Health care's taking a backseat in this election. That's a missed opportunity, expert says
Health policy scholar Colleen Flood says Canadian voters should put party leaders’ 'feet to the fire'
In this federal election period, the twists and turns of tariffs, annexation threats and other surprises from the Trump administration have stolen focus from addressing the state of public healthcare in Canada. A leading expert on health law and policy experts says that's a shame.
"We are in an emergency situation in Canadian health care, and we have been for a couple of years post pandemic," said Colleen Flood, who is also dean of law at Queen's University.
An estimated 6.5 million Canadians don't have access to a family doctor and one-third of those who do find it difficult to get an appointment. Patients waited 222 per cent longer to see a specialist in 2024 than they did in 1993, ranking Canada the worst in wait times of all high-income universal healthcare countries.
Across the country, more Canadians are paying out of pocket for health care that the Canada Health Act says should be available to them in the public system. Virtual private-pay family medicine is readily available, and most provinces and territories now have in-person clinics as well.
In November 2024, CBC Radio's White Coat, Black Art visited a busy private-pay family medicine clinic in Vaudreuil, Que., where patients pay $150 to see a family doctor for 15 minutes.
Flood told White Coat, Black Art host Dr. Brian Goldman that this election is an opportunity for voters to demand the next federal government provide Canadians with the healthcare they need. Here is an excerpt from their conversation.
The Canada Health Act includes an expectation of "reasonable access" to healthcare. Can you define it?
We all have a sense of what the bare minimum is, right? We want access to a family care team or a family doctor. We all want access to tests and diagnostic methods and specialists and hospitals within a reasonable time period.
The Canada Health Act sets out criteria: reasonable access, which is a bit of a joke at the moment; comprehensiveness, of hospital and physician services, effectively; [and] portability — you should be able to get health care where you need it across Canada. The only way those criteria can be enforced is if the federal government uses its discretion to withhold money.
The feds have never used their discretionary power to keep back money from a province that is allowing wait times to grow or not ensuring that everybody has access to a family doctor…. They're quite nervous about using a hammer rather than a carrot to get where they want to go.
You have written extensively about how the Canada Health Act could be strengthened or at least better enforced. Have a go at that.
That's a lovely thing to talk about. The Canada Health Act has been an incredible tool for Canadians since [former Minister of Health and Welfare] Monique Bégin brought it to pass. But it needs to evolve, in particular around reasonable access. I think the Canada Health Act should be overhauled so that the federal government requires the provinces to have a fair, transparent process to determine what reasonable access is. What does that mean for us in New Brunswick, in Manitoba, in Saskatchewan in terms of access to a family health-care team or a nurse practitioner or a primary care doctor? In terms of maximum wait times, in terms of coverage?…. And then this is revisited from time to time to make sure that it's updated to change with our needs, because our needs do change.
Any idea what the federal parties are saying about what's happening in this current election environment?
With the very serious situation in the U.S., health care is unfortunately taking a back seat. And that is a real shame because we are in an emergency situation in Canadian health care, and we have been for a couple of years post pandemic. We need the parties to speak to their plans for improving public medicare. And Canadians must hold their feet to the fire on this. I counsel everyone to ask their candidates about what they specifically will do to make sure that everybody has access to the care that they need.
A lot of public health care in Canada came to pass after the Depression and World War II, where people realized that medicare should be available to everybody. So maybe this will actually bring us together more around the importance of public health care, that we need to protect it.
What would you like to see the party leaders saying about the future of health care during this election period?
Honestly, I'd like to see them say anything about what they will do. Conservatives may involve more private for-profit care inside of public medicare. The Liberals may involve more of a [mix] of getting there. The NDP may prefer more public hospitals, perhaps more salaried physicians, and moving more to an NHS-style system like you see in the U.K. Everybody may have their different recipe for improvement, but I think that's what Canadians need to hear: What are your plans? What will you actually do? And how will you ensure that myself and my family are going to be able to get the care when we need it?
I want to close by asking you, what should voters be listening for during this election period when it comes to health care?
Voters should be looking to parties to acknowledge that we are actually in a crisis, we're in an emergency, and that we need to take very significant steps very quickly to fix medicare. It is simply unacceptable that 6.5 million Canadians do not have reasonable access to the most basic of care, family medicine. It is even worse than that they are queuing up and desperate for care, clogging up ERs and so on, waiting to a point where the condition that could have been dealt with has got away on them. So what we want to see is that the parties are taking this crisis, this emergency, extremely seriously, and they have a serious plan to deal with it.
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Q&A has been edited for length and clarity
