we pushed the government to announce in the last budget, 2024, a national caregiving strategy. It has not been implemented yet. There's more work to be done. But that includes things like having a refundable tax credit
and a caregiver allowance to ease the financial strain. You know, one in five caregivers spends over $1,000 a month out of pocket to care for a loved one. So they need help. And I think we need better home support. We know that seniors and people who need care do better when they're at home. So if we can adapt our system with better support from nurses, occupational therapists, physiotherapists,
those kind of things, who can come visit patients in the home, as well as offering respite care, then I think we can keep folks healthier in their homes longer, and we can also give some relief to those millions of Canadians who are providing care to their loved ones.
Some of the party's campaign platforms were released after recording our interviews. The Bloc is calling for increased federal health transfers. The Conservatives and the Liberals are promising to increase the number of MDs in Canada and to work with the provinces to create nationally recognized licenses for doctors and other providers. The NDP is promising that every Canadian can access primary care by 2030 and to help address the doctor shortage by boosting health transfers by 1%.
The Green Party is promising to introduce a new Primary Care Health Act to guarantee every Canadian can access a family doctor, nurse practitioner or community health team. That's our show this week. White Coat Black Art was produced by Samir Chhabra and Stephanie Dubois with help from Jennifer Warren, our digital producers Ruby Buiza, our senior producers Colleen Ross. I'm Brian Goldman and I'm proud to bring you stories from the Canadian side of the gurney. See you next week.
For more CBC Podcasts, go to cbc.ca slash podcasts.