OP-ED: Canada’s healthcare monopoly is killing us

Gwyn Morgan writes, "Canada spends more on health care than almost any other country in the world and delivers some of the worst results."

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Author: Gwyn Morgan

Canadians are proud of their universal healthcare system. Politicians hold it up as proof of our compassion, while unions fight to preserve it and judges unfailingly defend it. But pride and rhetoric can’t mask reality: Canada spends more on health care than almost any other country in the world and delivers some of the worst results. Our hospitals are overloaded, wait times are intolerable, and tens of thousands of patients die each year before receiving the treatment they need.

Consider just two heartbreaking stories. Last year, 16-year-old Finlay van der Werken of Burlington, Ontario, spent eight fruitless hours in a local emergency room crying out in pain from sepsis and pneumonia before being sent to hospital in Toronto. By then it was too late. His parents faced the unimaginable: taking their son off life support. In another case known to me personally, the eight-year-old daughter of a carpenter doing some work for us endured agonizing pain from noon until nearly midnight before finally receiving treatment for severe injuries. She survived, at least.

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These are not isolated cases. A May 2025 report from the Foundation for Economic Education revealed that some Canadian emergency rooms have exceeded 200 per cent of capacity, forcing patients into hallways and even onto floors. In 2023 alone, more than 1.3 million Canadians abandoned emergency room visits due to excessive waiting times.

Beyond the ER, the picture is no better. A study by the think-tank Second Street estimated that 15,474 Canadians died in 2023–24 before receiving diagnostic scans or surgeries. Because provinces often refused to provide full data, Second Street believes the true number is more like 28,000. Those findings are in line with the results of the Commonwealth Fund’s annual health policy survey, which ranked Canada dead last among 31 high-income countries with universal health care for timely access to services.

How did we get here? The answer begins with the Canada Health Act, passed in 1984 during the final months of Pierre Trudeau’s government. Politicians of the day never asked how they would fund their ambitious promises. Within years, hospitals faced budget shortfalls and began reducing operating room hours. Surgical time for doctors like Brian Day, a young orthopaedic surgeon in Vancouver, was cut from twenty hours a week to as little as five. Rationing became the norm.

Day’s frustration led him to co-found the Cambie Surgery Centre in 1996. His goal was simple: to give Canadians a private alternative while helping relieve pressure on the public system. Cambie succeeded. It performed procedures at 40 to 50 per cent of the cost of public system and cut wait times at government hospitals by handling complex cases. But success drew the ire of unions and bureaucrats. In 2009, the B.C. Nurses Union pressured the provincial government to shut down private clinics. A lengthy legal battle ended in 2023 when the Supreme Court of Canada simply refused to hear Cambie’s appeal.

The result? Canada remains the only universal-care country that bans or severely restricts private options. Every other nation surveyed by the Commonwealth Fund permits private-pay care alongside government-funded care. The logic is obvious: when patients have a private alternative, demand on the public system eases and overall access improves. Yet Canadian politicians cling to the myth that a government monopoly is the only way to ensure fairness. In truth, it ensures suffering.

Prime Minister Mark Carney epitomizes this contradiction. On the campaign trail, he promised to “defend the Canada Health Act” while also pledging to “add thousands of new doctors” and “build a system Canadians can be proud of.” These goals cannot be reconciled. For decades, medical school enrolments were deliberately capped to ration supply on the theory that more doctors would lead to higher costs. Reversing that policy would require massive, long-term expansion of training capacity. No government could deliver on Carney’s promises quickly, and certainly not while clinging to the Act that caused the problem in the first place.

The crisis in Canadian health care is not about money. It is not about the number of doctors or the fine details of regulations. It is about the structure of the system itself. Government monopolies almost always fail, and they usually fail at great cost. In health care, that cost is counted not only in wasted billions but in human lives.

The evidence from around the world is overwhelming. Private delivery alongside public insurance yields better outcomes for patients who pay directly and faster access for those who remain in the public system. It works in the UK, Australia, and across Europe. It could work here too.

Canadians deserve more than rhetoric and promises. They deserve access to timely, effective care. That will never happen until our leaders muster the courage to reform the Canada Health Act and end Canada’s fatal obsession with a failing monopoly.

The original, full-length version of this article was recently published in C2C Journal.

Gwyn Morgan is a retired business leader who was a director of five global corporations.