Ontario’s health-care system is crumbling. For more than 70 years, Canadians have lauded the Canada Health Act (CHA) as a beacon of universal care, yet it’s woefully outdated in the face of modern challenges.
Chronic diseases are surging, hospitals are buckling under demand, and rural areas are often left without adequate access to care. Meanwhile, politicians patch the bleeding wounds with temporary Band-Aid fixes, prioritizing electoral wins over systemic reform. It’s time to demand bold, unapologetic change before the patient bleeds to death.
The CHA was built for a 1950s health-care landscape, emphasizing hospitals and physician visits. Fast forward to 2024, and the health-care needs of Ontarians are radically different. The Ontario Hospital Association (OHA) projects a staggering rise in chronic illnesses, such as diabetes and mental health disorders, driven by an aging population. These conditions require continuous, community-based management – something the CHA doesn’t effectively support.
Ontario’s long-term care (LTC) facilities, tragically exposed during the COVID-19 pandemic, exemplify these failures. Residents in LTC homes could often avoid hospitalization with robust primary care integration, yet the system remains siloed and reactionary. Emergency department (ED) closures in rural Ontario further illustrate how centralized, hospital-centric models neglect smaller communities, creating health-care deserts that leave millions without timely care. We all know someone in the 6.5 million and growing list of Canadians without a family doctor.
Ontario’s health-care woes aren’t new, but short election cycles have perpetuated a culture of short-term solutions. Politicians chase “wins” that look good on paper – temporary staffing bonuses, infrastructure announcements or flashy digital pilot programs – while avoiding the messy, long-term work of systemic reform. Politicians want Pavlovian results!
Leadership churn compounds the problem. The Proximity Institute highlights that more than one-third of Ontario hospital Chief Executive Officers have left their positions since 2020. Without stable leadership and succession planning, our health-care system lacks the strategic vision needed to implement lasting change. Leaders are distracted by the daily firefighting of ED backlogs, workforce burnout, and public backlash, leaving no time for transformative action. In addition, it must be exhausting to be a CEO and not able to fix a problem with stable, predictable funding.
Ontario’s future health depends on shifting focus from treatment to prevention.
Ontario’s future health depends on shifting focus from treatment to prevention. Primary care must be the foundation of the system, serving as the first line of defence against chronic disease and unnecessary hospital visits. The OHA’s findings stress that early intervention through community health teams can dramatically reduce the burden on hospitals. Imagine a system where mental health services, physiotherapy, medication reconciliation and diabetes management are available at your local family medicine clinic, preventing conditions from escalating into life-threatening crises.
The pandemic demonstrated the power of virtual care, yet its implementation remains half-hearted. Investing in digital infrastructure – remote monitoring tools, telemedicine platforms and electronic health records – would revolutionize how care is delivered, especially in underserved areas.
Moreover, Ontario’s LTC system must be integrated into primary care. Seamless coordination between LTC facilities and community family medicine teams would improve outcomes for residents, keeping them healthier and reducing costly hospital readmissions. This is possible. It is happening now at Bruyere Health in Ottawa.
The future of health care in Ontario demands courageous leadership, not political appeasement. Leaders must reject the cycle of short-term fixes and commit to bold reforms that address workforce burnout, rising patient demands and technological modernization. Leaders must demand full funding with five-to-10-year stability.
We must invest more in family medicine clinics in the community paid in a fixed payment model like Family Health Organizations (or teams) and Community Health Centres that will expand access to health promotion services like screenings, mental health support and chronic disease management. These team-based multidisciplinary teams will deliver care in local communities, reducing pressure on hospitals. They already do this for a third of Ontarians. Why only a third? And this extra money is available according to the Financial Accountability Office of Ontario.
We can cling to the outdated ideals of the CHA and watch our system collapse under its own weight, or we can rewrite the playbook. By prioritizing primary care, embracing digital innovation and building resilient leadership, we can create a system that delivers on the promise of universal health care in the 21st century.
The time for Band-Aids is over. It’s time to cure Ontario’s health-care crisis, once and for all.
