Nearly 24,000 patients died waiting for care last year, an MEI note reports
Canadians waited a median of 28.6 weeks between referral and treatment last year, and 23,746 patients died before receiving the care they were queued for, according to figures cited in a new Montreal Economic Institute (MEI) note.
The note argues Canada should lift its bans on duplicate private health insurance.
The note, published Monday, contends that Canada could expand treatment capacity and shorten wait lists by following Australia and Denmark, which pair universal public coverage with private insurance for services the public system already funds.
Much of that private coverage in both countries flows through workplace plans, a point of direct relevance to Canadian employers, where roughly two-thirds of the population already carries supplementary group coverage for drugs, dental and vision care.
Canada should adopt "proven solutions" from Australia and Denmark to widen access to care, whether public or private, said Conrad Eder, the research associate who wrote the note.
He worked on it with MEI economist Emmanuelle B. Faubert.
Canada spent an estimated $399bn on health care in 2025, or $9,626 per person, the note says, placing it among the highest spenders in the OECD at 12.7 percent of GDP.
Public funding rose 6.5 percent in 2023, 6.6 percent in 2024 and 3.9 percent in 2025, yet 1.4m procedures remained on wait lists as of 2025.
The MEI reports that 17 percent of Canadians have no primary care provider, and that 74 percent of those who do could not secure a same or next day appointment.
Duplicate private insurance covers examinations, procedures and surgeries already included under public plans, the note explains, giving policyholders faster access and wider choice of provider.
The MEI argues the broader effect matters more: by pooling risk and charging predictable premiums, such coverage lowers the cost of private care, expands the paying customer base and makes it commercially viable to build and staff clinics, surgical centres and diagnostic facilities that would not otherwise exist.
Private facilities then absorb demand that would otherwise congest public hospitals, according to the note, and governments can contract them to treat publicly insured patients when the public system falls behind.
The MEI also calls for lifting restrictions on mixed practice, which lets physicians treat both public and private patients.
In Denmark, doctors in mixed practice provide an average of 5.2 additional hours of care per week without reducing their public workload, the note states.
In Australia, about 45 percent of the population held duplicate coverage in 2025, with monthly premiums equivalent to roughly $84 to $293, as per the note.
Its 647 private hospitals admitted 5.1m people in 2024, accounting for 40 percent of hospital admissions while providing 35 percent of beds.
The MEI says the growth of private insurance there did not substantially raise overall hospital use but instead moved patients out of public hospitals, a shift it links to modest reductions in public wait times.
Denmark, where about 32 percent of residents hold duplicate coverage largely through employers, recorded a 36.7 percent drop in average surgical wait times between 2001 and 2011, the note reports, though it attributes that decline to private hospital use alongside other reforms such as activity-based funding.
Employer-paid insurance also cut total public hospital use by 10 percent, according to the study the note cites.
Premiums run the equivalent of about $65 to $129 a month.
Six provinces functionally prohibit duplicate private insurance for medically necessary services: British Columbia, Alberta, Manitoba, Ontario, Quebec and Prince Edward Island, the note says.
Four others do not formally ban it but have seen no market develop because of other barriers, including limits on mixed practice.
Eder argues these provincial restrictions exceed what the Canada Health Act requires.
The note frames the change as voluntary and says tax-funded public coverage would stay in place.
It also pushes back on equity concerns, arguing that status and connections already shape who gets care, pointing to queue-jumping documented in provincial audits and to an estimated 105,000 Canadians who travelled abroad for treatment in 2025.
A system where private and public care work together is "what a truly universal system looks like," Eder said.
The goal is to complement the public system, not replace it, and to treat more patients faster, he added.
