A recent report by the Fraser Institute challenges Prime Minister Mark Carney's assertion that he is the 'guardian' of Canada's health-care system, calling it 'precisely what's wrong with Canadian health care.' The report argues that Canada's one-size-fits-all approach, which prohibits parallel private delivery under the Canada Health Act, is outdated and ineffective.
Alberta's Push for Private Care
Alberta Premier Danielle Smith's government is developing a plan to allow patients to purchase non-urgent care privately. Carney has indicated he will oppose such a move. The Fraser Institute report, authored by Nadeem Esmail and Mackenzie Moir, highlights that private alternatives improve the performance of the public system by expanding access 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 states. Allowing doctors to work in both public and private settings would increase the volume of care.
Quebec's Private Sector and Federal Transfers
It is noteworthy that Carney would stand in the way of expanding private care in Alberta when Quebec already has a large and growing private health sector. Provinces must adhere to the Canada Health Act to receive full health-care transfers. If Alberta wants to continue receiving transfer money, it must obtain federal approval for changes. Between 2014/15 and 2023/24, Ottawa cut $267 million in transfers from non-compliant provinces, later reimbursing $195 million to those that complied.
Historical Precedent: Chretien's Flexibility
The report recalls that in the 1990s, Prime Minister Jean Chretien reduced federal health and welfare transfers but allowed provinces more flexibility in 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. This approach suggests that treating provinces as capable entities, rather than relying on centralized control, can lead to better results.
Canada remains one of the few developed countries without private options in health care. While many tout the public system, it is increasingly strained. The report advocates for a more flexible system that includes private alternatives to improve access and efficiency.
