EDITORIAL: A cure for what ails our health system

Canada is one of the few countries in the world that takes a one-size-fits-all approach

Published May 15, 2026  •  2 minute read

Ambulances line up outside the ambulance bays at the Grey Nuns Community Hospital in Edmonton, Jan 8, 2026. Photo by Greg Southam /Postmedia Network

A recent report by the Fraser Institute says Prime Minister Mark Carney’s assertion that he’s the “guardian” of this country’s health-care system is “precisely what’s wrong with Canadian health care.”

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Alberta Premier Danielle Smith’s government is working on a plan that will allow patients to purchase non-urgent care privately. Carney has indicated he’ll oppose such a move.

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Canada is one of the few countries in the world that takes a one-size-fits-all approach to the delivery of health-care services: Go public or go home.

The Canada Health Act (CHA) prohibits parallel private delivery. Yet, in almost all other developed countries, private options are available.

We like to brag about our public health system. The reality is that it’s creaking at the seams and it’s a brave politician who dares to make changes.

Private alternatives improve performance

The report’s authors, Nadeem Esmail and Mackenzie Moir, point out that private alternatives improve the performance of the government system by expanding access to services and raising standards through competition.

“When the government prevents private providers from delivering timelier and more patient-focused care, there’s little pressure or incentive to do so anywhere else in the system,” the report says. Allowing doctors to work in both public and private settings would expand the volume of care.

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It’s odd that Carney would stand in the way of an expansion of private care in Alberta when Quebec already has a large and growing private health sector.

For other provinces to get their full health-care transfers, they must stick to the terms of the CHA. If Alberta wants to continue to receive transfer money, it must get approval for changes from the federal government. Between 2014/15 and 2023/24, Ottawa cut $267 million in health-care transfers from provinces that didn’t comply with the CHA; provinces that ultimately toed the line were reimbursed $195 million.

Chretien allowed more flexibility

The report recalls how, in the 1990s, with federal and provincial governments experiencing debt and deficit problems, then-prime minister Jean Chretien reduced federal health and welfare transfer but allowed more flexibility for health-care delivery.

“When Ottawa stepped back and allowed the provinces to vary policy to their unique circumstances, Canadians got improved outcomes for fewer dollars,” the report concludes.

What a concept! If the feds treat the provinces like grown-ups, they don’t need Big Daddy to dole out largesse as he sees fit.

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