Public health care didn’t develop in Canada by accident. It was fought for by people across the country. Those grassroots efforts grew into the public health care system we know today, first enshrined as a national right in 1984. At the time, the Canada Health Act (CHA) was passed unanimously by all parties sitting in the House of Commons. This political consensus was the product of grassroots organizing and provincial leadership from Saskatchewan.
It is important to know and celebrate this history, while acknowledging that the job of building a truly equitable, universal, accessible, and comprehensive public health care system in Canada is not done. Gaps in access to care exist along many lines, including those rooted in geography and identity.
We must be honest about the challenges facing the public health care system, but that does not mean abandoning this system. Unfortunately, that’s exactly what privatization forces are pushing for: the end of public health care in Canada.
Elements of health care privatization exist across Canada, but none more extreme than what is occurring in Alberta. With the passage of Bill 11, Danielle Smith’s government is introducing a two-tier, American-style health care system to the province in ways that clearly violate the principles of comprehensiveness and accessibility enshrined in the Canada Health Act.
There is no good evidence that these shifts will reduce wait times, expand public access to health care, or address staffing shortages for health care workers. Despite the lack of supporting evidence for health care privatization, the federal government has been silent, ignoring Bill 11’s clear violation of the CHA and the harm it poses to Albertans and to public health care across Canada.
At the Manitoba Health Coalition, we believe in a fully public, truly universal health care system that provides expansive, equitable access to all who live in these territories. We also know that public health care is a work in progress.
Too many Canadians and Manitobans are without a family doctor. Wait times at the emergency room, for diagnostics, and for surgeries are too long.
The system is also not the same for everyone who uses it. Inequities and structural barriers persist.
For Indigenous Peoples, structural racism and jurisdictional issues between the provincial and federal government create dangerous gaps in care and barriers to access. In some provinces, access to public health care for international students, migrant workers, and their families is not considered a right. Without access to housing and a health card, public health care is out of reach for some of our most vulnerable community members.
In these ways, we have forms of two-tier health care already in Canada. The answer to those injustices is the expansion of public health care, not further exclusion and more privatization.
Manitoba is taking action to combat structural racism in health care. Shared Health’s new Dismantling Racism framework provides a five-year plan to address systemic racism as a barrier to accessing equitable health care in Manitoba. The very existence of this framework shows how much further we have to go to build a truly universal, equitable public health care system in Manitoba and across Canada.
Access to public health care is a right in Canada, but it is not yet a reality enjoyed equally by all who call these territories home. We must fight to defend public health care while confronting its shortcomings and addressing the urgent need for improvement and expansion of public access to care.
The solution will never be more privatization where health care is accessed based on ability to pay, not medical need. The answer to wait times as well as gaps in access based on geography and personal identity is more investment and direction from patients and providers of care. We need our health systems to uphold The Canada Health Act, especially in Manitoba. Not only because it is the law, but because it is the right thing to do.
Opinion piece by MHC’s Provincial Director, Noah Schulz. Originally published in the Winnipeg Free Press, July 25th, 2026.