Opinion: Status quo the greatest threat to Canadian health care

If there's one thing we don't need, it's more of the same.

In 2025, patients endured a median wait of 28.6 weeks from referral to treatment, and one in four said their health worsened because of delays accessing care. Behind those numbers are real people facing delayed diagnoses, postponed surgeries and prolonged suffering.

Yet, too often, politicians show little interest in exploring innovative solutions, preferring to defend the status quo and continue pouring money into the same government-run health-care monopoly. The result: a backlog of 1.4 million procedures.

As politicians posture, critics condemn any suggestion of substantive reform, warning that changes to the current model would usher in "American-style" health care. But that framing misses both the reality of Canada's current system and the weight of international evidence.

Despite our single-payer model, Canada is anything but single-tier.

Provincial health-system audits have documented how status and connections influence access to care. Meanwhile, the most affluent already secure faster treatments abroad. In 2025 alone, more than 100,000 Canadians left the country for health care.

The fact that inequalities exist is no justification for abandoning fairness. Rather, it underscores the need to better address the reality of unequal access.

That starts with expanding our health-care system's capacity. More hospitals and clinics mean more appointments, more procedures and more timely access to care — not for a privileged few, but for all Canadians.

Some assume the solution is simply more government spending. Yet, Canada already ranks among the biggest health-care spenders globally, having spent approximately $400 billion in 2025, while an estimated six million Canadians still lack access to a family doctor.

It's not the spending; it's the structure.

In Canada, the government functions as a near-monopoly payer of health care and, as a consequence, a near-monopoly organizer of care delivery. This structure limits competition, leaves little room for innovation and chokes off private investment in health-care infrastructure.

If we're serious about change, we must be willing to look beyond our borders for solutions. In particular, we need to look to countries such as Denmark and Australia that share Canada's commitment to universal health care, yet achieve considerably better results.

One reform to draw on is duplicate private health insurance, which would allow Canadians to purchase private insurance for services already covered under their provincial health plan.

By charging predictable premiums, private insurance effectively lowers the cost of private care, which expands the share of the population who can access it, making it commercially viable for private facilities to be built and staffed. As these facilities treat patients who would otherwise congest public hospitals, they help reduce wait times with private coverage.

When the public system is unable to treat patients in a timely manner, private facilities can be used to deliver faster care to publicly insured patients. And as the number of private settings grows, they can help expand the clinical workforce by supporting the training of future physicians.

For all Canadians to benefit from duplicate insurance and private care options, provincial restrictions should be removed, leaving consumer demand to determine whether and how such markets develop.

Unfortunately, it seems many of our elected representatives have lost sight of our objective — universal access to timely, high‑quality care. Instead, they've become fixated on preserving a single-payer model, which is far from the best way of achieving that objective.

Canada's commitment to universal health care is worth defending, but the way we deliver on that promise has to change. If we are unwilling to consider alternative approaches, we should not be surprised that the system continues to falter. But if we are prepared to learn from our peers, we can restore both access to, and confidence in, Canadian health care.

Conrad Eder is an associate researcher at the MEI, a think-tank with offices in Montreal, Ottawa and Calgary.