Hub Podcasts The health-care status quo is failing
Nov 17, 2025
Sean Speer, The Hub's editor-at-large and a public policy expert, discusses Quebec's Bill 2, highlighting how it attempts to reform physician compensation, targeting deep-seated issues in Canadian Medicare. Graham Gordon, a senior editor focusing on economic analysis, explains Canada's disappointing productivity growth compared to the U.S. He critiques government spending in green initiatives, emphasizing the need for capital investment and talent attraction to spark innovation and improve economic performance.
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Systemic Incentives Shape Doctor Behavior
- Sean Speer argues Canada's single-payer design socializes physicians by constraining supply and compressing compensation.
- That incentive structure mutes accountability and produces slower, less responsive care compared to a market-like system.
New York Market Drives Doctor Hustle
- Sean Speer contrasts his New York City experience where doctors operate in a market and compete for patients.
- He describes a culture of hustle where physicians follow up, respond to messages, and reorganize schedules to earn reputation and income.
Pair Accountability With Liberalization
- Pair performance accountability with supply-side liberalization like more medical seats and relaxed residency rules.
- Encourage patient choice, competition among providers, and autonomy for clinics to reward innovation.