The West Block – Episode 19, Season 13 – National

THE WEST BLOCK
Episode 19, Season 13
Sunday, January 21, 2024

Host: Eric Sorensen

Guest:
Mark Holland, Health Minister

Location:
Ajax, ON (Zoom)

Political Panel:
Jonathan Madison, Republican Strategist—San Francisco
Sarada Peri, Former Obama Senior Speechwriter—Silver Spring, MD.

Location:
Ottawa Studio

Eric Sorensen: Overcrowded hospitals, long wait times, not enough staff. What’s the solution to Canada’s health care crisis?

I’m Eric Sorensen, sitting in for Mercedes Stephenson. The West Block starts now.

A year ago, the federal Liberals announced billions of dollars in health care spending for the provinces. So why are doctors and patients saying the system is getting worse?
Ahead of the Liberal cabinet retreat, we asked the federal health minister.

[Crowd cheering]

And, after a resounding victory in Iowa, can anyone stop Donald Trump’s momentum? As primary season gets underway, we dig into the Republic race for president and the implications for Canada.

The prime minister is meeting with his cabinet in Montreal for the next two days. It’s a chance for the Liberals to reset the agenda ahead of next week’s return to Parliament. It comes at a time when they’re struggling in the polls against Opposition Leader Pierre Poilievre and the Conservatives on the agenda, housing affordability, and improving health care, and that’s our focus today.

Last week, we heard from two doctors who described the crisis hitting emergency rooms and hospitals right now.

Dr. Trevor Jain, Canadian Association of Emergency Physicians: “You talk to any emergency department. We can stand being busy. We don’t mind being busy, but overcrowding kills and that’s what we’re starting to see.”

Dr. Kathleen Ross, CMA President: “We’ve gotten very good at naming the problem. We’ve identified solutions. We haven’t been the greatest at implementing those solutions.”

Eric Sorensen: Joining us ahead of the cabinet retreat is Health Minister Mark Holland. Minister Holland, thanks for joining us.

The doctors we spoke with last week, I mean they say the problems in health, the wait times, the backlogs, are only worse than they were a year ago. Why?

Mark Holland, Health Minister: Well I think coming out of the pandemic, we have a health workforce that was exhausted. We had backlogs as a result of the pandemic, and this is something that we’re seeing all over the globe, really major health demands. And the good news is we’re working with provinces and territories. We have bilateral agreements. We’re going to be making $200 billion in investments over the next 10 years, and that includes in individual programs in provinces and territories, four of which have already been announced, where we very specifically outline what improvements that money is going to deliver and then create a report card for every province so you can see in metrics those improvements. So the system is under a lot of strain. That’s natural coming out of the pandemic, but we’re here to work with provinces and territories.

Eric Sorensen: You said that you’ve signed four agreements with provinces, but that means many have not signed on yet, including Ontario and Quebec. What’s the holdup?

Mark Holland, Health Minister: Well, getting the agreements right. You know, if you look at British Columbia, if you look at P.E.I., if you look at Alberta, if you look at Nova Scotia, where we’ve done these agreements, they’re phenomenal agreements. They spell out in real clarity exactly where we’re going to meet the challenges of health workforce issues, how we’re going to make sure that everyone has a relationship with a family health team and a family doctor, how we’re going to reduce wait times. So, you know, getting these agreements right is what we want, and so it was always contemplated that this was going to take some time. And I’ve been really excited to talk with health ministers across the country to make commitments not just on the money but the transformation in our health system generally. So it’s about working collaboratively and getting these agreements right. You’re going to see the rest of the agreements flowing out over the next two months, and I’m really excited to be able to share the fruits of that work. But it’s important that we get it right and that’s what we’ve been focused on.

Eric Sorensen: The doctors and nurses and health officials say they want to sit down with you as well and with the premiers. You had this gathering with the premiers a year ago, maybe you need another summit, like right away, and with those officials as well.

Mark Holland, Health Minister: Well you know one of the things that I’ve done is been on the road constantly. In five months, I’ve been to every province with the exception of Saskatchewan and I’ll be there very soon. Many, in some instances, four times. Four times to B.C., four times to a few other provinces, meeting on the ground with health officials, talking with doctors, talking with nurses, talking with the regulatory bodies. So we made huge announcements, for example, for credential recognition, getting that down to a 90-day service standard. Working with the College of Physicians and Surgeons on taking what normally is over a two-year process, getting that down to three months. So we’ve been really working through these issues and so—and there will be a lot of joint meetings. I’m doing that regularly, so that’s going to continue. You’re going to see me travelling all of the time, meeting on the ground where these issues are, finding solutions and working collaboratively. And it doesn’t matter if it’s a New Democratic government in Manitoba or a Conservative government in Nova Scotia. Wherever it might be, we’re working together and recognize that the differences that we have are not important. What is important are solutions, we need to all be pulling in the same direction and getting things done. That’s very much the spirit of Charlottetown. You know we had an incredible meeting in Charlottetown with all the health ministers making announcements on health workforce, making announcements on data and interoperability, making headway on health workforce issues, retention issues. So I think by working collaboratively that’s really the answer here. We have a lot of demand, but the answers are there and the solutions are going to be found through collaboration.

Eric Sorensen: But when? When will we see the solutions that you’re talking about, the results that doctors and everyone else is—that they want to see?

Mark Holland, Health Minister: Immediately. You can take a look at the, for example, in Nova Scotia, the College of Nurses there has undergone incredible transformation, that others are following to be able to bring folks to allow people to travel within provinces and recognize their credentials immediately, in sometimes less than an hour, and also, too, as I mentioned with foreign credential recognition, to get those timelines way down, to get to a 90-day service standard to work with the process of recognizing credentials, to get that way down. So, you know, you’re seeing immediate results there. You’re seeing immediate results in these bilateral announcements, which are very explicit about exactly what improvements are going to happen to the health care system. You also are going to see annual report cards, where there are common indicators across provinces and territories. So you can see how your province or your territory is doing relative to the commitments that were made and see that year over year progress. So you’re going to see these—you’re seeing the action taken immediately now. You’re seeing the change happen immediately now, and you can see the trajectory of that as we work collaboratively to get out of the challenges that we have right now with health workforce and with these backlogs into a new paradigm.

Eric Sorensen: You know one solution for more health care would be more private health care and the Ontario government of Doug Ford is pushing forward with more private clinics, not just for MRIs and CT scans, but also for hips and knee surgeries. That sounds like the slippery slope into two-tier medicine.

Mark Holland, Health Minister: We’re not going to allow that to happen. Let me be very clear, Canada and Canadians are deeply proud of having a public health care system, one where when you walk into a health facility, the question is: How do we get you better, not what is the size of your bank account? And we know that not only is it a deterioration of care to allow private care to expand, but it really has a huge injurious impact on cost as well. It’s way too expensive. So the answer here is look, there’s some challenges. Provinces are using some stop gap measures, but we’re going to be very clear in our enforcement of the Canada Health Act that the care that people get must be public and that the costs associated with that need to be within a public system. And so we’re working with provinces and territories. We understand they have some interim challenges and we understand that there’s going to need to be more clarity on things like virtual care, but, you know, our adherence to the Canada Health Act is absolute.

Eric Sorensen: I want to move onto a question about drug sales to the United States. The U.S. FDA is permitting Florida to purchase and import drugs from Canada. You’ve given assurances that Canada will safeguard such sales for Canadians to have enough drugs for themselves here, but in the past the government was very concerned about doing something like that. What’s changed?

Mark Holland, Health Minister: Well let me be clear, there is—we’re going to do everything to absolutely ensure that Canada’s drug supply is protected and there is no way any country is going to raid our drug supply in a way that endangers domestic supply. I have had extremely productive conversations with Ambassador Cohen from the U.S. My U.S. counterpart Secretary Becerra and I had an extremely positive contribution—conversation as well and we’re on the same page. You know, where Canada can expand our pharmaceutical industry and export drugs in a way that does not hurt domestic supply, of course we’re there. We want to be supportive of our G7 partners and particularly our relationship with the United States, and it’s a great opportunity to expand Canadian enterprise. But that cannot come at the cost of Canada’s ability to supply its own population. Secretary Becerra and Ambassador Cohen indicated their support for that position, and we talked about our desire to work collectively to make sure that not only for our two countries but for our allies and for all countries that drug supply issues are addressed and that we have an adequate and safe supply and the importance of working collaboratively.

Eric Sorensen: Just one quick question. You’re entering this Liberal retreat where the emphasis is very much on housing, on affordability. What is your message to your colleagues to ensure that the health issue is not last year’s issue but is still front and centre?

Mark Holland, Health Minister: Well we saw in Manitoba, we saw in Nova Scotia, elections turn on health. Canadians care deeply about their health care, and so I know that my colleagues are as committed as I am to making sure that we work with provinces and territories. We’ve already set aside these dollars, money, in particularly if you look at us compared to other G7 countries, the money that provinces and territories have is absolutely sufficient to meet the need. But we need to also work together to help provinces and territories transform their health systems to deal with data challenges, interoperability, to look at the ability of deploying new technology and new ways of working. And I’m really excited. There’s a spirit of collaboration there when I travel the country to see the solutions that are present and possible. You know, I’m going to be going in saying not only do we have to keep the pressure on, but that as we are doing that, great things are possible and will happen for our health system.

Eric Sorensen: All right. Health Minister Mark Holland, thank you for joining us.

Mark Holland, Health Minister: Thank you, Eric.

Eric Sorensen: Up next, the race for the White House heats up. We dig into the political stakes and what it could mean for this country with our U.S. political panel.

Jonathan Madison, Republic Strategist: “I think ultimately it’s going to be a matter of keeping Trump at bay, so to speak. I don’t know anyone who can do that.”

[Break]

Eric Sorensen: It promises to be one of the most unusual American elections in history. Last week’s Iowa caucuses launched Donald Trump far ahead of his opponents for the Republican nomination. And up against a sitting U.S. president who’s made it clear that he is running. The contest for the two nominations appears to be all but over. Or is there a sliver of hope that New Hampshire could inject some uncertainty into the Republican race?

Joining us to discuss the very high stakes in this year’s presidential election are Republican strategist Jonathan Madison and Democratic strategist Sarada Peri. Thanks to you both for joining us.

Jonathan, first to you. New Hampshire is just two days away. It’s a different dynamic from Iowa. What does Nikki Hailey have to do to make this a contest or is it over?

Jonathan Madison, Republic Strategist—San Francisco: You know I think she needs to continue to do what she’s been doing. You know, she was out there about 35 days and had about 49 events, almost 50 events within that timeframe. She’s doing everything she can, and I think she’s going to make a very big impact, right? All she has to do is establish herself as a credible threat to Trump, right? She doesn’t have to win. And if you look a recent 538 poll, it doesn’t look like she’s projected to win, but as long as she comes out within some kind of margin of error, she’s going to be in a very great position to make this a very contested race going down the road. So I think she’s going to surprise a lot of people.

Eric Sorensen: Sarada, from a Democratic perspective, does that sound like just the best thing that could happen?

Sarada Peri, Former Obama Senior Speechwriter—Silver Spring, MD.: I mean, I hear what Jonathan’s saying and she has certainly run a somewhat compelling race thus far being able to gain some amount of traction in at least the state of New Hampshire. However, she and her fellow opponents of Trump have not ever really gone after him in a way to distinguish themselves from him and compel people that they could actually beat him. So let’s just say she does come in second in New Hampshire, and as of now, you know, Donald Trump is so far ahead that second is probably the hope—the best she can hope for. Well then she goes, you know, we’ve got a fair amount of time before the next primary, which is in her home state of Carolina—South Carolina. And in South Carolina, she is, you know, orders of magnitude behind Trump, in part because the New Hampshire electorate is very different from the rest of the Republican electorate in the country. It’s more moderate. You have far more independents there who are going to vote in a Republican primary because the Democratic primary isn’t really one. And so it’s a really different electorate and she’s been able to make some strides with college educated voters out there, however it’s just not clear that anybody can beat Trump. Now of course, I am not one to make predictions ever again after the 2016 election, as many aren’t, and anything is certainly possible, but it just seems unlikely and she’s got a tough hill to climb, I think.

Eric Sorensen: Jonathan, every U.S. election is deemed historic. Is this one more historic? Are the stakes from your point of view, higher?

Jonathan Madison, Republic Strategist—San Francisco: They are. They’re higher for a number of reasons. One in which is right now, America feels very much demoralized. If you’re a resident here, you get the sense that the world doesn’t look at us the same on a national level—on an international level, rather. We’re not respected the same as we once were. People are looking back to the past for validation, as opposed to the future. And I think that people see in Trump, a lot of people in this country, a leader who could sort of restore us to that footing, that respectable place. And that’s very debatable. That’s a very contentious idea, but it’s very pivotal, to answer your answer—we’re in a period right now where a lot of other countries, a lot of countries around the world are turning inward rather than outward. And they’re turning into a protected status rather than a welcoming status. You look at organizations like NATO and the EU, the IMF, they’re having very difficult—they’re in a lot of difficulty because their leaders are struggling to keep up with the demands of their constituents, the perspective of their constituents in terms of protecting their own, as opposed to protecting the world. So—and I think that’s why you hear a lot of this rhetoric from Trump about NATO and whatnot, but it’s important because it’s what kind of set the tone and the conditions pre-World War I and pre-World War II, which is scary to some extent as well. But I think that’s why this election is very important.

Eric Sorensen: Well Sarada, I imagine you don’t disagree that it’s very important, but for maybe different reasons.

Sarada Peri, Former Obama Senior Speechwriter—Silver Spring, MD.: Yeah, I think Jonathan’s right, the stakes couldn’t be higher. And it’s funny, you know, you frame this election up front as sort of historic, but it’s also just a rematch, right, of 2020 between essentially two incumbents in a sense. And I think there is a sense of uncertainty right now among the American people, but I think globally, too. And I—it’s not clear to me that this has so much to do with individual leadership as it does with just the rapid changes that are taking over people’s lives and a sense that maybe their kids futures aren’t going to be as bright as they imaged, as bright as their own were, right? We’re just at this pivotal moment in history in terms of technology and all the rest. And so I think it’s just this sort of scary time in general. I would say that if you’re interest is in building this as a world where countries are working together to fight our shared challenges, whether it’s climate change or growing authoritarianism, or global poverty, the notion of bringing back America First Trump seems epithetical, right? And in fact, I think what we’ve seen in Joe Biden is a president who perhaps does not have the bombast of a Trump, which I think is beneficial to the country, but also has had relationships with leaders around the world and a huge amount of experience, and what you hear from global leaders is that they now have a sense of stability in President Biden that they did not have with Trump because you couldn’t rely on Trump to keep the deals that he negotiated or live up to his word, and he was cosying up to dictators and authoritarians that were frankly, terrifying to the rest of the world. So I think at least in Joe Biden, you have somebody who does believe in our democratic ideals.

Eric Sorensen: I just—I want to ask you about, you know, Canadian leaders who always tread carefully on the subject of U.S. elections because they have to work with whoever is elected, but our Prime Minister Justin Trudeau was asked in a Q&A this week and he said this: Do Americans want a nation that is optimistic? Or will they choose a step backwards, nostalgia for a time that never existed, a populism that reflects anxiety and fury without necessarily offering solutions?

Jonathan, that is highly charged language. What strikes you about a foreign leader who would speak in that way, clearly talking about Donald Trump?

Jonathan Madison, Republic Strategist—San Francisco: Well first of all, I commend him for his confidence in just speaking his mind. I mean, Trump has no problem speaking his, you know? And, I mean some of what he said kind of related to what I just said as far as a lot of people in this country are looking back. And that’s one of the criticisms that Trump has had, it’s that he’s been trying to point the country in the direction of a past time that some people argue never really existed, making America great again. You know, so I think that’s what he was speaking to, but I would also say I’ve heard and read some comments from the prime minister that said no matter who is in office, it’s going to be a challenge, you know, whatever American presidency they work with. I think he also mentioned it was a challenge working with Barack Obama, Joe Biden as well. So whoever is in office, it’s going to be a challenge. I think ultimately, it’s going to be a matter of keeping Trump at bay, so to speak. I don’t know anyone who can do that. So I’m sure that’s what the prime minister is referring to, and hopefully we can all figure that out soon enough.

Eric Sorensen: Sarada, most Canadians want a normal relationship with Washington. I think that many view Biden as normal and Donald Trump maybe not so much. What is your advice to a Canadian leader approaching this election?

Sarada Peri, Former Obama Senior Speechwriter—Silver Spring, MD.: Well I think, you know, Trudeau speaks for probably a lot of global leaders who feel like we’re at this pivotal moment in history as I talked about in that there’s never been a more important time for really steady global leadership that is, as Jonathan said, looking to the future and not just litigating the arguments of the past. And so, I would hope—and, I think that they’re—we’re at this moment where, you know, frankly, democracy around the world is under threat. The individual freedoms around the world are under threat. And so it’s incumbent upon all leaders and all societies that believe in those values to be fighting for them, you know, at home and in their alliances abroad. And so, you know, I—as Jonathan said, nobody can really control Trump, and I think that it’s really important for all of us to come together to make sure that he does not win the presidency again because frankly, after what we saw on January 6th, 2021, it’s not clear that if he were to win, he would ever leave office. We are—the stakes are truly that high. We have never seen anything like this. And so for everybody who believes in the idea of democracy, it’s going to be really important to make sure that the United States does not elect Donald Trump again.

Eric Sorensen: Sarada, Jonathan, it’s a fascinating subject and a worrisome one for Canadians as they watch this. The West Block will be assembling this panel at regular intervals all through this year, so we look forward to talking to you again. Thank you for talking to us today.

Jonathan Madison, Republic Strategist—San Francisco: Thank you. Good to be here.

Sarada Peri, Former Obama Senior Speechwriter—Silver Spring, MD.: Thanks for having us.

Eric Sorensen: Up next, wild winter weather challenged Canada’s energy grid in some parts of the country last week and showed how much climate change is affecting decision-makers all year round.

[Break]

Eric Sorensen: Now for one last thing …

We learned this month that 2023 was the hottest year in modern history, and that 2024 could break that record.

When we kick around topics for one last thing, we think about current issues like climate but also immigration, housing, homelessness, jobs, and you soon realize how many big issues tie into climate change. Immigration, refugees on the move because of drought, the homeless increasingly besieged by extreme weather, housing will have to be made climate resilient.

And then there’s energy. The electrical grid across North America is stretched almost to the limit, winter and summer.

Alberta has had four times as many grid alerts the last three years compared with the three years before. Overshadowed in Alberta’s energy emergency last weekend and who’s to blame, people were asked to reduce their power usage to avoid blackouts, and it worked. Albertans responded to a climate-related weather crisis. It’s one small example, but together, one small solution was found. So many solutions are needed in housing, jobs, the energy grid, all bound together in part by the need to adapt to climate change. We are all in it together. Albertans got through it together last weekend. And in what could be the hottest year ever, we’re going to need more of that.

That’s our show for today. Thanks for watching. We’ll see you next week.