Navigating the Growing Divide in Canada’s Health System
This article was authored by CEO of our Canadian partner agency, energiPR, Carol Levine
I’m old enough to remember when house calls were a regular part of healthcare. As a child, my pediatrician would come by to take my temperature, listen to my chest, and write a prescription. That was my first experience being cared for by anyone other than my mother’s home remedies, like chicken soup.
Canada’s healthcare system has grown vastly more complex since those days. Once lauded as a model of socialized medicine, available to all in exchange for our tax dollars, it is now a system where access can be uneven. The wealthier among us can afford to pay for certain services not covered by public insurance—like faster diagnostic tests or elective surgeries—while many others endure long waits within the public system.
So, how did we get here? Like many other developed nations, Canada faces significant challenges, including an aging population and the strain COVID-19 placed on the healthcare system and its workers. However, our universal healthcare system, while comprehensive, comes with constraints. These include salary caps for doctors, bureaucratic hurdles, and, in some provinces, limits on operating room time and medical school enrollments. The result is a patchwork of access that often leaves Canadians questioning the system’s fairness.
Consider Quebec, for example. The province has strict regulations on private healthcare, yet private clinics still exist, offering services like colonoscopies to reduce wait times. However, the provincial government has placed limits on these operations, creating tension between the public and private sectors. Meanwhile, if you can afford upwards of $25,000 CAD for a hip replacement or back surgery, you can seek out private options—though these costs and the availability of services can vary.
So, when did things start to change? When my family doctor retired a few years ago, I faced a tough choice: go without a doctor who knew my family’s medical history or pay for private care outside the public system. I opted for the latter, starting at $2,500 CAD, with a 30% increase the following year. What once felt like a rare luxury is now becoming more common for those who can afford it. For many, it feels like the only viable option in a system where public access is increasingly strained.
While private access is convenient for those who can pay, it also turns healthcare into a commodity. We now compare prices, locations, and aftercare services like we’re shopping for a new car. Bedside manner not up to par? Let’s find someone more empathetic.
An article in the New York Times earlier this year reported on the growing private-sector involvement in Canadian healthcare. Canadians might be surprised to learn just how entrenched private medicine has become. According to Dr. Katherine Fierlbeck, a political science professor at Dalhousie University, about 30% of health services in Canada—everything from drugs to physiotherapy—are provided privately. This statistic, however, includes services that have always been outside the public system, like dental care and prescription drugs.
Dr. Fierlbeck also raises a warning flag. While most private clinics in Canada are small, independent operations set up by local doctors, the door is opening for large, aggressive healthcare corporations, particularly from the United States, to enter the market. If that happens, the landscape could shift dramatically, leading to constant lobbying and lawsuits aimed at expanding the role of private business in our healthcare system.
The question for Canadians is simple: Are we willing to accept the further privatization of our healthcare, knowing that it could lead to an American-style system driven by profit rather than patient care? While Canada’s public healthcare system remains deeply entrenched, the growing influence of private interests is something we must confront. As the debate continues to unfold, it’s a question we’ll need to answer sooner rather than later.