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Arguably, though, Ottawa wouldn’t even need to get coercive about it. Simply dispelling misunderstandings might be the first step. According to one former government advisor, the provinces have historically been reluctant to permit private options within their jurisdictions—not because they’re legally prevented from doing so, but because prior federal Liberal governments made them fear it could affect the level of health funding they received if they did.

This Liberal government could choose to set a different tone—although this so far doesn’t seem likely. In a 2016 speech, Health Minister Jane Philpott acknowledged that Canada requires reforms to bring our system into line with international counterparts, and even cited the Commonwealth Fund studies as support. Yet, she curiously did not draw the obvious conclusions from those studies: that Canada should imitate the mixed systems of the world’s best health care providers. Instead, Philpott emphasized the necessity of “maintain(ing) a strong, publicly funded health infrastructure.”

The Conservatives could embrace health care as an issue on which to meaningfully differentiate themselves from their competitors

Thus, it may fall to braver souls to slay this sacred cow. The Conservatives could embrace health care as an issue on which to meaningfully differentiate themselves from their competitors. As fiscal conservatives, it would make sense for them to sell Canadians on a vision for how health care—something that currently eats up 11 per cent of our GDP, and accounts for, on average, 38 per cent of total provincial spending—could be offered more efficiently and effectively, while still universally.

Presumably, health care reform is an issue that could resonate with Canadians if politicians got the messaging right. The problem, though, is that may first require our leaders to disabuse the public of the fantasy that our system is first-rate—a bubble no politician is likely inclined to voluntarily pop. Perhaps a court ruling confirming long wait times and patient rights will pop it for them.