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October 2020

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Responding to Bullying – A Perspective

Wednesday, April 10, 2019 @ 12:04 PM

In recognition of Pink Shirt Day – here is my perspective on anti-bullying that I co-authored in 2016. Sadly not much has happened in the way of any government legislation or regulation against bullying since then.

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- Marc Kealey

Expanding Canadian Healthcare in the USA: A New Frontier for Arizona

The Co-Chairs of the Canada-Surprise, Arizona Cross-Border Healthcare Task Force hosted a panel presentation and discussion on the topic of Expanding Canadian Healthcare in the USA: A New Frontier in Arizona

By Casey Kuhn
Senior Field Correspondent
91.5 KJZZ

They say the leaves don’t change here — but the license plates do. ‘Tis the season for snowbirds traveling south to Arizona. One city is looking to bring health care that is targeted especially for those coming from our northern border neighbor.

Canadian health care leaders are in the Valley this week with Surprise officials discussing how to bring Canadian medical services to the area.

Jeanine Jerkovic is Surprise’s economic development director and helped spearhead the program.

“When you’re a city called Surprise, you know you have to be interesting,” Jerkovic said. “We like to welcome new people, we like to pilot new things, we’re a very young community.”

The idea is to set up a place in Surprise where Canadian doctors can practice and the snowbirds can get medical services and rehabilitation in a warm place.

Marc Kealey is a Canadian advocate of health reform and says the wait times in Canada for orthopedic surgery are long.

“This is a valve release,” Kealey said. “If we looked at this and said right now the wait times in Canada for hips and knees are anywhere from twelve to eighteen months. That’s unconscionable.”

There are about 20,000 Canadian-owned housing units in the Valley, and many are being occupied now as winter arrives and snowbirds migrate.

Canadian lawyer Chris MacLeod said it’s a good opportunity.

“The genius of what Surprise has done is create or at least capture a real opportunity that exists to deliver Canadian health care to Canadians in a climate and community that is welcoming and endearing,” said MacLeod.

A feasibility study is still being conducted to figure out the cost of bringing Canadian doctors to Surprise.

Original article:


image © Jacob Stanek

By Richard Smith
Independent Newsmedia

Canadians already flock to the Valley of the Sun — and the Northwest Valley in particular — in droves every winter.

Arizona is home to more than 350 Canadian companies and more than 1.1 million Canadians visit our state annually, according to the Canada Arizona Business Council. While many are here on vacation, some Canadians could get work done if an ambitious venture from Surprise and a Canadian healtchcare leader comes to fruition.

“There are so many Canadians that visit and invest in the market,” said Surprise Economic Development Director Jeanine Jerkovic, a former a trade commissioner for the Canadian Consulate in Phoenix.

During the June 20 City Council work session Ms. Jerkovic and Marc Kealey, CEO of Kealey & Associates in Toronto, presented the possibility of a new Canadian medical service center in Surprise aimed at patients who desire Canadian medical standards without the long wait times for services.

Mr. Kealey said a increasing percentage of the Canadian population is age 65 or older, and a decent amount of this aging population already spends a considerable amount of time in the United States — with Arizona a top destination.

Healthcare in Canada is publically (i.e. government) funded but privately delivered. Mr. Kealey said it is not free for consumers, a common misconception, but costs are generally manageable.

However, this model affects how often physicians can work and the availability of some types of medical procedures. For example, Mr. Kealey said, in many parts of Canada, orthopedic surgeons can only work one day a week, since it is too expensive to keep their facilities open four or five days a week.

“There are people that are in Canada who are waiting up to 18 months to get a (new) hip or knee,” Mr. Kealey said.

In the province of Ontario alone, he said, 30,000 residents are waiting for these replacements. Mr. Kealey has spent three decades in healthcare and said the wait times have been an issue at least 25 of those years.

Plus, Canada’s harsh winters wipe out a good chunk of the year for post-operation rehabilitation.

“It is really stupid to do a hip or knee (replacement) in Canada in February,” Mr. Kealey said.

Kealey & Associates is an advocacy and strategy implementation firm in Canada specializing in healthcare and drug reform.

He said a lot of people have tried to operate private clinics in upstate New York, Florida and on the West Coast.

For years, Mr. Kealey searched for a place to do something a bit different. Surprise became the choice, he said, because of its assertive nature and willingness to think outside the box.

In February, Mayor Sharon Wolcott appointed Ms. Jerkovic and Mr. Kealey as co-chairs for a cross-border taskforce to research and identify ways in which Surprise can support expanded healthcare services to Canadians who visit or reside in the area.

Councilman John Williams lived in New York before Surprise and is familiar with the Canadian health system.

“I love the concept. We’re serving the greater good. The wait times have been going on for a long time,” he said.

While the big-picture concept is sound, the rest of this year is likely to be spent seeing if details can be worked out. Roundtables are scheduled for Toronto later this summer and Surprise in the fall.

A decision should come in the winter and, if favorable, the program could start in 2018.

Surgeries are more likely in winter, early spring or late fall, followed by a rehabilitation stint here.

“One of the things we’ve landed on is the notion that there is infrastructure here already. The infrastructure here is complementary to what we want to do,” Mr. Kealey said. “As a concrete example, we know that if you can’t get a hip or knee (replacement) in Canada for 18 months and there is an option to do that here, we’ll market that to patients. We looked at things like once a patient is here, how long would they need to be here. When you look at opportunities for post-op, there’s an existing infrastructure in tele-medicine that could link from Surprise, Arizona to that patient’s physician back home, even before the surgery.”

In particular, he is talking about MD24, the Surprise-based tele-medicince company that grew from Surprise’s incubator. That kind of medical integration is exciting, Mr. Kealey said, and a hallmark of the Canadian system.

Second issue is to formalize the feasibility of providing the service here. Costs, providers and facilities would have to be consistent with those in Canada.

Mr. Kealey said the extra cost to patients — and earnings potential for Surprise — would be travel related.

Employment for local workers would come from the ancillary medical jobs, such as nurses, personal suppork workers and nurse practicioners.

“There are issues with having Canadian physicians credentialed to actually practice here. Obviously we’re looking at Canadian phisicians concentrating on Canadian patients who would be here. We’ve got to make sure the regulatory issue is handled,” Mr. Kealey said. “We’ve done the econo-metrics on this. We know our fee structure in Canada, so we want to have the fee srtucture from Canada actually imposed down here. The analogy would be almost a consular service for health care — walking into a Canadian clinic, as it were. There’s a Canadian flag flying outside, the physicians doing work are to Canadian standards and are Canadian physicians and the fee structure is the Canadian system.”

Photo credit: Jacob Stanek
Original article:


Canadian Healthcare: Resource Crunch

Tuesday, May 16, 2017 @ 11:05 PM

The resources crunch is coming in Canadian healthcare,
and tough choices must be made.

Click the play button to listen.



Canada and Vietnam have much to celebrate internationally – Canada’s natural resource management, for example, has prompted world recognized innovation in mining and processing for mined material, Canada is a leader in banking innovation and it is also recognized worldwide for its expertise in healthcare. Canada, however, is more widely known for being understated when promoting achievements. Vietnam, in direct contrast, has emerged in recent years as the engine in ASEAN (Association of South East Asian Nations) and has fast become a go to investment market from other Asian and western markets. Canada has been tacitly interested in Vietnam – until recently. Much has been noted in Canada about the emerging opportunity in Vietnam and the hyper-growth that is being realized there as a result of investments in certain sectors – now including healthcare.

From left to right Marc Kealey, principal Triple Eye Corp; His Excellency Le Sy Vuong, Ambassador; David Tsubouchi, principal Triple Eye Corp and Co-Chair CVBC; Danny Leung, Principal Triple Eye Corp and Co-Chair

The government of Vietnam recognized early that outreach and collaboration with western economies is the life-blood for growth and economic stability. One initiative in recent years that capitalized on the special relationship shared between Canada and Vietnam is the establishment of the Canada Vietnam Business Council, an initiative of the government of Vietnam. Vietnam’s government and business community realized, too, that Canada is a country that should have stronger and longer term economic relations with Vietnam. This was demonstrated when Canada’s Governor General, the Rt. Hon. David Johnston visited Vietnam in 2012 and recently Canada’s Minister of Foreign Affairs, Hon. John Baird visited the nation to promote more trade between the two countries. This past February, Canada’s Prime Minister, Stephen Harper, celebrated “Tet” among Canada’s largest Vietnamese-Canadian community in the Greater Toronto Area, officially signalling the importance of the relationship between Canada and Vietnam.

From a more tangible perspective, healthcare in Vietnam is one of the more important public policy issues facing the country. At a 2010 meeting in Toronto, Canada between His Excellency Le Sy Vuong Ha, Ambassador to Vietnam and members of the Canada Vietnam Business Council the topic of healthcare was the focal point.

Specifically, the Ambassador recognized that Vietnam and Canada have a special relationship.  He pointed out that Vietnam’s understanding of Canadian healthcare and, particularly, its knowledge of the structure of Canada’s healthcare system – publicly funded and privately delivered –  place  Vietnam uniquely in a position to exploit opportunities to promote private sector investment in healthcare in their country. Canada’s healthcare system, by virtue of its funding mechanism(s) make it one of the most unique systems in the world.  That noted, however, Canada – specifically trade organizations and government, must do a better job to promote its healthcare system to and in emerging markets like Vietnam and by extension ASEAN, but that is a topic for another day.

Today, the Vietnamese economy continues to strengthen and Vietnamese citizens in urban areas reap the economic benefits of this growth – specifically Hanoi and HCM City.  Social and lifestyle issues continue to improve  as the Doi Moi (the renovation policies) unfold.  However,  for some Vietnamese there remains a disparity in health equity and, as such, health quality  and access to health services available in Vietnam have not kept pace.  “There is tremendous stress on the public system in Vietnam and alternative, private sector based opportunities have to be unlocked. There is, however,  one immutable benefit of the Doi Moi – a segment of the population of Vietnam are becoming wealthier.  As such,  the opportunity to access quality healthcare for those with means in the country is terribly limited so most Vietnamese with economic means,  seek personal healthcare outside Vietnam”, said Marc Kealey, a principal at Triple Eye Corporation of Canada – a health infrastructure company.

Ambassador Ha cited numbers as high as six billion dollars ($6 billion) a year that is spent outside of Vietnam by its citizens seeking healthcare services in countries like Singapore, Malaysia, Japan, Australia and China. Those countries reap the benefit of Vietnam’s  developing healthcare system, while Vietnam struggles through its renovation policies.  Ambassador Ha, through myriad meetings with the Canada Vietnam Business Council  and Triple Eye Corporation, expressed the desire and rationale of his government to repatriate that capital, encourage direct foreign investment in healthcare in Vietnam  and  encourage more private sector investment in healthcare services.

One such company that has risen to the challenge to invest in healthcare opportunities in Vietnam is Canada’s International Infrastructure Inc (better known as Triple Eye), one of the founding members of the Canada Vietnam Business Council (CVBC). Senior partners in the  company took up Ambassador Ha’s challenge and travelled to Vietnam in 2010 to answer the call on health care investment opportunities.  On the first visit, with  other members of the CVBC, Triple Eye participated in an historic signing of a cooperation agreement on developing healthcare opportunities there.

With considerable experience in developing and designing emergency medical services, Triple Eye executives have worked  in Latin America, Eastern Europe and other Asian countries.  On the visit in 2010, members of Triple Eye –  Marc Kealey and Danny Leung met with the Chair of the Dai An Joint Stock Company (JSC), Madame Phuong Truong Tu ,whose organization operates one of  Vietnam’s  largest economic free trade zones – one is located in Hai Duong province, east of Vietnam’s capital city, Hanoi.  At meetings in Hai Duong,  Madame Phuong made it apparent that her vision matched the vision of  Ambassador Ha’s with respect to  the necessity of repatriating Vietnamese healthcare dollars in Vietnam.  She also offered ideas to improve  and provide quality care services for Vietnamese citizens who might otherwise seek their care in foreign jurisdictions – her idea was to look to countries like Canada, Japan, Taiwan and other such places.  After an initial qualification process in Vietnam, Triple Eye presented its bona fides and outlined how working together for a protracted period of time (25 years) rather than, say, a five year payback would encourage public policy decision makers in Vietnam to endorse the model of greater participation with Canada in healthcare investment.  Triple Eye and Dai An immediately began to negotiate.

Months later and several trips back and forth to Vietnam and Canada (for both parties),  agreement was reached  on a site for a hospital to be built at the Dai An Industrial Zone along Hwy 5 in Hai Duong province – east of Hanoi.  The intention to build the hospital, a first between Canada and Vietnam was announced in media after a visit by a large delegation to Canada from Vietnam in June of 2012 and shortly after that Triple Eye spent considerable time in the summer and fall of 2012 in Hai Duong to prepare pre-feasibility on the proposed hospital site.

The Hospital project

Recommended and located on several hectares of serviced land in Hai Duong, the proposed site for what has become known as “Madame Phuong’s hospital project” is strategic for the provision of private sector health services for ex-patriates living in that area of Vietnam and for those in Vietnam with means and  for employees and their families who are employed at plants located at the Dai An Industrial zone.

The prefeasibility study, conducted by a team of health specialists led by Marc Kealey of Triple Eye in 2012 determined if the land for siting the hospital was suitable for building a hospital and other practical issues – like sizing –  environment and ease of access for patients and their families to the proposed site.  Preliminary economic issues were discussed too, including costing and planning.  It was determined after considerable study the project is viable and that the overall cost for a 200 bed hospital in Hai Duong would be $265 million dollars.

Site for proposed hospital project at Dai An Industrial Zone, Hai Duong province, Vietnam

Site for proposed hospital project at Dai An Industrial Zone, Hai Duong province, Vietnam

Triple Eye delegates Marc Kealey and Danny Leung and officials from Dai An JSC negotiated the terms of reference for the relationship between Triple Eye (the project manager for the proposed hospital) and Dai An JSC.  Agreement was reached to proceed as a corporation to build a hospital and  that milestone was announced in late summer of 2012 after considerable meetings with government officials in Vietnam including at the most senior of levels at the national government like the Vice Chairman of the country and the Minister of Health.  Triple Eye delegates Kealey and Leung  also met with senior decision makers at the provincial government in Hai Duong Province.  In late summer of 2012 a signing ceremony was held and the cooperation agreement between Dai An JSC and Triple Eye was ratified. A celebratory dinner was held in Hai Duong and attended by hundreds of government, business and Canadian Embassy officials.

The meeting with the Minister of Health in Vietnam bore particular fruit for the proposed hospital project and credibility for the relationship between Dai An JSC and Triple Eye.  Of note was the discussion between the  country’s Minister of Health and Marc Kealey of Triple Eye where Minister Tien gave endorsement and support for private sector investment in healthcare in her country. The Minister endorsed the agreement between Triple Eye and Dai An JSC and gave an impassioned plea that private healthcare investment was needed for the country because health care policies have not kept pace with the expansive growth in the economy.

The Minister made it clear in her remarks that the government encourages private sector investment in healthcare and her aspirations for such an investment meshed perfectly with that of  Ambassador Ha’s about repatriating capital from Vietnamese seeking healthcare in foreign jurisdictions.

Kick-starting health care policy aspirations for any developing nation accrues to the government , she noted, and in the case of Canadian investment in healthcare, like the proposed project to be built by the Dai An Vietnam Canada International Hospital Corporation, there is, seemingly active interest and immediate results for Vietnam.  The Minister offered her unqualified support.

Marc Kealey, pictured left meets with Vietnam Minister of Health Nguyễn Thị Kim Tiến at their meeting in Hanoi in late summer 2012 to discuss investment in hospital project

Marc Kealey, pictured left meets with Vietnam Minister of Health Nguyễn Thị Kim Tiến at their meeting in Hanoi in late summer 2012 to discuss investment in hospital project

The delegation from Canada meeting with members of the Hai Duong province legislature in fall 2012 at a special meeting to discuss the hospital project considered for at Di An Industrial zone in Hai Duong province. Pictured beside Marc Kealey (centre) to the right are Madame Phuong, Chair of Dai An JSC and partner to Triple Eye Corp

The delegation from Canada meeting with members of the Hai Duong province legislature in fall 2012 at a special meeting to discuss the hospital project considered for at Di An Industrial zone in Hai Duong province. Pictured beside Marc Kealey (centre) to the right are Madame Phuong, Chair of Dai An JSC and partner to Triple Eye Corp


The business case for a private hospital

A private hospital corporation  developed by agreement between a Vietnamese Corporation like Dai An JSC and  Canadian company Triple Eye Corporation could be of significant benefit to Vietnam says Marc Kealey, principal of Triple Eye Corporation.  “It behooves us as Canadians to try and find alternatives within our own system to help Vietnam realize her potential in a global world where health dollars should stay close to home” he says.  He noted that options for healthcare are being considered in Vietnam by other countries like Malaysia, China, France and the United States  and  they are being closely examined to see how they can work.  The benefit of a Canadian proposal is that the policy framework for private sector hospital projects or PPPs has worked in Canada and may be adopted in Vietnam.

“Private sector investment  in healthcare is the way to go in  country’s like Vietnam as the country matures – state run systems without adequate capitalization are never good.  And as economies grow, so too, does choice for those with means who live there”, says Kealey. “There is a lot of talk from foreign companies who claim to have all the answers, we aim to have all the pieces in place, make a full contribution and realize the potential we set out to provide with our partner in Vietnam.”

The agreement between Triple Eye Corporation and Dai An JSC has prompted the establishment of a corporation in Vietnam called the “Dai An Vietnam Canada International Hospital Corporation”, which, is now in the throes of  achieving its investment certificate.    It is anticipated that the certificate will be granted when all the paperwork has been signed off.  There have been hurdles and some bureaucracy from both Canada and Vietnam that have slowed things a bit, but the path is clear that a certificate will be granted and the project will begin.

For its part, Triple Eye Corporation of Canada is actively interviewing Canadian companies with who it will partner for the engineering, design, construction and staffing of the 200 bed hospital slated for completion in late 2015.

In the meantime, Triple Eye continues to lecture and promote the project widely across Canada.  In recent months it has sought and garnered Canadian medical staff and a recognized Canadian university to work alongside in education and staffing for Vietnamese workers.  There continue to be many emails and letters from interested Vietnamese health workers to Triple Eye about employment opportunities and Triple Eye is actively promoting the project to funding partners for financing the project – interest is high.

One of the greatest challenges facing Triple Eye in Canada comes from funding sources who inquire as to how to mitigate risk in Vietnam.  This fear, Triple Eye believes comes largely from of lack of practical knowledge of the current Vietnam.  “I personally believe that Canadians have to visit Vietnam if they are interested in that market and see for themselves the potential that exists there” says Kealey, “once  Canadian business people and those available to deploy finance for large projects like our hospital corporation, well see how the economy is shifting and they will see the enormous opportunity that also exists there.  Once that’s realized, the appetite for investment will increase and the fears for risks will be minimized.  We have the right partner in Dai An JSC, the right economic environment, the right policy directives set from the highest levels of government in Vietnam and the Canadian Embassy in Hanoi is extremely helpful.  Our job is to demonstrate the viability of the project to deploy funding from the finance sector and risk management organizations  in Canada to see what we see in Vietnam”, said Kealey.

Time is of the essence for projects of this magnitude and Triple Eye and its partner Dai An JSC is striving to have all its papers in order by the end of summer 2013 to begin construction as soon as possible and have this, the first such hospital, ready for patients in 2015.


K&A Team visits India

Thursday, April 4, 2013 @ 09:04 AM

Late last month, members of K&A’s Infrastructure team travelled to India to investigate project opportunities. During the visit they met with various government officials and members of India’s business community to discuss one of the country’s most ambitious infrastructure projects, the National Waterways Technology project.
The most celebrated part of the visit was the presentation to the villagers in a remote community in southeast India of a mobile hospital as part of K&A’s commitment to the PURA Mission. This initiative was founded by former President Abdul Kalam – his vision is to Provide Urban Amenities to Rural Areas of India.

The presentation of funding for a mobile hospital to be operational in rural communities in southern India was met with deep appreciation and gratitude and it confirmed and strengthened the bond that exists between Canada and India.
The K&A team plans to return to India in late spring to continue this work and present abstracts to members of the National Waterways task force.

- Marc Kealey

PURA Trust Awards

Friday, March 8, 2013 @ 05:03 PM

An evening in honour of Dr. Lucky Lakshmanan for his outstanding contribution to the PURA Mission.

Taken at The Westin Bristol Place Toronto Airport

The Story of PURA

PURA (“Providing Urban Amenities in Rural Areas”) is an initiative founded in 2004 by His Excellency, Dr. Abdul Kalam, former President of India. More than half of all communities in India are rural or remote. As India rapidly moves to first world status, the goal of making basic amenities like good roads, drinking water and healthcare available and accessible is what PURA aspires to provide.

In establishing the PURA Trust, Dr. Kalam believes that a fully developed India can be realized by empowering rural communities and the people who live there. He believes that the establishment and development of physical, electronic and knowledge connections will lead to economic connections among rural villages thereby accelerating rural development.

The PURA Trust In Canada

Dr. Kalam shares a special relationship with Canada borne from the support of governments, academic institutions, business relationships and individuals throughout Canada all of whom recognize that improving the social and economic standing of people in both countries serves to bolster the future development of both.

Canada is well known for expertise in the management of its natural resources and its unique healthcare system. India recognizes the value of this expertise and initiatives like the PURA Trust lean on Canada for its expertise in designing processes and systems to better the economic aspirations and healthcare for developing areas throughout India. The mobile hospital design for PURA is being developed from Canada. The PURA Trust in Canada strives to raise funds and awareness of this initiative.

The PURA Trust Award

Founded in 2012 by Daniela and Marc Kealey, and inspired by the vision of Dr. Kalam transcending boundaries from India to Canada, the PURA Trust Award recognizes the achievements of individuals who have inspired the establishment of physical, electronic or knowledge connections between Canada and India. The Award is granted on an annual basis.

Canada and India share a unique relationship. Both were founded on the principle that hard work and success should be shared. Canada and India have given much of each other to the world. The PURA Trust Award recognizes the achievements of Canadians who have given their talents, energy and resources to further those links between these two great nations and, more importantly, to ensure the sustainability of rural development in India.

- Marc Kealey

Canada celebrates growing importance of Vietnam

Sunday, February 10, 2013 @ 03:02 PM

The Vietnamese Lunar Celebration TET is an annual event worldwide.  In Canada, Prime Minister Stephen Harper visited Mississauga mid-January to celebrate the growing influence of the Vietnam community in Canada by attending TET this year.

TET Toronto

The growth of interest about Vietnam in Canada is likely borne from the growing influence of the community in Canada – nearly 350,000 strong – many being professionals and business people across Canada, with quiet effectiveness.

Vietnam boasts one of the fastest growing economies in the Association of South East Asian Nations (ASEAN).  What’s not known is that the risk profile favours foreign direct investment (FDI) and stable returns for that investment.  We, as Canadians, just need to learn more about Vietnam and its aspirations for the future.  Vietnam is tiny country geography-wise, but is home to ninety (90) million people- where practicality and innovation are a characteristic. For example, Vietnam encourages FDI through industrial zones – areas where there is ample land to grow foreign manufacturing facilities.  Its workforce is skilled, educated and innovative.

In 2012, Prime Minister Harper challenged Canadians to innovate. Our group took up the challenge, travelled to Vietnam to explore opportunities with one of our most unique selling propositions – health care.

VN Minister of Health

Healthcare in Vietnam is evolving.  Most people with means in Vietnam seek their healthcare in places like Japan, Singapore, Malaysia and China.  K&A through Triple Eye Inc signed an historic partnership agreement with a local partner to build a Canadian branded hospital in a province (close to Hanoi) where thousands of workers who need health care close to home live and work.   Expatriates living in the area are delighted because they believe that Canadian healthcare is the best in the world and they won’t have to travel to other countries to get better healthcare. In fact, Vietnam’s Minister of Health (pictured above – taken in Hanoi September 2012) along with her colleagues in the ministries Foreign Affairs and Foreign Investment see Canadian healthcare as a brand on which to build its new model for domestic healthcare.   Other government officials like the project because they believe that repatriating dollars spent outside of Vietnam could be in the billions.  Media reports about our particular projects have surfaced and excitement is palpable.  We are presently in the process of securing our financing for the project, identifying the EPC partners and getting ready to deploy there in 2013.  K&A will be project manager and have agreed to manage the hospital, train Vietnamese healthcare workers and hopefully expand the model to other places throughout Vietnam.  It truly is a call action for Canadians taking up the challenge of innovating by exporting our know-how.

Look for more attention from the government of Canada specifically in Vietnam where our hospital project and other opportunities abound and are sure to be celebrated.

- Marc Kealey