From the Fraser Institute

By Yanick Labrie

For decades, Canadians have been told that our health-care system is the envy of the world, a symbol of national pride. But the reality, as exposed in the new book My Fight for Canadian Healthcare by Dr. Brian Day, is far less flattering—and far more troubling. Dr. Day’s account of his 30-year battle to put patients first reveals a system bogged down by ideology, political inertia and an aversion to necessary reform. His message is clear: it’s time for Canadians to take off the rose-coloured glasses and demand a system that actually works for patients.

The book is not an argument for dismantling universal health care—it’s a plea for modernization and responsiveness. Dr. Day, an orthopedic surgeon and founder of the Cambie Surgery Centre in Vancouver, offers a front-line perspective on how rationing, administrative inefficiency and outdated policies systematically deny timely care to patients. Through detailed stories and compelling data, he documents the tragic human cost of excessive waiting lists—patients suffering needless pain, enduring irreversible deterioration, and in some cases, dying of preventable deaths.

One of the most disturbing revelations in the book is the deliberate limitation of health-care capacity by provincial governments. Faced with budget constraints, administrators limit operating room time and restrict physician access, effectively forcing patients to suffer on long waiting lists. This isn’t the result of unavoidable resource shortages; it’s a consequence of deliberate policy choices aimed at controlling spending, even if that means denying patients the care they need when they need it.

What makes this all the more unacceptable is that many of the very politicians and bureaucrats who defend this system seek care in private clinics (including Dr. Day’s Cambie Surgery Centre) when their own health is on the line. This double standard—one system for the public, another for the elite—undermines the entire moral justification of Canada’s approach to health care. If the system were truly world-class, those in power would not seek alternatives.

Dr. Day’s legal battle began in 2009 when his clinic became the target of a government lawsuit for allegedly violating an existing prohibition on patients paying with their own money for medically necessary care. This same prohibition had already been found unconstitutional in Quebec by the Supreme Court’s Chaoulli ruling in 2005, on the grounds that it violated fundamental rights to life and security.

The case dragged on for more than a decade, exposing the dysfunction of both the health-care system and the legal process meant to evaluate its constitutionality. Evidence presented in court—including government data showing thousands of patients dying while waiting for care—was damning. Unfortunately for Canadians, the British Columbia Supreme Court ultimately upheld the government’s authority to ration care and forbid patients from seeking private alternatives.

This legal defeat underscores a core truth that Dr. Day has long emphasized—Canadian health care is driven more by ideology than by evidence. The obsession with preserving a government monopoly has become an end in itself, eclipsing the system’s primary purpose: ensuring timely quality care for all. In no other sphere of life would we tolerate this. Imagine being told you couldn’t pay for private tutoring if your child’s public school was failing him. Yet this is precisely what Canadian health-care policy imposes.

Crucially, Dr. Day’s critique is rooted not in theory but in practise. He has seen firsthand the harm caused by delays, the deterioration of patients left waiting months or years for treatment, and the exodus of talented young doctors who leave Canada because the system restricts their ability of practise to their full potential. He has also seen the benefits of mixed public-private models in countries such as Australia, Sweden and Germany—countries with universal care that still allow room for private-sector innovation and competition.

Predictably, critics paint Dr. Day as a champion of privatization at any cost, but this is a gross mischaracterization. His vision is not American-style health care but rather a modernized patient-centred system that retains universal coverage while embracing flexibility, innovation and patient choice. In short, he wants Canada to catch up with the rest of the developed world, where public and private systems work together to ensure patients receive timely care regardless of their financial means.

Perhaps the most sobering aspect of My Fight for Canadian Healthcare is the reminder that reform is not only necessary, but inevitable. Canada’s population is aging, demand for care is rising, and the costs of maintaining the current system are unsustainable. Clinging to outdated structures will only deepen the crisis. The choice is not between public and private care—it’s between a system that works and one that fails.

As Dr. Day argues, the ultimate victims of our broken system are the patients themselves—ordinary Canadians left to suffer while politicians cling to outdated dogma. His fight has been long and costly, but it offers a valuable lesson: health-care reform is not about ideology. It’s about compassion, common sense and the courage to admit when something isn’t working. The time for that honesty is now.

Yanick Labrie

Senior Fellow, Fraser Institute