Health care and the Canadian election: What experts are hoping to hear

I would like to see candidates commit to passing two pieces of legislation. The first for a primary care act that guarantees every resident of Canada access to high-quality primary care, just like Jane Philpott recommends in her book, Health For All. The second is for legislation that asserts the right of every person in Canada to have access to their own health records.

Together, these two pieces of legislation would go a long way towards achieving the OurCare Standard, a set of six simple statements that summarize what every person in Canada should be able to expect from the primary care system. They distill the essence of what we heard through our 16-month consultation with nearly 10,000 people across the country.

I’d love to see candidates articulate a vision for primary health care in this country that is actually based on what Canadians expect and want to see. Based on public opinion polling survey data, we know Canadians want to see a team-based model of care that most closely aligns with our community health centres.

In some provinces, we have community health centres (that) are team-based, non-profit primary care organizations. Within a context of pretty severe economic uncertainty and fiscal shock to a lot of provincial budgets, it becomes increasingly important that we actually get serious about addressing primary care.

What we see from the evidence based out of both Ontario and the United States is that the most cost-effective models, the best patient outcomes and the greatest likelihood of reducing health-care utilization in hospitals are aligned with the community health centre model. So, my hope is for candidates to articulate that vision and get serious about making that happen.

We are in a time of overlapping crises in health care: crises of access, poverty, housing and threats to equity, especially for those who are racialized, Indigenous, disabled and 2SLGBTQ+. My colleagues and I see the health impacts of these crises play out in real time in our offices every day. This may feel overwhelming, but I offer three specific policy directions I hope will feature prominently in the next federal election:

First, the Canada Disability Benefit. This new income support program holds the potential to take a generational step forward in income supports for some of the most marginalized people in our society. As we did for seniors, and then for children, we now have the opportunity to offer people living with disabilities an adequate income that will support a life of inclusion and dignity. The biggest first steps are to improve access to the program, beyond using the deeply flawed Disability Tax Credit as a gateway and allow everyone on disability-related social assistance to automatically qualify. Then we need to increase the benefit amount to a livable level, which will require far more than the initial, paltry $200 per month.

Second, we need equitable access to primary care. Solutions must focus first on access for people who face social and historical barriers to obtaining health care. This will require the tying of federal funding to specific outcomes goals for these groups, and the deep integration of community ownership and empowerment into the primary care system, to ensure it is shaped and responsive to the needs of those whose voices have been marginalized through the years.

Finally, reconciliation. In six years, we have addressed only a few of the calls to action of the Truth and Reconciliation Commission (TRC). This is unacceptable and responsibility lies largely with governments to support, fund and prioritize. Health providers and institutions will contribute, but the federal government must ensure the TRC vision in its entirety is realized. There cannot be advances in health equity in Canada without addressing the health devastation caused by our colonial past and present.

We need to see health care remain on the agenda for candidates this election, in particular because of what we’re seeing going on in the U.S. with the tariff threats.

We know that income is the No. 1 determinant of health, and that means that Canadians’ health is going to be impacted by any changes to the economy. But we need our health-care system to be stronger than ever to help mitigate that and improve the health of Canadians when they’re facing these economic challenges. I want to see every single party talking about the ways that we can strengthen our health-care system.

All Canadians and all political parties have similar goals in mind. We want Canadians to be healthy, and that means that we need to be investing in the things that keep us healthy.

We’re 23,000 family physicians short in Canada, and we need to be doing many different things simultaneously to address that number. No one solution is going to get us to that 23,000 mark.

We need to address the administrative burden. Our family doctors spend about 10 to 19 hours a week doing paperwork. If we bring in team-based care, we can share the workload, expertise and health records in the same space together. We can also expand the number of people we care for. We can increase the number of training spots, the number of international graduates that we have working in the system and fund our colleges to do more assessments. These are all solutions that we can put in place that will have a positive impact on that number.

The toxic drug crisis is the most important public health issue facing Canadians today. Toxic drug deaths have been increasing since 2016 and claim the lives of more than 20 Canadians every day.

However, not all Canadians are affected equally. Indigenous peoples face an increased risk of overdose. A response requires Indigenous-led solutions and deep reflection on reconciliation and to act and support changes with resources commensurate with the scope of these harms.

There has been recent attention and focus on addressing the supply side of this crisis (Where is fentanyl coming from? Who is producing it? How do we stop the production and flow?), responding to pressures from the U.S. stemming from tariffs related to fentanyl trafficking and organized crime in North America. While this is clearly important, we need to simultaneously address the prevention and demand side with a renewed sense of urgency.

We don’t have a functioning substance use system of care in Canada, which compounds the difficulty to coordinate a response to not only reduce toxic drug deaths but also offer timely treatment for those who need it as well as prevent the development or worsening of substance use disorders in the first place.

Developing this comprehensive continuum of care will require innovation and investment by all levels of government, as well as a commitment to research and evaluation to ensure we’re implementing these approaches effectively and in a way that benefits Canadians regardless of where they live.

Candidates need to recognize that brain health is one of the most pressing health and economic issues facing Canada today. One in five Canadians live with a brain condition, making it the leading cause of disability. That means millions struggling to work, families stretched thin as caregivers, and a health-care system that simply can’t keep up.

But there’s hope. Breakthroughs in conditions once thought untreatable – like Alzheimer’s, depression and ALS – are changing what’s possible. For the first time, we are making real progress in understanding how these conditions develop and how to stop them. Canada has world-leading brain researchers across the country that can push these discoveries across the finish line. But progress alone isn’t enough – Canada needs a plan.

A Canadian Brain Research Initiative (CBRI) will bring researchers, clinicians, patients and innovators together with the stable funding needed to drive solutions forward. As brain health and research becomes a global priority, do we want to lead or be left depending on others?

This isn’t just about research funding. Brain health must be a pillar of Canada’s economic future, ensuring investments in research, talent and innovation translate into real-world breakthroughs.

My hope is that candidates will propose solutions to address the crisis in access to primary care. Making timely access to primary care teams for all Canadians a goal would be a start.

We need to support primary care providers through enhanced teams, providing tools to enhance their productivity and helping them develop more robust routines to meet population needs.

This could include expanding access to multidisciplinary teams built from available staff, expanding the scope of each team member to manage a subset of patient needs, with family doctors doing complex tasks consistent with their training.

It would also include enhancing the core functions of primary care (like triaging incoming requests, diagnosis and treatment, patient education and self-management support, panel management with risk stratification to prioritize patient outreach, and ongoing monitoring) with digital tools that allow simple problems to be addressed quickly and free up time for physicians to address the more complex ones.

Primary care teams should be supported by digital ecosystems that reduce the estimated 19 hours a week physicians spend on administrative tasks.

For the 6 million people that do not have a dedicated primary care team, we need central and regional digital or phone-based front doors for patients that can help with system navigation, triage clinical concerns, escalating care to the appropriate virtual or in-person provider. These systems exist but they need to be strengthened and put forth as an essential way of optimizing care in a context of resource constraint.