A pervasive sense of crisis is gripping Canada's health care system, defined by critical shortages and deadly delays. Millions of citizens are without a family physician, while thousands die each year waiting for non-emergency surgeries. This reality persists despite Canada funding one of the most expensive universal health-care systems in the developed world.
A System in Decline: Record Wait Times and Doctor Shortages
The data paints a stark picture of a system failing its patients. In 2025, the median wait for medically necessary treatment in Canada has reached 28.6 weeks—more than half a year. This marks the second-longest delay between a family doctor's referral and treatment in over three decades. The longest wait on record, 30.0 weeks, occurred just last year.
This represents a dramatic tripling of wait times since 1993, when patients waited a median of 9.3 weeks. This deterioration has unfolded despite decades of government announcements and reform plans paired with significant injections of taxpayer money. According to analyst Mackenzie Moir of the Fraser Institute, these efforts amounted to minor tinkering, leaving the core structure of the health-care system essentially unchanged.
Learning from Abroad: How Other Universal Systems Succeed
The solution to Canada's crisis, Moir argues, is not simply more funding for a broken model. A look at other nations with universal health care reveals that the structure of the system, not the amount spent, is the root cause. Countries like Australia, Germany, Switzerland, and the Netherlands provide their citizens with far better access to care and shorter wait times, often while spending a similar or lower amount than Canada.
These higher-performing systems employ fundamentally different approaches. A key difference lies in hospital funding. In most Canadian provinces (excluding Quebec and potentially Alberta), hospitals receive a lump-sum budget at the year's start. This model inadvertently discourages hospitals from treating more patients, as each additional case represents a cost to their fixed budget.
In contrast, nations like Germany and the Netherlands often use activity-based funding, where hospitals are paid for each patient they treat. This transforms patients into a source of revenue, incentivizing hospitals to increase services and reduce backlogs.
Embracing Public-Private Partnerships for Timely Care
Another critical distinction is the role of the private sector within these universal frameworks. These countries seamlessly integrate private and public partners in health care delivery. For instance, 60% of all hospitalizations in Switzerland occur in private facilities. In Australia, private hospitals handle the majority of non-emergency surgeries. Germany utilizes a mix of public and private hospitals, and in the Netherlands, all hospitals are privately operated.
In each case, the system is designed with one primary goal: ensuring timely, quality care for all patients, regardless of who delivers the service. This stands in sharp contrast to Canada's more rigid model.
Moir concludes that policymakers must break from the status quo and consider the multitude of reform options proven successful elsewhere. Continuing to pour money into an outdated structure will not solve the crisis. The first step toward healing Canada's health-care system is the willingness to think and act differently.
