It was bound to happen sooner or later. Donald Trump brought up Canadian health care as an example of a “flawed” public system during the second U.S. presidential debate at Washington University in St. Louis on Sunday. During a discussion about health care, the Republican nominee repeated a lie saying when Canadians “need a need a big operation, they come into the United States in many cases, because their system is so slow.” “Their system is so flawed,” Trump said, before calling it “catastrophic in certain ways.”

Democratic presidential candidate Hillary Clinton listens to Republican presidential candidate Donald Trump during the second presidential debate at Washington University in St. Louis on Oct. 9. (Photo: Tasos KatopodisAFP/Getty Images) Trump’s claims may have conflated the findings of a Fraser Institute report published last year that found 52,000 Canadians travelled abroad for non-emergency medical treatment. There is no information within the report to support Trump’s debate claim that droves of Canadians are choosing to go to specifically American facilities to pay expensive medical fees for major procedures. The highest number of Canadian “medical tourists” were neurosurgery patients — 2.6 per cent went out of country for specialist treatment in 2014. There is no data to show how many went to the U.S. versus elsewhere. Those who do go abroad for medical attention may do so for a variety of reasons including long waits for quality health care at home, or recommendations by experts, the report notes.

The Canadian health care system has its faults. It is not “catastrophic.” — colin horgan (@cfhorgan) October 10, 2016

Trump confuses Clinton’s position While discussing the Affordable Care Act, Trump falsely accused Democratic presidential nominee Hillary Clinton of advocating for a publicly funded single-payer system. He appeared to have confused the differing positions on health care held by Clinton and Vermont Sen. Bernie Sanders. Under Clinton’s plan, the government would have an increased role in the system. The current one is a hybrid of employer-sponsored coverage, government programs such as Medicare and Medicaid, and private insurance. Approximately 11 million Americans have private coverage, whereas about 155 million have job-based coverage.

Patrons in a bar watch the second presidential debate between Hillary Clinton and Donald Trump in New York City on Oct. 9. (Photo: Kena Betancur/AFP/Getty Images) Clinton reiterated that while Trump would repeal the act, she would stick with the program and fix it. She acknowledged that prices remain high. Still, Trump blasted the program by calling it expensive, saying it “will never work,” adding it is “very bad” and provides "very bad health insurance.” “We have to repeal it and replace it with something absolutely much less expensive,” he said.

Canadian health care doesn't work? What a mean thing to say. I'm going to the doctor to get my feelings checked. For free.#DEBATE — the spookyrain (@the_suzerain) October 10, 2016

Trump's comment contradicts the praise he applied to Canada’s health-care system last year. “As far as single-payer, it works in Canada,” Trump said during the first GOP debate last August. “It works incredibly well in Scotland. It could have worked in a different age, which is the age you’re talking about here,” he said at the time.

Trump denounces single-payer health care, saying Canada's is a disaster. Fact check: Canadian life expectancy, 81 years. US, 78 years. — Nicholas Kristof (@NickKristof) October 10, 2016

Trump's about-face on Canadian health care made quite an impact online. Several notable Canadian personalities ranging from "Schitt's Creek" co-creator Dan Levy to Juno winners Tegan and Sara, author Kelly Oxford and actress Tara Spencer-Nairn were among the many to share their takes on his revised opinion.