Canada’s health care system is in crisis. Millions of Canadians an estimated 6.5 million don’t have a family doctor. Wait times for basic procedures stretch on endlessly, leaving patients frustrated and, at times, desperate. In this climate, private medicine is being sold as the cure. But is it really the solution or just another way to deepen the cracks in our system?
Across the country, we’re seeing governments and businesses push private delivery in various forms. Ontario is expanding public funding for cataract surgeries and MRIs in private clinics, with plans to move hip and knee replacements in the same direction. In Quebec, hundreds of doctors have left the public system entirely, setting up private practices where patients pay thousands a year for primary care. Others are skirting the rules by having nurse practitioners, rather than doctors, run clinics outside the public system. And for those who can afford it, there’s always the option of traveling abroad for surgery.
Meanwhile, hospitals are struggling with nurse shortages so severe that many are plugging the holes with temporary staff from for-profit agencies. In theory, private options might look like a release valve for an overwhelmed system. In practice, they often siphon away the very health care workers the public system desperately needs.
Dr. Joss Reimer, president of the Canadian Medical Association (CMA), puts it plainly: “When the solutions being put forward are to have private services fill the gaps, it’s still the same health care providers who end up working in these private services.” She’s seen it firsthand in Winnipeg, where hospital wards sit closed for lack of nurses, even as nurses leave to work for higher pay at private agencies.
The CMA recently released draft recommendations, after consulting over 10,000 providers and patients. Their findings are clear: care delivered privately, whether funded publicly or paid out-of-pocket, tends to cost more and deliver worse outcomes than publicly delivered care. That’s not ideology it’s what the evidence shows.
Yes, Canada’s system has always been a hybrid. Doctors bill the government, not draw a salary from it. For-profit labs already run many diagnostic services. But the line in the sand the Canada Health Act has always been that “medically necessary services” can’t be charged directly to patients. This is what makes the system universal and equitable.
The erosion of that principle, particularly in Quebec where nearly 800 doctors have opted out of the public system, threatens to leave behind those who can’t pay. And make no mistake, once profit becomes the priority, patient care suffers. Just ask pharmacists in Ontario, who report being pressured by corporate owners to boost sales at the expense of patient focus.
Canada doesn’t need more privatization. It needs investment in people the doctors, nurses, and allied health professionals who actually deliver care. It needs smarter coordination between provinces and the federal government to shore up shortages and reduce bottlenecks. And it needs to protect the core principle that has long defined our health care system: that access to care should be based on need, not the size of your bank account.
Change is inevitable in a system under strain. But the direction of that change matters. Do we want a system that fractures further, where quality care becomes something you buy? Or do we want to fix the one we have, so it works for everyone?
The answer should be obvious.
