“Canada’s health care system is in trouble precisely because it lacks flexibility,” concludes the latest background paper from the Canadian Health Care Consensus Group (CHCCG).

Author Brian Ferguson, an economics professor at the University of Guelph and AIMS Fellow in Health Care Economics suggests that if we are to successfully address problems within our nation’s health care system, then we must be open to a multitude of options. In The Potential of Private Sector Health Care in Canada, Ferguson points out that the original intention of Canada’s public health care system was to ensure that no one lacked care because they didn’t have money. That concept has since been perverted so that any suggestion of non-governmental insurance or suppliers is deemed un-Canadian.

“In the years since the early 70s, the role of the government, which was originally primarily to provide insurance cover, has expanded to include taking more and more control over both the day-to-day operations and long term planning function of the system. Indeed, some people would, with considerable justification, argue that this is not just a problem with the health care system but the key problem with the health care system. Instead of acting as an insurer and external quality assuror for the system, government has effectively become the system’s manager.”

Ferguson says that means the decision-making authority has moved farther and farther away from the delivery end of the system, and the resources available for decision-making have become overloaded.

“A medical care system is too complicated a thing to be micro-managed by a centralized bureaucracy. As decision-making authority moves to the Department of Health, the system’s decision-making capacity is actually reduced, as the people responsible for delivering care are effectively removed from the management and information system,” he writes.


The Potential is one of a series of background papers prepared for the CHCCG, which are intended to contribute to that new debate. These papers do not represent official positions of the Consensus Group, and are not themselves consensus documents, but rather are intended to act as starting points for debate, some of which will occur on the Consensus Group’s website (www.consensusgroup.ca).

To read the complete paper, click here. 

This research was made possible through the generous support of the Lotte and John Hecht Memorial Foundation.