Healthcare Innovation Isn’t ‘Scary.’ Canada’s Broken System Is

From the Frontier Centre for Public Policy

“Our healthcare system is a monopoly installed at every level with the culture inherent to monopolies, whether public or private. The culture is based on regulation and budgetary controls, closed to the outside world, impermeable to real change, adaptation and innovation. It is a culture that favours inefficiency.”

Why is the Globe and Mail afraid of healthcare reform that works?

The Globe and Mail editorial board seems to find healthcare innovation “scary.”

On Sept. 3, it published an editorial called “Danielle Smith has a scary fix for healthcare,” criticizing the Alberta Premier’s idea to introduce competition in the province’s health system. Premier Smith’s plan involves third-party leasing of underperforming hospitals while the government retains ownership and continues funding.

Let’s be clear: the real problem isn’t Smith’s proposal – it’s the current state of healthcare across Alberta and Canada. Sticking with the status quo of underperformance is what should truly alarm us. Rather than attacking those trying to fix a broken system, we should focus on much-needed reforms.

So, what exactly is Smith proposing? Contrary to what you may have heard, she isn’t dismantling Alberta’s universal healthcare or introducing an American style system. Yet the public sector unions – and certain media outlets – seem to jump into hysterics any time innovation is proposed, particularly when it involves private-sector competition.

Predictably, groups like Friends of Medicare, with their union ties, are quick to raise the alarm. Yet media coverage often fails to disclose this affiliation, leaving readers with the impression that their views are impartial. Take Global News’ recent coverage, for example:

In late August, Global News reporter Jasmine King presented a story on potential changes to Alberta’s healthcare system. She featured a spokesperson from Friends of Medicare, who predicted that the changes would be detrimental to the province. However, the report failed to mention that Friends of Medicare is affiliated with public sector unions and has a history of opposing any private sector involvement in healthcare. The news segment also included a statement from the dean of a medical faculty, who was critical of the proposed changes. Missing from the report were any voices in favour of healthcare innovation.

Here’s the real issue: Canada is an outlier in its resistance to competition in healthcare. Many European countries, which also have universal healthcare systems, allow private and non-profit organizations to operate hospitals. These systems function effectively without the kind of fear-mongering that dominates the Canadian debate.

Instead of fear-based comparisons to the U.S., let’s acknowledge the success stories of countries that have embraced a mixed system of healthcare delivery. But lazy, fear-driven reporting means we keep hearing the same tired arguments against change, with little context or consideration of alternatives that are working elsewhere.

It’s ironic that The Globe and Mail editorial aims to generate fear about a health care policy proposal that could, contrary to the alarmist reaction, potentially improve efficiency and care in Alberta. The only thing we truly have to fear in healthcare is the stagnation and inefficiency of the current system.

Claude Castonguay, the architect of Quebec’s Medicare system, released a report in 2008 on that province’s health system, calling for increased competition and choice in healthcare.

“In almost every other public and private areas, monopolies are simply not accepted,” he wrote. “Our healthcare system is a monopoly installed at every level with the culture inherent to monopolies, whether public or private. The culture is based on regulation and budgetary controls, closed to the outside world, impermeable to real change, adaptation and innovation. It is a culture that favours inefficiency.”

The fear of competition is misguided, and Canadians are increasingly open to the idea of paying for private treatment when the public system falls short.

Let’s stop demonizing those who propose solutions and start addressing the real issue: a system that is no longer delivering the care Canadians need. The future of healthcare depends on embracing innovation, not clinging to outdated models and misplaced fears.

Joseph Quesnel is a Senior Research Fellow with the Frontier Centre for Public Policy.

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The Canadian Energy Centre’s biggest stories of 2025

Published on December 30, 2025

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From the Canadian Energy Centre

Canada’s energy landscape changed significantly in 2025, with mounting U.S. economic pressures reinforcing the central role oil and gas can play in safeguarding the country’s independence.

Here are the Canadian Energy Centre’s top five most-viewed stories of the year.

5. Alberta’s massive oil and gas reserves keep growing – here’s why

The Northern Lights, aurora borealis, make an appearance over pumpjacks near Cremona, Alta., Thursday, Oct. 10, 2024. CP Images photo

Analysis commissioned this spring by the Alberta Energy Regulator increased the province’s natural gas reserves by more than 400 per cent, bumping Canada into the global top 10.

Even with record production, Alberta’s oil reserves – already fourth in the world – also increased by seven billion barrels.

According to McDaniel & Associates, which conducted the report, these reserves are likely to become increasingly important as global demand continues to rise and there is limited production growth from other sources, including the United States.

4. Canada’s pipeline builders ready to get to work

Photo courtesy Coastal GasLink

Canada could be on the cusp of a “golden age” for building major energy projects, said Kevin O’Donnell, executive director of the Mississauga, Ont.-based Pipe Line Contractors Association of Canada.

That eagerness is shared by the Edmonton-based Progressive Contractors Association of Canada (PCA), which launched a “Let’s Get Building” advocacy campaign urging all Canadian politicians to focus on getting major projects built.

“The sooner these nation-building projects get underway, the sooner Canadians reap the rewards through new trading partnerships, good jobs and a more stable economy,” said PCA chief executive Paul de Jong.

3. New Canadian oil and gas pipelines a $38 billion missed opportunity, says Montreal Economic Institute

Steel pipe in storage for the Trans Mountain Pipeline expansion in 2022. Photo courtesy Trans Mountain Corporation

In March, a report by the Montreal Economic Institute (MEI) underscored the economic opportunity of Canada building new pipeline export capacity.

MEI found that if the proposed Energy East and Gazoduq/GNL Quebec projects had been built, Canada would have been able to export $38 billion worth of oil and gas to non-U.S. destinations in 2024.

“We would be able to have more prosperity for Canada, more revenue for governments because they collect royalties that go to government programs,” said MEI senior policy analyst Gabriel Giguère.

“I believe everybody’s winning with these kinds of infrastructure projects.”

2. Keyera ‘Canadianizes’ natural gas liquids with $5.15 billion acquisition

Keyera Corp.’s natural gas liquids facilities in Fort Saskatchewan, Alta. Photo courtesy Keyera Corp.

In June, Keyera Corp. announced a $5.15 billion deal to acquire the majority of Plains American Pipelines LLP’s Canadian natural gas liquids (NGL) business, creating a cross-Canada NGL corridor that includes a storage hub in Sarnia, Ontario.

The acquisition will connect NGLs from the growing Montney and Duvernay plays in Alberta and B.C. to markets in central Canada and the eastern U.S. seaboard.

“Having a Canadian source for natural gas would be our preference,” said Sarnia mayor Mike Bradley.

“We see Keyera’s acquisition as strengthening our region as an energy hub.”

1. Explained: Why Canadian oil is so important to the United States

Enbridge’s Cheecham Terminal near Fort McMurray, Alberta is a key oil storage hub that moves light and heavy crude along the Enbridge network. Photo courtesy Enbridge

The United States has become the world’s largest oil producer, but its reliance on oil imports from Canada has never been higher.

Many refineries in the United States are specifically designed to process heavy oil, primarily in the U.S. Midwest and U.S. Gulf Coast.

According to the Alberta Petroleum Marketing Commission, the top five U.S. refineries running the most Alberta crude are:

Marathon Petroleum, Robinson, Illinois (100% Alberta crude)
Exxon Mobil, Joliet, Illinois (96% Alberta crude)
CHS Inc., Laurel, Montana (95% Alberta crude)
Phillips 66, Billings, Montana (92% Alberta crude)
Citgo, Lemont, Illinois (78% Alberta crude)

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Alberta Next Panel calls for less Ottawa—and it could pay off

Published on December 29, 2025

Todayville

From the Fraser Institute

By Tegan Hill

Last Friday, less than a week before Christmas, the Smith government quietly released the final report from its Alberta Next Panel, which assessed Alberta’s role in Canada. Among other things, the panel recommends that the federal government transfer some of its tax revenue to provincial governments so they can assume more control over the delivery of provincial services. Based on Canada’s experience in the 1990s, this plan could deliver real benefits for Albertans and all Canadians.

Federations such as Canada typically work best when governments stick to their constitutional lanes. Indeed, one of the benefits of being a federalist country is that different levels of government assume responsibility for programs they’re best suited to deliver. For example, it’s logical that the federal government handle national defence, while provincial governments are typically best positioned to understand and address the unique health-care and education needs of their citizens.

But there’s currently a mismatch between the share of taxes the provinces collect and the cost of delivering provincial responsibilities (e.g. health care, education, childcare, and social services). As such, Ottawa uses transfers—including the Canada Health Transfer (CHT)—to financially support the provinces in their areas of responsibility. But these funds come with conditions.

Consider health care. To receive CHT payments from Ottawa, provinces must abide by the Canada Health Act, which effectively prevents the provinces from experimenting with new ways of delivering and financing health care—including policies that are successful in other universal health-care countries. Given Canada’s health-care system is one of the developed world’s most expensive universal systems, yet Canadians face some of the longest wait times for physicians and worst access to medical technology (e.g. MRIs) and hospital beds, these restrictions limit badly needed innovation and hurt patients.

To give the provinces more flexibility, the Alberta Next Panel suggests the federal government shift tax points (and transfer GST) to the provinces to better align provincial revenues with provincial responsibilities while eliminating “strings” attached to such federal transfers. In other words, Ottawa would transfer a portion of its tax revenues from the federal income tax and federal sales tax to the provincial government so they have funds to experiment with what works best for their citizens, without conditions on how that money can be used.

According to the Alberta Next Panel poll, at least in Alberta, a majority of citizens support this type of provincial autonomy in delivering provincial programs—and again, it’s paid off before.

In the 1990s, amid a fiscal crisis (greater in scale, but not dissimilar to the one Ottawa faces today), the federal government reduced welfare and social assistance transfers to the provinces while simultaneously removing most of the “strings” attached to these dollars. These reforms allowed the provinces to introduce work incentives, for example, which would have previously triggered a reduction in federal transfers. The change to federal transfers sparked a wave of reforms as the provinces experimented with new ways to improve their welfare programs, and ultimately led to significant innovation that reduced welfare dependency from a high of 3.1 million in 1994 to a low of 1.6 million in 2008, while also reducing government spending on social assistance.

The Smith government’s Alberta Next Panel wants the federal government to transfer some of its tax revenues to the provinces and reduce restrictions on provincial program delivery. As Canada’s experience in the 1990s shows, this could spur real innovation that ultimately improves services for Albertans and all Canadians.