Free Online Townhall: How to Fix Health Care in Canada? Thursday, Sept 24 at 7pm ET.
If Canadians lived healthier lives, we could reduce demand for emergency services, orthopaedic surgeries, primary care and more.
For instance, if you visit the Canadian Cancer Society’s website, you’ll read that “about four in ten” cancer cases are preventable. The Heart and Stroke Foundation notes that “almost 80 percent of premature heart disease and stroke can be prevented through healthy behaviours.” A similar number of Diabetes cases are also preventable.
Many joint replacements and visits to ERs and walk-in clinics could also be avoided through healthy living.
To be sure, not all health problems can be avoided through healthy living – everyday the system treats Canadians with genetic conditions, helps those injured in unavoidable accidents and more.
But there is an opportunity to reduce pressure on the health care system through Canadians shifting to healthier lifestyles – better diets, more exercise, etc.
To learn more, watch our Health Reform Now documentary (scroll up) or see this column.
European countries will partner with anyone who can help patients.
It doesn’t matter if it’s a non-profit, a government entity or a private clinic. What matters is that patients receive quality treatment, in a timely manner and for a competitive price.
In Canada, governments often delivery services using government-run hospitals instead of seeing if non-profit or private clinics could deliver the services more effectively.
When governments have partnered with non-profit and private clinics, the results have often been quite good – Saskatchewan, Ontario and British Columbia are just a few examples of where partnerships have worked well.
Canada should pursue more of these partnerships to reduce wait times and increase the volume of services provided to patients.
To learn more, watch our Health Reform Now documentary (scroll up) or see the links above.
In Canada, citizens pay high taxes each year and we’re promised universal health care services in return. The problem is, wait times are often extremely long in our health system – sometimes patients have to wait years to see a specialist or receive surgery.
If patients don’t want to wait long periods, they often have to reach into their own pocket and pay for treatment outside the province or country.
Throughout the European Union, we also find universal health care systems. But a key difference is that EU patients have the right to go to other EU countries, pay for surgery and then be reimbursed by their home government. Reimbursements cover up to what the patient’s home government would have spent to provide the treatment locally.
If Canada copied this approach, a patient waiting a year to get their hip operation could instead receive treatment next week in one of thousands of surgical clinics throughout the developed world.
Governments benefit too as the patient is now back on their feet and avoiding complications that sometimes come with long wait times – meaning the government doesn’t have to treat those complications on top of the initial health problem.
To learn more, watch our Health Reform Now documentary (scroll up) or this shorter video.
Canada is the only country in the world that puts up barriers, or outright bans patients from paying for health services locally.
For instance, a patient in Toronto cannot pay for a hip operation at a private clinic in Toronto. Their only option is to wait for the government to eventually provide treatment or leave the province and pay elsewhere.
Countries with better-performing universal health care systems do not have such bans. They allow patients a choice – use the public system or pay privately for treatment. Sweden, France, Australia and more – they all allow choice.
Why? One reason is that allowing choice means some patients will decide to pay privately. This takes pressure off the public system. For instance, in Sweden, 87% of patients use the public system, but 13% purchase private health insurance.
Ultimately, more choice improves access for patients.
To learn more, watch our Health Reform Now documentary (scroll up) or watch this short clip on this topic.
In Canada, most hospitals receive a cheque from the government each year and are then asked to do their best to help patients. This approach is known as “block funding”.
Under this model, a patient walking in the door represents a drain on the hospital’s budget. Over the course of a year, hospital administrators have to make sure the budget stretches out so services are rationed. This is why you might have to wait until next year or the year after for a hip operation, knee operation, etc.
In better-performing universal health systems, they take the opposite approach – hospitals receive money from the government each time they help a patient. If a hospital completes a knee operation, it might receive, say, $10,000. If it completes a knee operation on another patient, it receives another $10,000.
This model incentivizes hospitals to help more patients – to help more patients with knee operations, cataract surgery, etc. This approach also incentivizes hospitals to spend money on expenses that help patients (e.g. more doctors, nurses, equipment, etc.) rather than using the money on expenses that don’t help patients (e.g. more admin staff).
To learn more about this policy option, please watch our Health Reform Now documentary (scroll up) or see this post by MEI.
FINANCIAL POST: England’s Michaela model offers education lessons for Canada
October 5, 2026
SecondStreet.org's Research Director, Bacchus Barua remarks on the success of England's Michaela Free School and asks: what can Canada learn from the Michaela approach?
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“Hooray!!” That was the one-word tweet from Katharine Birbalsingh, “Britain’s strictest headmistress,” as students at the Michaela Community School, located in the shadow of London’s Wembley Stadium, received their “A-levels” — exams that would determine which university they went to. Significantly more students at her school (about 70 per cent) achieved top grades (A or A*) compared with the national average (28.5 per cent). A remarkable feat for a government-funded school with a sizeable portion of its students coming from financially disadvantaged backgrounds.
The Michaela School was controversial when it launched, but its story has been one of unqualified success. Could the Michaela model hold lessons for education reform in Canada?
Canadian students continue to fare better than those in the average developed country, but performance has been declining. According to newly-released OECD test results, the slide in student scores on key subjects (particularly reading and math) is so bad that today’s 15-year-olds are testing at the level of 14-year-olds in 2006.
Although the pandemic and social media affected results around the world, Canada’s negative trend spans decades. It’s no coincidence that it coincides with the K-12 system shifting away from traditional teaching approaches. For example, instead of “structured literacy” with an emphasis on sounding out words (phonics), kids were increasingly taught to use cues and clues to guess words. Math moved away from times-tables and rote memorization to “discovery math,” where kids had to invent their own approaches to problem-solving. A decline in literacy and math skills was inevitable. To make matters worse, an increasingly lax approach to discipline led to an “epidemic” of school violence.
Against the backdrop of similar challenges in the U.K., Headmistress Birbalsingh understood that this approach didn’t work, and founded the Michaela Community School in 2014 following a raft of reforms that expanded school choice. Established as a free-school academy, Michaela is funded by the government but operates as a non-profit. It can determine its own curriculum and teaching methods, set different hours for teaching and exercise some control over its budget. Michaela took advantage of these freedoms to focus on traditional instruction (the teacher is there to teach), strict discipline (detention if you’re late or unruly) and longer school days (extra-curricular activities take place after school hours, not during).
The result? A school for ordinary and even disadvantaged kids with grades rivalling those at England’s most famous private school, Eton.
Canadian parents may not be familiar with the Michaela model, but polling data indicates they generally support its approach. A recent survey found over half of respondents want schools to return to traditional teaching methods (only about one in four support the new methods), while over 70 per cent favour a return to traditional responses to student misconduct (unruly behaviour results in suspension, marks are deducted for late assignments, etc.). In essence, parents want schools to get back to basics.
Several independent schools in Canada do follow this approach, but many of them may be financially out of reach to many families. Which raises the question: Can the Michaela model — government-funded schools not beholden to government diktat — be replicated here?
Alberta has something similar to England’s “free schools” — namely, charter schools. Funded by the government, charter schools are run by non-profits with independent boards. Unlike Michaela, they do not have full autonomy over the curriculum, but they can focus on specific topics and teach as they see fit. For example, the STEM Innovation Academy in Calgary focuses on science, technology, engineering and math, while the Calgary Classical Academy focuses on classical education (art, arithmetic, Latin, history and so on).
Recent analysis by SecondStreet.org comparing provincial test scores on key subjects found kids at charter schools regularly outperform their peers at other government-run schools. Last year, students at these schools scored 10.5 percentage points higher on average than those in regular government-run schools, and 9.5 percentage points higher than students in government-funded Catholic schools. That’s essentially a full letter-grade difference on average. No wonder waitlists for these schools go into the tens of thousands and the majority of parents outside Alberta (56 per cent) want their province to copy this approach.
The example of Michaela Community School in the U.K. demonstrates the importance of traditional approaches to instruction and discipline — values generally supported by most Canadian parents. As regular public schools grapple with the question of whether and how to revisit these tried and tested approaches, the very least provincial governments could do is embrace Alberta’s charter school model, which performs demonstrably better than other government-funded options. Our children’s futures depend on it.
Bacchus Barua is Research Director at SecondStreet.org
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