Insights on Canadian Healthcare System (ft. The Hon. Tony Clement)

Thanks for tuning to Digital Voices Podcast, where we chat digital transformation challenges and opportunities across healthcare and life sciences. And now your host, Ed Marx.

Hey, it's Ed. Welcome to another edition of Digital Voices. This is so fun. So even though we've done like almost 300 episodes, this is the first time we've ever had a An honorable person, Honorable Tony Clement. Tony, welcome to Digital Voices.

Ed, it's great to be on your program. Congratulations on your success.

Yeah, thank you. That's because great guests like you, truly, and that's what makes it a lot of fun. It's so interesting, we've never talked about Canadian healthcare, which we're going to dive into. We've never had a politician, and so this is gonna be so much fun for me. So we first met, just so the audience knows, we first met, we're both on an advisory board for a company, and So I was like, wow, this is cool. Again, someone from Canada, and I have an affinity for Canada. I think I mentioned to you before that when I grew up in Germany as a German, to learn English, I went to a French military base and they had a Canadian school. It's weird. And that's how I learned to speak English. And so for 3 years, I pledged the— they don't call it pledge allegiance, but I sang the national anthem for Canada in both Canadian and French.

Yes, English and French. Yeah, that's right. You are our anthem. You can sing it either in English or in French or do a mixture if you want as well.

So before we go any further, Tony, what songs are in your playlist? What do you like to listen to?

Yeah, I'm a kind of a classic rock, alt-rock guy. So obviously it depends on my mood, but I attend a lot of live shows. And so we'll be seeing Coldplay in about a week's time. Just got off, uh, uh, on June, June the 30th, saw a great Canadian band called Billy Talent, which was a kind of an alt-rock punk band. Uh, saw the Wallflowers recently as well. And my big claim to fame is I'm traveling this month to the UK to see Oasis at Wembley Stadium. So very excited about that. The big— after 16 years apart, the brothers, uh, the Gallagher brothers are back together and, uh, hopefully they stay together. They won't be fighting, uh, during this, uh, reunion tour, hopefully. So we'll see.

Yeah, that's very cool. Sort of a destination concert. Exactly. And you actually travel a ton, like all over the world.

Uh, I do. Yeah.

Yeah. So we're gonna jump into that as well. What people can't see because we're a podcast that's strictly audio. Is in the background, speaking of music, I see some instruments. So, are you a player yourself? Yeah.

Yeah. Yeah, I'm a guitar player. Here's the thing, Ed, and, you know, this probably touches on some of the things that you like to talk about, but I started playing guitar when I turned 50 years old. Never touched the instrument before. Never took musical theory. None of that was part of my scholastic background, or nobody in my family played any instruments. And then I was closing in on 50, and I thought, you know, I've always wanted to play guitar. If I don't start now, it'll never happen. You know, the arthritis will kick in, or it just—you know—the the muscle memory will be impossible. I've seen all those studies. I'm sure you've seen them too—that when you're listening to music, really good for your brain. When you're playing music, your brain is just—the the neurons are firing. every which way. It's so good for your brain health. So I thought for health reasons as well as creativity reasons, I would learn to play guitar. And I've been in a band, which was a lot of fun, and I'm hoping to be back in a band soon. So, and I do these jam sessions with locals around my house here in Muskoka, Ontario. And it's just, it's a nice part of my life for sure.

Cool. Yeah, I love that, right? Because a lot of times we think we're too old or whatever. But you pick something up, you know, around 50, and, and now it's a big part of your life. That, that's really cool.

And, you know, YouTube helped. I got to tell you, my original lessons were a guy named Marty Schwartz, who is kind of famous for his YouTube videos of how to play different songs and whatnot. And, uh, yeah, so, you know, it's the old adage, uh, when you got YouTube, you can learn anything. So maybe I am— I can encourage some of your listeners, uh, just takes 10 minutes a day and before you know it, you're playing guitar.

I love that. Uh, yeah, I was just writing myself a note. That is, that is so great. What about life message or mantra? Are there words that you live by that help guide you?

Yeah, I guess the latest one came out of a New Year's resolution a couple of years ago. You know, I'm a person who maybe has accomplished a few things, but I've always had, you know, On the, on the edges, resentment issues or anger issues or what have you. You know, the, the intensity of life sometimes drags me down a little bit. So I just started this thing where twice a day I count my blessings. And I tell you, it's made a real difference for me, especially dealing with resentment issues. Yeah. That, you know, sometimes you're looking at the glass and it's half empty and you're You're grinding your teeth. Why is this glass half empty? And who's doing this to me? And why are they doing this to me? And I don't deserve it. And all of these things that we say on the inside. But the counting your blessings, it just gets you on a different path. It's a path of serenity. It's a path of self-knowledge, in my view. And so, yeah, I just go through the prayers of thanking, in my case, God, but it could be just the cosmos. It doesn't have to be God. Yeah. For all of the good things in my life, my family, my wife, my health. Yeah. You know, some accomplishments that I'm working on or have done. And it just puts me in the right mindset. So that's, that's been my mantra the last couple of years. And it's, it's made a big difference in my life for sure.

Love it, Tony. We're at 6 minutes and we've already like hit 3 big things, 2 of them life-changing for people listening, right? One is Well, the fun one is Oasis getting back together, but the whole concept of playing guitar and not the guitar specifically. I know you know what I'm talking about. My listeners do as well. It's like trying something big, hairy, audacious, new. And then the second thing, yeah, just count your blessings. I mean, that's a major life change for many, many people, and that is so awesome. So that's going to foreshadow how we're going to spend the next few minutes. So now that we know so much about you already, tell us more. Like, where did you grow up? Who Who is the Honourable Tony Clement?

Yeah, I'm an immigrant to Canada. I was born in Manchester, UK. My father hailed from the island of Cyprus in the Mediterranean. My mother was British, but her mother was from the Middle East. She was a Syrian Jew, you know, from Aleppo, was educated by Coptic nuns in Egypt, and then found her way to Manchester where she met my grandfather, who was a tobacconist. That's what you called him in those days. Sold tobacco. And, um, and that's, that's where I was born, in Manchester. We stayed there until I was about 4 years old, then we emigrated to Canada in the mid-'60s. And we, uh, we settled in a place called Hamilton, which is just outside of Toronto. It's a big industrial blue-collar town, uh, steel city, you know, for, for Canada.

Yeah.

Hamilton. Anyway, uh, and, um, my— eventually my parents got divorced. My mother And I moved to Toronto, and that's where I finished off my schooling, including my university at the University of Toronto. You know, doing my undergraduate degree and then my law degree. Started to practice law in the city of Toronto. Decided very early on that I hated practicing law, that it was not for me. Nothing against law or lawyers, but it just was not my personality type. So I ended up becoming a bit of an entrepreneur and Right around that time, the Berlin Wall had just fallen, 1990, 1989. And I ended up doing work in Central and Eastern Europe, in Czech Republic, in Romania, and even in Russia, and learned a lot about entrepreneurialism and crazy times over there. Just nuts, the characters that you met and the kinds of things that were going on. But it was a great opportunity to become an entrepreneur. Then the call of politics started for me because at the same time that I was doing that, I was also president of my political party, the Conservative Party of Ontario, and ended up running in an Ontario election for what they're called the Progressive Conservatives and won. There was a sea change election where the center-left got bounced after 10 years of governing, and I was a Conservative, and so we ended up in power for 8 years, over 8 years. And then the voters got sick of us and we got bounced out of power. And then the call of national politics, federal politics as we call it, and I ended up getting elected in 2006 to the House of Commons. In our system, we have a fused executive and legislative branch, unlike America. Our— you get your cabinet from the legislative branch. So I served as a member of parliament and also served in the cabinet and was Minister of Health for a few years and then Industry Minister for another few years and then finally what we call President of the Treasury Board, the Treasury. Basically, when you're in that role, you're kind of like the chief operating officer of the government. And so I had those roles. Then we got kicked out of power.

Right.

I served in the opposition in the House of Commons for a few years. And then, you know, circumstances, my mental health was taking some hits and it just was time to go. So I did go and just retired from parliamentary politics. And I looked at— I looked around at my political career, Ed, because I then I wanted to know what to do with— okay, I've had all these experiences, but what do I do with them? And a lot of my colleagues, well, a few of them, a few of the successful ones, they sat on boards, they became vice chair of banks, you know, those kinds of roles. But I looked at how I did things in politics, and it was clear I was not a sort of a standpat kind of executive, if I want to put it that way. I was a change agent. I loved creating change for the betterment of whatever department I had. And so I felt that I was an entrepreneur more than anything else. And so I became a startup entrepreneur in tech and healthcare. I even have a sports, professional sports startup that I'm working on. And, you know, I'm juggling a few of these things and having some fun with it, meeting some interesting people, and generally trying to create some wealth and just having some fun with it. So. I spend a lot of my time doing that. And another chunk of my time is in media. So, I mentioned to you off air, I have a podcast. I'm starting a new podcast. And I also have a television show on a startup television news station. The news station is called The News Forum. My particular show is called Boom and Bust. And it's about economics, finance, tech, cyber, national security. And I've done over 550 episodes of that television show, which is broadcast on all of our major satellite networks in, in Canada. And yeah, so I've got this nice little mix of business and media and commentary, and I'm enjoying, I'm enjoying life. I happen to live in a place called Muskoka, Ed, which is, I think, one of the most beautiful places in Canada. We've got over 8,000 lakes and trees and rocks and not the cityscape That perhaps loses its luster after a while, and so yeah, life is good.

Yeah, no, you're like a Renaissance man. That's amazing. I thought I knew you, but man, you just dropped like a 50% new things. It's pretty amazing. All the different things that you've done and continue to do. Yeah, and so Miss Colga, is that like? I'm fairly familiar with Severn Severn Lakes, and it's beautiful up there. Is that about the same area of Canada?

Yeah, Severn is just to the south of us for sure. Yeah, for for American listeners, it's kind of like the Adirondacks. Yeah, it's beautiful. Right. And, uh, uh, people from the city come up in the summertime to just enjoy the lake country. And they might have second houses here, which we call cottages, and, uh, just get some fresh air, see some stars at night, and just generally, you know, have a better standard of living than just being stuck in the cities.

Yeah. And you can look, I remember looking down on the water like 10, 15 feet. You know, you could see the bottom. I mean, it's just amazing. Now, going back to the politics, to translate some of that into what most of my— 70% of my audience is United States based, 30% global. How does that fit in? Because you were a big, big deal. And that's why it's honorable, right? That's how you get conferred honorable. You were like the equivalent of what, like Secretary of Health and, and being a senator or congressperson.

Sure. Yeah, absolutely.

That's huge for all of Canada.

Yeah, it was a great honor. It was a real blessing, a great honor to, to get to know my country so well and, uh, to represent Canadians on, on national issues. Yeah. The highest honor, uh, sort of, uh, non-family honor. I think having kids and having a wife is honorable too. But certainly professionally, it was a great honor to do all those things for 10 years nationally and another 8 years in the province of Ontario. And, and you really get to know your country. I've traveled practically every square mile of our country and seen places that are amazing. People working with people with all sorts of backgrounds and doing different things that are helping their communities and helping our country. So there's no higher honor as far as I'm concerned than public service.

Yeah. Thank you. I'm not Canadian, but we're brothers, you know, and—

Well, we like to think so, although it's been a bit rough recently.

I just have to laugh sometimes. That's all you can do. You mentioned all the travel, but I know you're also traveling. Aren't you like traveling to Africa a lot and places like that? What are you doing?

Yeah, most recent trips were to Taiwan, Kosovo, and Ukraine, actually. So Taiwan, I was a guest of the Taiwanese government to speak at an international conference they were doing and spoke on healthcare transformation, actually, Ed. And but that was a very interesting conference on many different issues, security issues, economic issues, social welfare issues, that kind thing. And that was back in March. And then I was in May, I was in Kosovo, which was a really interesting experience because all we remember of Kosovo perhaps might be, might be the civil war they had there, the Serbs and the Kosovars fighting it out, and then Bill Clinton stepping in to end that conflict. But pretty quiet now, which is nice. And I was awarded an honorary degree at the University of Business and Technology in Pristina, the capital. Yeah. And so that was— and spoke at a conference there. And then most recently, Ukraine. I was invited to participate in an international security conference in Odessa at the end of May, beginning of June. So that was quite an experience, of course, with the war ongoing there, but learning a lot about the state of the conflict and some of the amazing things Ukrainians are doing to survive, I would say. You mentioned Africa. I had a trip there last year, more of a political trip to Ghana to talk about tech tech and AI in the political context, how it's changing things politically. But I also have a business interest in Nigeria, which is deploying AI for educational and pedagogical purposes. They've got a huge booming young population in Nigeria. It's the most populous country in Africa. And yet not too many teachers, right? They don't have enough teachers to teach everybody. So deploying AI, you know, so that if a student has a tablet and they don't understand what's happening on page 32 of their algebra text, they can deploy on AI, ask questions of an AI tutor, and get some answers immediately. So we've deployed that throughout Lagos and some other school boards in the area, and hoping that that can be a template for Kenya and other countries in Africa. So it's nice to be part of this AI project and use AI for for some positive outcomes. Yeah, that's, that's really cool.

And you probably pick up on some of their music as well and then bring your guitar in the future.

Yeah, exactly. Yeah, no, they've got such a rich musical tradition there. And, uh, yeah, I'm very impressed with a lot of things going on there. I mean, everybody has probably sullied views of Nigeria in particular. There are corruption issues. There are, you know, they like to There's a small cadre of criminals who like to bilk people out of their hard-earned money, but the young people that I met there, they're great, they're savvy, they want to use their tech skills to be part of the world economic market, and that's to be applauded, I think.

So I do want to cover a little bit about Canadian healthcare. But I also super fascinated about some of the things you already shared. So I'm gonna go off script a little bit and ask you a question because I think it's transferable to every day and transferable certainly to healthcare leadership as well. When you are, so Canada, like US, sounds like you have a two-party, basically two-party system.

Well, we didn't until this last federal election and it evolved us all of a sudden to a two-party system. But before that, it was more of a 3 or 4 party system. Okay. Things kind of polarized in the last federal election. So now it's a 2 party system.

Okay. Well, even in the 3 or 4 party, you have to negotiate, should we say? You have to sometimes, what's the word? When you negotiate, you sort of, you can't win everything. So what's your approach to leadership? Because you had to get very adept. You spent so much time in politics doing this. To be successful, you had to learn the art of negotiation and how to give and take and things like that. What would you say from a leadership perspective? You know, how do you approach leadership? Because, you know, sometimes we may come in with a mandate for our health system or whatever we're gonna do XYZ, but you get feedback from doctors or nurses or other administrators, like, you know, pushing back a little. How do you handle something like that? Like, what was your way of compromise?

Yeah, no, that's a good, that's a very good point. And, and I would add that it wasn't, it wasn't necessarily the political system per se, like in our system. As composed, compared to the American system, the Canadian system, once you win power, you have like 98% of the power. Okay. Okay. We don't have this separation that you have between the judicial and the legislative and the executive, right? So in our system, the government and the prime minister in particular appoints the cabinet, right? That's the executive branch, assuming they have the power to pass legislation because they've got enough seats. They pass all the bills, right?

Yep.

That's what makes them the government, because they have— they command a majority in the House of Commons. They appoint the upper chamber. You have an elected Senate, we have an appointed Senate.

Got it.

So the upper chamber is appointed by the, by the Prime Minister.

Okay.

He appoints all of the, uh, this— the higher court officials. So all the judicial branch is appointed, not There's no Senate confirmation hearings. Like, they're appointed.

Yes.

So the Prime Minister in particular has a lot of power in our system. Having said all that, we have provinces, right? Like you have states, we have 50 states, we have 10 provinces and 3 territories. And they have a lot of power too, particularly the way our Constitution was created. They have power over healthcare, transportation, education, All the social services, administration of justice, all of these are provincial. They're not federal. So if you want to get something done nationally, you have to negotiate and convince 10 premiers— well, 13, because we have 3 territories— 13 premiers to sign on. So that takes negotiation.

Yeah.

It also takes a little bit of money to grease the wheels. Like, you know, we've got a new program. The first thing a premier of a province says is, well, pay for it. We don't have any money for that. You got to pay. So then you're into that kind of negotiation. And yeah, so you really have to get used to that as a national leader trying to drive change. You don't have all of the levers. A lot of these are out of your control. So you have to use your convening power. You have to use your spending power. And most importantly, you have to convince them that this is the right way to go for the health and welfare of Canadians. So that's, that's where the negotiation comes in. It's not really negotiating with your opposing member. Like we don't have a, we don't have a majority leader, a minority leader like you have in the House of Representatives or the Senate. You have the, the government and then you have the opposition leaders. And the opposition leaders have very little, very few levers. A few. I'm not saying it's completely out of their control, but not as many as in the United States system, for sure.

Yeah. Wow. That's, that's so interesting. So on healthcare, can you share something that maybe most Americans, most United States citizens might not be aware of? You know, I think generally people believe that Canadian healthcare, it's all free. And then some would argue, yeah, it's free, but you have to wait forever. That's probably the extent of what most US citizens know. Tell us something, something else that may be more accurate.

Well, it's not free. I mean, we do pay taxes and we pay Right. More taxes than Americans, and a lot of that has to do with our healthcare system for sure. It's not as expensive as the U.S. system. Like if you look at that as a percentage of GDP, I think the U.S. you might be around 14 or 15 percent of GDP. We might be 11 or 12 percent of GDP, something like that. So it's it's a little bit less expensive. It is a closed system, however. You you you you have private providers, doctors like general practitioner doctors are. not employees of the state per se. They are self-employed, but their only way to get paid is in the system. They can't offer— they can't moonlight outside the system and offer additional services. Although there's starting to be some changes there. I'll get into that in a second. But that's generally the system. So it is a closed system that way. And yeah, that has the very predictable effect, as you've alluded to, that there's a When it's free to the payer because they've already paid for it in their taxes, you have a lot of demand and less supply.

Right.

And so how is that compensated for? Well, to be honest with you, for those who can afford it, if the lineups are too long to get a test done or to get a procedure done, since 90% of Canadians live within 100 miles of the US border, They just drive down to the U.S. to a clinic there, pay for it, and for diagnostics or for procedures. And that's the safety valve that we have in the Canadian healthcare system is the U.S. healthcare system. Yeah. Which is pay for play in those in those instances. So yeah, I mean, even though Canadians would say you know our system is you know you've already paid your taxes, so everything. on offer is available. Theoretically it is, but there are so many instances where the time lag is not healthy for the patient that if they have the means, they will use the US system.

Got it. Yeah, that is super interesting. I think there's a lot of pros and cons to each, and maybe someday we'll figure out leveraging the pros and cons of both and both becoming better.

Well, Canadians really have prided themselves on the Canadian system being better than the US system. It's funny, you know, it used to be the case, maybe that's degrading a little bit, but the worst insult that you could say in Canada about healthcare is you're trying to Americanize the system. The worst insult you can say in the United States is you're trying to Canadianize the system, right? You know, and then all of these different things about the system that you mentioned, you know, the wait times are way too long and so on. I will say this about the Canadian system. If you really need it, Like if it's life or death, you get it immediately without payment. And so it is there for those cases. But if you need a hip replaced or a knee replaced or these kinds of things, there's going to be a lineup for sure.

Tony, this has been so interesting. And I wish we had more time because I want to ask you all about leadership as well, although we sort of weaved it in throughout. Let me just ask you one last question. Like, how do you recharge your batteries and stay fresh. And maybe the guitars in the background explain some of that. But you've done so much and you travel so much. What do you do for yourself?

Yeah, I mean, I really think it's important to have as much balance as possible. I mean, living in the environment that I'm living in with rocks and trees and lakes, I think helps. And whenever I have to make a trip to— a business trip to Toronto or elsewhere, I really can't wait to get back to my rocks and trees and lakes. So there's that. And I think, you know, I'm just a driven person. Like, I'm not very good just sitting around. I like to read. I like to decompress with a good book, mostly history or biography rather than fiction. My wife is an accomplished fiction writer as well as being a lawyer. So she's got a bestseller that she wrote a few years ago, but fiction is not as much my jam as maybe hers. I'm just reading my 20th book on Winston Churchill right now that I've read. So these kinds of stories I find inspiring. And yeah, I think just finding outlets. I play golf, I play squash. I haven't got into pickleball yet. I'm trying to resist that with every fiber of my being sticking. Like, I'm the only person I know except for 2 other guys that actually still play squash. But yeah, so I've got, I do have outlets. In the wintertime, of course, I live in a winter wonderland. There's usually 18 feet of snow or something like that. So I go snowshoeing and, and take advantage of the winters that we have here because they tend to be longer than we'd like. But yeah, those are things that I like doing.

We covered so much from music and just creating space for yourself and taking care of yourself, your mental health. And we talked about your amazing, super interesting upbringing, especially I think on your mother's side in particular, but then also how you got into politics and the different roles that you had. And we talked about Canadian healthcare and a little bit What did we miss, or is there anything you want to double down on?

Yeah, I just think it's important to check in on one another on mental health issues. I would just advocate that. I did have a little bit of an issue a few years ago that I think really resonated once I got through it, that especially for men's mental health, you know, there's so much stigma for men. You know, we're taught to suck it up and not share and all of those things. And So, it's very important to check in on your male friends. I do that constantly with my male friends and just make sure that they're— they need somebody to talk to or need to work something out, that I'm there for them. I just would encourage your male listeners and female listeners who love their men.

Yes.

That's a good way to help males deal with challenges. Let's face it, the world's changing at a rapid pace and some men have been left behind and it's created problems in our society. So that would be my final message.

I love it. I'm thankful to Connexall, where we serve on the advisory board together, for bringing us together.

Yes.

And the truly honorable Tony Clement, thank you for being my guest.

For sure. Thank you.

Thank you for listening to Digital Voices Podcast with Ed Marx. If you enjoyed this episode, subscribe on your preferred streaming service and leave a rating and review. And most importantly, thanks again for listening.