Inside a Facebook group for Canadians suffering from knee and hip pain, a woman asks whether anyone has had private surgery in another province. An Ottawa man says he went to Quebec. A Calgarian writes that he “paid for a knee in Toronto.” A Winnipeg woman says she went to Montreal. An Alberta resident explains he was able to get his privately in Alberta, but only because the clinic flew in a surgeon from out of province.

Why this nonsensical migration of patients and surgeons? Well, in Ontario, it’s illegal under the province’s health care laws for an Ontarian to pay privately for a hip or knee surgery, but above board for an Albertan who’s just visiting. In Alberta, the law makes it practically impossible for Albertan surgeons to provide private surgeries to Albertans by capping what they can charge, but they can charge whatever they want to Ontarians.

This absurd situation is just one example of how Canada’s health care laws–designed to crowd out private payment for health care–no longer make sense. Ontarians need to recognize that the world has changed since 1966, when Parliament passed the Medical Care Act, which uses federal funding to encourage provinces to adopt universal health care, and the updated version of the law, the Canada Health Act, 1984.


While we should be proud to have public health insurance, we need to stop being nostalgic for an era when that system functioned well. Times have changed. The old way of thinking no longer makes sense. We need private options to relieve congestion in the system–not unlike the private Highway 407 relieves congestion on the public 401.

It will only get worse if we don’t find new revenue for the system. Canada has grown much older since medicare was first rolled out. In 1966, the country’s median age was 25.4 years. Last year, the median age was 40.3 years. In 1970, the median life expectancy was 68.7 years for men. Now, life expectancy for men is 79.9 for men (and 84 for women). Back then, seniors represented 8 percent of Canada. Now, they represent 18 percent. In 2031, they’ll be 31 percent.

As the population continues to age, the demand for health care will only grow exponentially. Meanwhile, Canada’s hospital capacity has shrunk. In 1970, we had seven hospital beds per 1,000 population. Now we have 2.5 per 1,000 people.

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