Tag Archives: public-healthcare

The Fine Line: Public Funding vs. Hospital Foundations in Canada

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Canada’s healthcare system is publicly funded, built on the principle that access to essential medical care should not depend on one’s ability to pay. Yet despite this ideal, hospitals across the country increasingly rely on charitable foundations to fill financial gaps; particularly when it comes to acquiring or upgrading capital equipment such as MRI machines, surgical suites, or even hospital beds. This raises an urgent question: where do we draw the line between what taxpayers should fund and what private donations should cover?

Historically, charitable giving and volunteerism have been strong elements of Canadian civic life. From Terry Fox Runs to hospital galas, Canadians have given generously of both time and money. Foundations like those supporting SickKids in Toronto or the Ottawa Hospital routinely raise millions for major equipment and infrastructure projects. This philanthropy has enabled many hospitals to expand their services, acquire cutting-edge technology, and improve patient care. However, relying on private donors to cover essential infrastructure can lead to inequities and accountability challenges.

Public funding should remain the primary source of capital investment for core hospital services. A hospital’s ability to deliver life-saving care should not depend on how wealthy its local community is or how effective its fundraising team happens to be. A well-off urban centre like Vancouver or Toronto may be able to raise tens of millions in months, while smaller or rural hospitals struggle to replace outdated X-ray machines. This creates a two-tiered system by the back door, one that undermines the universality and equity at the heart of Medicare.

Moreover, capital equipment is not a luxury; it is central to a hospital’s mission. When hospitals must wait on campaign goals or donor approvals to purchase a new CT scanner, patients pay the price through longer wait times and reduced diagnostic accuracy. Public infrastructure should be predictable, planned, and guided by population health needs—not marketable donor narratives or foundation marketing strategies.

Local philanthropic families who donate millions often have their names emblazoned across hospital wings or research centres, a modern version of constructing Victorian Follies or erecting statues in the town square. While some see this as genuine civic pride, and a way to give back, others question whether it’s philanthropy or vanity, blurring the line between public good and private legacy.

That said, there is still a legitimate and valuable role for hospital foundations. Philanthropy should enhance care, not substitute for the basics. Foundations can support research initiatives, pilot programs, staff development, and the “extras” that make hospitals more human; like family rooms, healing gardens, or neonatal cuddler programs. They can even accelerate the purchase of capital equipment, but only where government has committed base funding or provided a clear upgrade timeline.

Ultimately, drawing the line is about reinforcing accountability. Governments must be transparent about what the public system will fund and ensure consistent, equitable investment across the country. Hospital foundations should be free to inspire generosity, but not to carry the burden of maintaining essential care. Public healthcare must never become dependent on private generosity. That’s not a donation, it’s a symptom of underfunding.

Sources
• Canadian Institute for Health Information (CIHI). “National Health Expenditure Trends, 2023.” https://www.cihi.ca/en/national-health-expenditure-trends
• Globe and Mail. “Canada’s hospitals increasingly rely on fundraising to cover capital costs.” https://www.theglobeandmail.com/canada/article-hospitals-capital-equipment-fundraising/
• CanadaHelps. “The Giving Report 2024.” https://www.canadahelps.org/en/the-giving-report/

Why Canada Needs Scandinavian-Style Healthcare

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Canada stands at a crossroads. After decades of underfunding, patchwork reforms, and increasing pressure on provincial systems, it has become clear that tinkering around the edges will not save our healthcare. The discussion is no longer about marginal policy adjustments. It is about fundamental structure, equity, and national priorities.

The emergence of more private clinics across the provinces signals a shift that should alarm anyone who believes healthcare is a public good rather than a marketplace. These clinics, often operating in legal grey areas, effectively allow those with means to bypass wait times. Whenever that happens, the wealthy exit the shared system and the political incentive to invest in the public infrastructure weakens. The logic is simple. When elites can buy their way into faster care, they stop fighting for the kind of universal system that benefits everyone.

If Canada wants the best possible healthcare, the solution is not more private clinics. It is adopting the guiding principles of the Scandinavian model. Denmark, Norway, Sweden, Finland, and Iceland have built systems where high-quality care is universal, publicly funded, and delivered within a single unified framework. These countries consistently outperform Canada in access, outcomes, preventative care, and equity. Their success is not accidental. It comes from three structural principles that Canada must embrace if it wants to lead the world rather than trail behind it:

  1. A single-tier system with no private escape hatch. Everyone, including the wealthy, participates in the same system, which creates constant political pressure to maintain high quality. You get better healthcare when everyone — especially the most influential — depends on the same hospitals and clinics.
  2. High and stable public investment. Scandinavian countries fund healthcare at levels that match the real needs of their populations. Healthcare workers, equipment, and facilities are not considered costs to minimize but critical infrastructure, as essential as clean water or transportation.
  3. Integrated national planning. Instead of fragmented provincial systems, Scandinavian countries operate with cohesive national strategies. Canada’s provincial patchwork creates duplication, competition for resources, and wildly inconsistent service quality. A national framework would produce unified standards, better resource allocation, and greater accountability.

Canada can choose this path. It can reaffirm that healthcare is a public good, not a commodity. But doing so requires political courage and a public willingness to reject the slow creep of privatization. Allowing a private system to grow alongside the public system is not harmless. It undermines the very foundation of universal care.

If Canada truly wants world-class healthcare, the answer is not creating more private lanes. It is building a system where private lanes are unnecessary because the public system is so strong, so well-funded, and so well-managed that everyone is treated with the same quality and dignity. The Scandinavian model proves that this is both possible and sustainable.

To protect universal healthcare, Canada must follow those lessons. We need a single, high-functioning system that everyone pays into and everyone relies on. Only then will the political will align with the real needs of Canadians. Only then can we build the best healthcare system in the world.

Sources and Studies

  • Canadian Institute for Health Information. “Health Spending in Canada.”
  • OECD Health Statistics. “Health at a Glance” reports.
  • World Health Organization. “Universal Health Coverage: Evidence from Nordic Countries.”
  • European Observatory on Health Systems and Policies. “Nordic Health System Profiles.”
  • Commonwealth Fund. “International Health Policy Survey” annual comparative studies.
  • Government of Canada. “Canada Health Act Annual Report.”
  • University of Toronto Institute of Health Policy. “Public vs Private Delivery: Impacts on Wait Times and Equity.”
  • Fraser Institute critique reports on privatization proposals, for contrast and analysis.
  • Norwegian Ministry of Health. “Organisation of the Norwegian Health Services.”
  • Swedish National Board of Health and Welfare. “Equity and Quality in the Swedish Health System.”
  • Danish Ministry of Health. “Health System Performance and Financing.”