Canada’s public healthcare system has a brand problem

Canada is in the process of reimagining how it will address national healthcare needs in the face of some very big challenges. It is going to take significant new tax dollars, sound leadership, and importantly buy-in from Canadians if we are going to save our public system. This moment is that significant. 

Wait times continue to rise. Shortages of healthcare workers are increasing at an alarming rate. But most importantly, more than one in five Canadians do not have a family physician or nurse practitioner who they see regularly, something that contradicts the fundamental promise of our system – equal access to quality healthcare for everyone.

For decades, Canadians have staunchly defended the system. In the to and fro of geopolitics, it has been a defining characteristic of our nation. Now that may be about to change. The emotional connection we once held with the public delivery of care is waning. 

The most recent poll numbers from the Angus Reid Institute show only 39% of Canadians oppose introducing private care into our system, 28% are strongly in favour of private care, and 33% are curious but hesitant about introducing private care as a solution to the current problems we face. This means that one in three Canadians are now questioning the fundamental value of publicly funded healthcare. More than one in four have already crossed the divide and welcome the commercialization of care. The values that we once held high in support of universal healthcare are now under water.  

Why would so many Canadians be willing to open the door to private healthcare, particularly when we see what goes on south of the border? In short, our collective experience with the system is increasingly distant, impersonal and transactional. As a result, our emotional connection to our public system is evaporating.

In this context, Canada’s public healthcare system has a terrible brand problem. 

Successful brands create a strong emotional connection with their users – a connection that is forged through experience. Successful brands are consistent and can be counted on. We are willing to pay more because we perceive them to be delivering higher value. And when these brands trip up, we are inclined to give them the benefit of the doubt. Unfortunately, our public representatives are drowning in tactical battles, while the actual war – regaining majority public support for a fully-funded public system – is being lost. 

Yes, we need to improve collaboration and knowledge sharing across the system. Yes, we need to reshape how healthcare teams are structured. Yes, we need to prioritize homecare and so much more. But it will take time – time that we may not have. 

So what do we do in the meantime, while pursuing positive change within the system? How do we shore up Canadians' confidence in the merits of a fully-funded public system – one that works in the interests of all? How do reverse the current downward trajectory of public support, so that the privatization of care does not take hold in ways that are irreversible? 

We need to do what great brands do in times of crisis and get back to basics. Our first priority must be to re-establish primary care for everyone. However we do it – whether team-based care or other alternatives – it is essential that we ensure everyone has a personal relationship with our public system – one that they can count on – nothing less. If we do not take this essential action, public support for private sector alternatives will continue to rise. 

By re-establishing a primary and personal connection to our healthcare system for everyone, we will give ourselves a fighting chance to raise the hard earned tax dollars needed to re-engineer our hospitals and primary care facilities, as well as undertake many of the other changes and improvements that need to be done. 

At one time, universal access to care through a public system was a majority view among Canadians. We had collectively agreed that healthcare is not a business; it is a fundamental right. If we continue to drift toward the promise of quick fixes through private clinics and services, we will be doubling down on the reactive path that got us here. And, I fear, there will be no going back.