A Golden Opportunity: How to Get Medicare Back on the Winners’ Podium

By Laurent Carbonneau
CCI Vice President of Policy and Advocacy

Health care is one of our great national obsessions as Canadians. And much like one of our other national obsessions, our health care system is not exactly in best-on-best gold medal territory.

Canada’s annual health care spending is growing faster than the economy. This is not a sustainable trajectory. We’re seeing that in strain on the system. 17% of Canadian adults don’t have a family doctor. Median wait times for specialist appointments (let alone procedures) are well over 6 months. The biggest block of users of hospital bed-days are patients who would be more appropriately served by a different level of care. As Canadians get greyer, costs will rise more rapidly.

We’re already paying more than the average across the OECD and are less satisfied with the level of care we’re getting.

The reality that these two diverging numbers is creating is grim and leaves us with two options if we want to maintain and improve care (which we do!): get more out of the dollars we spend in the health care system, or ensure that economic growth catches up with or even outpaces the accelerating costs of health care.

We’ve just released Care at Scale, a policy report about how public buying, alongside better policies around valuable intangible assets, can save money, provide health care workers with more time to focus on patient care, and help Canadian innovators scale their companies into global powerhouses that can unlock more prosperity for Canada.

Canada spent about $400 billion on health care in 2025. Most of this is on salaries and benefits, but a very healthy proportion is on everything else: drugs, supplies, equipment, technology, and infrastructure costs. This is, for the most part, public buying. The policies that structure procurement can make an enormous difference in how much we get for our dollar in terms of improved care, hours saved, and economic growth.

Digital health is a great place to start. Canada has been slow to modernize operations in the health care system. While 80% of Canadians are interested in accessing their personal health information online, only 40% actually do. There’s a real gulf between what Canadians want and expect, and what they’re getting.

There are always risks to buying new digital systems. Buyers don’t want to be locked into systems that don’t work for them and that create structural dependencies on single vendors. Procurement policy should start with the view that assessing total value is more important than just trying to bring the price tag of a single purchase down to the lowest possible cost. Investments that make the system more efficient and generate economic spillovers should be table stakes.

We should also make sure that there is a clear pathway from pilots to actual procurements. Innovators invest lots of time and energy on small pilot projects that end up lost in the fog once they’ve run their course, even when they’re very successful. This isn’t even especially complicated. If you can show that you’ve delivered against clear, measured targets, there should be a well-defined on-ramp to a contract.

Finally, the reality that health innovators face in Canada is that despite our public system, sellers have to navigate a maze of provincial governments, local health authorities, hospitals, and more. It becomes difficult to scale nationally in this patchwork. There have been early experiments in ‘piggybacking’ procurements – where buyers can effectively say, ‘we’ll have what they’re having,’ – that should become much more widespread.

We’ve written a lot about the whys and wherefores of innovation procurement over the years, but the key takeaway is that years of baking in procedures to minimize risk and maximize the perception of fairness have created a system that isn’t materially fair and creates huge risks. Giving buyers and innovators more flexibility to operate in the interests of the health care system would be a huge step forward.

Data governance is the other important leg for reform in how to adopt and use digital health. The decisions we make about who designs, owns, and controls services in the health care sector are critically important.

The value embedded in the health care system – like in any intangibles-heavy sector – is going to flow to the entities that control integration layers, platforms, and data governance. In the increasingly fraught context we’re operating in, this is one more reason to think really hard before shipping this value abroad.

For Canadians, health care is typically high on the list of political priorities, and our experiences with the health care system often leave us disappointed. The system we rightly see as a national treasure is under real systemic pressure, and we can’t just hire our way out of this problem.

Innovation will have to be a part of any realistic and sustainable solution. We need policies that enable public buyers to actually buy innovation to reduce costs, improve patient care, and leverage an existing world-class Canadian technology ecosystem that is ready to serve.

Thank you to our partners AlayaCare, Petal Health, Think Research and WELL Health Technologies for making this research possible.

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Laurent Carbonneau is CCI's Vice President of Policy and Advocacy. He can be reached at lcarbonneau@canadianinnovators.org. Mooseworks is the Council of Canadian Innovators' innovation policy newsletter. To get posts like this delivered to your inbox, sign up for CCI's newsletter here .