Canada’s healthcare choices need reform

Imagine living in one of the world’s highest-spending healthcare systems while facing some of its longest waits for medical treatment. That contradiction defines the experience of many Canadians today.

According to the Fraser Institute, Canada’s median wait time between referral from a general practitioner and treatment now exceeds 28 weeks. At the same time, more than 1.4 million medical procedures remained backlogged last year. These figures have intensified debate over whether Canada’s healthcare system should allow greater participation from private providers alongside the public system.

Countries such as Australia and Denmark have adopted different approaches. Both allow duplicative private insurance for medically necessary services, giving patients additional options while maintaining universal public healthcare.

Conrad Eder, Research Associate at the Montreal Economic Institute (MEI) and author of a recent study, believes those systems offer valuable lessons.

“By allowing duplicative insurance, Australia and Denmark have lowered the financial barriers to accessing the private sector, thus enabling it to help support the public system,” Eder explained. “This increases the treatment capacity of local healthcare systems, which benefits all patients.”

In most Canadian provinces, duplicative private insurance for medically necessary services is prohibited. According to the MEI, British Columbia, Alberta, Manitoba, Ontario, Prince Edward Island, and Quebec maintain restrictions that limit patients’ ability to purchase private insurance for services already covered under the public system.

Supporters of reform argue these restrictions reduce patient choice and place additional pressure on an already strained healthcare system. In Australia, comparable private insurance can begin at the equivalent of $84 CAD per month, while similar coverage in Denmark starts at $65 CAD, according to the MEI’s research.

To better understand the organization’s position, I spoke with Renaud Brossard, Vice President of Communications at the Montreal Economic Institute. “Our thinking when we start research like this is always about finding solutions to the issues that plague our society,” Brossard said. “Unfortunately, Canadians are forced to spend very long times waiting in the emergency room, waiting in a clinic, waiting for surgery, and that affects their access to care.”

When asked why reform has been so slow, Brossard pointed to political reluctance to revisit longstanding healthcare policies.

“Unfortunately, it is very hard to get politicians to move away from the status quo because they feel as though the debate is settled,” he said. “Every year, we see that Canadians want access to more healthcare options, whether public, private, or not-for-profit, because they understand the current system is not working well enough for them.”

Brossard noted that Alberta has introduced reforms intended to expand healthcare delivery, although he believes additional changes are still needed.

When asked what advice he would offer policymakers, Brossard encouraged them to examine countries that consistently achieve stronger healthcare outcomes. “We can look at healthcare systems that perform better and see what we can learn from them,” he said. “Whether it is Sweden, Norway, Denmark, France, Germany, or Australia, these countries allow greater involvement from not-for-profit and private providers in healthcare delivery, and patients have benefited.”

The debate over healthcare reform is about more than ideology. It is about whether Canadians should have additional pathways to receive timely care when the public system cannot meet demand.

Advocates argue that expanding carefully regulated private options would strengthen universal healthcare by reducing wait times and increasing treatment capacity. Whether governments embrace that approach remains a political decision, but for many patients still waiting for care, the conversation has become increasingly urgent.