The traditional single-payer system of health care in Canada is in need of reform. Photo by Brent Calver /Postmedia Network

Article content

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

Article content

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. 

Article content

Article content

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.

Article content

Article content

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.

Article content

Article content

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

Article content

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.

Article content

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

Article content

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.

Article content

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. 

Article content

Article content

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

Article content

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.

Article content

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.

Article content

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.

Article content

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.