THE HUB COLUMN: Health reform is a hit with seniors—so where are the federal parties?
Canadian federal politics was turned upside down in the last election as many younger Canadians shifted to support the Conservative Party, while a large segment of seniors sidestepped to the Liberals. Pundits and experts have discussed the change at length.
But something that has received less attention is: How to earn the support of those swing voters come the next election? When it comes to the seniors’ vote, health reform could be the answer.
Veteran political strategists and observers might scoff at this idea, recalling the old adage that health reform is the “third rail of Canadian politics”—touch it and you’ll get zapped. Conservatives, especially, have been fearful of the issue and the inevitable claims that they want to “Americanize the health system.”
But if there is one thing you remember from this column, this is it: public sentiment has shifted when it comes to openness toward health reform. This is not the debate it was 25 years ago. Dozens of public opinion polls show the public is ready for reform—it is the politicians that have yet to catch up to this new reality and opportunity.
Many readers will note that an entire federal election just passed and health care received scant attention. This despite there being policy options for Ottawa to pursue, even though health care is often thought of as a provincial issue.
To recap, the health system is in crisis right now. Government data shows thousands of patients are dying each year on waiting lists for various services—everything from MRI scans and hip operations to heart operations and cancer treatment. Millions of Canadians don’t have family doctors, and many emergency rooms have been closing due to a lack of staff.
Over the next few years, Canadians should expect the collapse to continue. Canada’s aging population will have a much greater impact than the handful of positive reforms we’re seeing in different parts of the country.
Polls show seniors care more about this issue than the rest of society. Unsurprising, given that, as an age cohort, they tend to use the health-care system more frequently and for more complex services.
Consider that 64 percent of Canadians agree with the sentiment that the health system needs a “major change.” According to the 2024 Leger poll, seniors were above the national average, while the lowest level of support came from those in the 18-34 category (still a majority at 58 percent). What’s interesting is that only 5 percent of Canadians indicated “more public funding” was the solution. The rest either felt the system needed “minor changes” or didn’t know.
Health reform is, of course, a vague concept, but what’s encouraging is that polls show the public is on board with some pretty common-sense changes.
Sixty-one percent of Canadians support the idea of keeping the public system but allowing patients to pay privately (or through insurance) for health services. This is what countries around the world do, including better-performing systems in Europe. Support for this option was highest among the 55-plus crowd, coming in at 64 percent.
Some readers might find this question confusing, as they know a friend or relative who flew to another province for private health care. The issue is a bit complex, but the problem is that government barriers generally make it extremely difficult for patients to pay for treatment in their own province (Quebec being an exception). This is why, nonsensically, Calgarians will fly to Vancouver for surgery while Vancouverites will fly to Calgary for the same surgery.
One reason these bans occur is due to the federal government cutting funding to provincial governments that allow patients to pay for treatment locally. In 2023 alone, Ottawa cut $76 million in funding to provincial governments that allowed patients to pay for diagnostic scans. Oh, the humanity of letting people use their after-tax income on something to improve their health!
A policy option for a federal politician seeking the seniors’ vote is this: Amend the Canada Health Act so that provincial governments no longer face financial penalties if they allow patients the option of using the public system or paying at private facilities. Initially, some provinces would keep the status quo, while others would allow private options.
Over time, we would see that provinces that do allow choice would also see improved patient outcomes. Not only would patients who pay for faster treatment benefit, but those who remain on government waitlists would see shorter queues as some decide to pay privately.
Similarly, critics have raised concerns about private clinics in Ontario allegedly contravening the Canada Health Act. They argue that some cataract surgical clinics are in breach of the act by allowing patients to pay for upgraded lenses instead of accepting whatever lens the state has rationed to citizens. Again, a thoughtful federal politician could amend the Canada Health Act to make it clear that such matters are a provincial jurisdiction. Why should patients have to leave the province if they don’t want to accept lower quality lenses for cataract surgery, hip implants that aren’t the best fit, or pacemakers with shorter battery lifespans?
A third policy idea at the federal level would be to inject some accountability in the system for the billions Ottawa hands over to the provinces each year.
In the European Union, patients have the right to travel to other EU countries, pay for surgery, and then be reimbursed by their home country. Reimbursements cover up to the same amount the home country would have paid for treatment locally. Simply put, if a patient in, say, France faced a long wait time for knee surgery, he or she could avoid it by travelling to another EU country and receiving surgery faster.
What do Canadians think of copying this idea? Seventy-three percent support it, according to a 2024 Leger poll commissioned by SecondStreet.org. And, you guessed it, the policy was most popular among seniors (76 percent).
Imagine if the federal government required provincial governments to offer this option to patients who are facing wait times that are longer than the recommended time frame? What a novel concept—patients pay a fortune in taxes, and if the government doesn’t provide the treatment in a timely manner, the government is held to account. At the very least, this should be the case for lifesaving treatments.
If this type of reimbursement policy were implemented in Canada, it could grant patients additional access to the thousands of global treatment facilities in the U.S., Europe, Japan, and other developed nations.
Needless to say, there are other reform options worth considering. If a federal political party finally realizes the public is ready for health reform and promises sensible reforms, don’t be surprised if they earn the support of senior swing voters in the next election.
Colin Craig is the President of the Canadian think tank SecondStreet.org. In his spare time, he is working on exercising more and cutting back on sweets.
This column was originally published in The Hub on September 26, 2025.
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