Health
B.C. government sends patients to U.S. while fighting private options in B.C.

From the Fraser Institute
By Mackenzie Moir and Bacchus Barua
Among universal health-care countries, after adjusting for age, Canada ranked highest for health-care spending as a percentage of the economy in 2021 (the latest year of available comparable data). The problem is how we do universal health care
The recent ordeal of Allison Ducluzeau, a wife and mother from Victoria who spent more than $200,000 out of pocket to seek life-saving cancer treatment in the United States, has been widely shared on social media. Unfortunately, Ducluzeau’s story is not unique.
According to Second Street, a Canadian research organization, Canadians made approximately 217,500 trips abroad to seek health care in 2017, long before the pandemic (and related health-care backlogs and delays). To understand why this happens within our universal system, simply look at the data. In 2023, Canadians could expect a median wait of 27.7 weeks between referral to treatment across 12 medically-necessary specialities. In B.C., patients had to wait four weeks to see an oncologist, and another 5.9 weeks for treatment. In fact, the total wait between referral to treatment for oncology in B.C. (9.9 weeks) is now about twice as long as the Canadian average (4.8 weeks).
Moreover, the Canadian Institute for Health Information reported last year that, among provinces, B.C. was the second-worst performer in the country in meeting the national benchmark for radiation therapy (that is, receiving treatment within four weeks after seeing a specialist).
Why is this happening? Why do B.C. patients face such daunting wait times for potentially life-saving treatment?
For starters, compared to its universal health-care peers, Canada has fewer medical resources available. After adjusting for population age differences among high-income universal health-care countries, Canada ranked 28th (out of 30 countries) for the availability of doctors, 23rd (of 29) for hospital beds, 26th (of 30) for CT scanners and 19th (of 26) for PET scanner availability.
In response to B.C.’s long delays for cancer care, the Eby government recently instituted a cross-border initiative that sends patients to Washington State for treatment. Although this is good news for some patients, it’s not a long-term solution to our health-care woes. And this selective and short-term initiative is cold comfort to patients suffering from other medical conditions and who remain without local options as they endure long delays for medically-necessary care. Indeed, Allison Ducluzeau needed chemotherapy and could not take advantage of this initiative.
To be clear, Canada’s relative dearth of resources and long wait times are not due to inadequate funding. Among universal health-care countries, after adjusting for age, Canada ranked highest for health-care spending as a percentage of the economy in 2021 (the latest year of available comparable data). The problem is how we do universal health care. Unlike Canada, most other universal health-care countries fund their hospitals according to activity levels to incentivize treatment. And they understand that the private sector is a valuable partner in their universal health-care frameworks.
For defenders of the status quo, private involvement in the financing and delivery of health care within our borders remains out of the question. In fact, the same Eby government that sends B.C. patients across the border for care has fought against private options in B.C. And you can be sure that PeaceHealth St. Joseph Cancer Center and the North Cascade Cancer Center in Washington State—where the Eby government is sending cancer patients—will not be subject to the same limitations the Eby government imposes on private clinics in B.C.
If the provincial government is unable to deliver timely access to care through our publicly-funded health-care system, it should allow patients to pay privately for alternatives within our borders. By forcing patients such as Allison Ducluzeau to leave their loved ones and travel abroad to receive life-saving treatment, our policymakers yet again cling to a stubborn and failed approach to universal health care.
Authors:
Health
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Aristotle Foundation
The Canadian Medical Association’s inexplicable stance on pediatric gender medicine

By Dr. J. Edward Les
The thalidomide saga is particularly instructive: Canada was the last developed country to pull thalidomide from its shelves — three months during which babies continued to be born in this country with absent or deformed limbs
Physicians have a duty to put forward the best possible evidence, not ideology, based treatments
Late last month, the Canadian Medical Association (CMA) announced that it, along with three Alberta doctors, had filed a constitutional challenge to Alberta’s Bill 26 “to protect the relationship between patients, their families and doctors when it comes to making treatment decisions.”
Bill 26, which became law last December, prohibits doctors in the province from prescribing puberty blockers and hormone therapies for those under 16; it also bans doctors from performing gender-reassignment surgeries on minors (those under 18).
The unprecedented CMA action follows its strongly worded response in February 2024 to Alberta’s (at the time) proposed legislation:
“The CMA is deeply concerned about any government proposal that restricts access to evidence-based medical care, including the Alberta government’s proposed restrictions on gender-affirming treatments for pediatric transgender patients.”
But here’s the problem with that statement, and with the CMA’s position: the evidence supporting the “gender affirmation” model of care — which propels minors onto puberty blockers, cross-gender hormones, and in some cases, surgery — is essentially non-existent. That’s why the United Kingdom’s Conservative government, in the aftermath of the exhaustive four-year-long Cass Review, which laid bare the lack of evidence for that model, and which shone a light on the deeply troubling potential for the model’s irreversible harm to youth, initiated a temporary ban on puberty blockers — a ban made permanent last December by the subsequent Labour government. And that’s why other European jurisdictions like Finland and Sweden, after reviews of gender affirming care practices in their countries, have similarly slammed the brakes on the administration of puberty blockers and cross-gender hormones to minors.
It’s not only the Europeans who have raised concerns. The alarm bells are ringing loudly within our own borders: earlier this year, a group at McMaster University, headed by none other than Dr. Gordon Guyatt, one of the founding gurus of the “evidence-based care” construct that rightfully underpins modern medical practice, issued a pair of exhaustive systematic reviews and meta analyses that cast grave doubts on the wisdom of prescribing these drugs to youth.
And yet, the CMA purports to be “deeply concerned about any government proposal that restricts access to evidence-based medical care,” which begs the obvious question: Where, exactly, is the evidence for the benefits of the “gender affirming” model of care? The answer is that it’s scant at best. Worse, the evidence that does exist, points, on balance, to infliction of harm, rather than provision of benefit.
CMA President Joss Reimer, in the group’s announcement of the organization’s legal action, said:
“Medicine is a calling. Doctors pursue it because they are compelled to care for and promote the well-being of patients. When a government bans specific treatments, it interferes with a doctor’s ability to empower patients to choose the best care possible.”
Indeed, we physicians have a sacred duty to pursue the well-being of our patients. But that means that we should be putting forward the best possible treatments based on actual evidence.
When Dr. Reimer states that a government that bans specific treatments is interfering with medical care, she displays a woeful ignorance of medical history. Because doctors don’t always get things right: look to the sad narratives of frontal lobotomies, the oxycontin crisis, thalidomide, to name a few.
The thalidomide saga is particularly instructive: it illustrates what happens when a government drags its heels on necessary action. Canada was the last developed country to pull thalidomide, given to pregnant women for morning sickness, from its shelves, three months after it had been banned everywhere else — three months during which babies continued to be born in this country with absent or deformed limbs, along with other severe anomalies. It’s a shameful chapter in our medical past, but it pales in comparison to the astonishing intransigence our medical leaders have displayed — and continue to display — on the youth gender care file.
A final note (prompted by thalidomide’s history), to speak to a significant quibble I have with Alberta’s Bill 26 legislation: as much as I admire Premier Danielle Smith’s courage in bringing it forward, the law contains a loophole allowing minors already on puberty blockers and cross-gender hormones to continue to take them. Imagine if, after it was removed from the shelves in 1962, government had allowed pregnant women already on the drug to continue to take thalidomide. Would that have made any sense? Of course not. And the same applies to puberty blockers and cross-gender hormones: they should be banned outright for all youth.
That argument is the kind our medical associations should be making — and would be making, if they weren’t so firmly in the grasp, seemingly, of ideologues who have abandoned evidence-based medical care for our youth.
J. Edward Les is a Calgary pediatrician, a senior fellow with the Aristotle Foundation for Public Policy, and co-author of “Teenagers, Children, and Gender Transition Policy: A Comparison of Transgender Medical Policy for Minors in Canada, the United States, and Europe.”
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