Report urges Canadian provinces to adopt private hospital model

A new report argues Canada's provinces should allow private, for-profit companies to own and operate hospitals to improve wait times and access. The report from the Fraser Institute says this model is common in other countries with universal health care and complies with the Canada Health Act. It points to nations like Australia, Germany, Sweden and Switzerland, where private hospitals deliver a significant portion of care without higher costs. The authors contend these systems achieve better performance metrics than Canada's government-monopoly approach.

The report notes that 100 per cent of top-performing universal health-care countries use private providers for hospital and surgical care. In Australia, 40 per cent of hospitals are private for-profit, delivering 41 per cent of all hospital care and 70 per cent of non-emergency surgeries. In Germany, 39 per cent of hospitals are privately run, while in Switzerland the figure is 65 per cent. The report says these countries spend a similar amount on health care as Canada but have more doctors, more medical technology and shorter wait times. "None of these countries has suffered the increased costs, poorer service and erosion of universality that many Canadian opponents of reform claim would inevitably accompany the presence of for-profit providers," the report states. It adds that empirical evidence finds for-profit hospitals are more efficient than nonprofit and government hospitals. The authors argue a government monopoly in hospital care is less efficient, innovative and patient-focused than a competitive sector that includes private providers.

The report highlights the case of St. Göran hospital in Stockholm, Sweden, which was taken over by the private company Capio in the 1990s. It says the hospital's operating costs were between 10 and 15 per cent lower than other hospitals in Stockholm County shortly after the takeover. In 2024, the hospital had the lowest average cost of treating patients in Sweden, running roughly 28 per cent below the national average. St. Göran also had shorter emergency room wait times, with an average wait 30 to 50 minutes lower than comparable hospitals between 2016 and 2024.

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Quality metrics at the private Swedish hospital remained strong, according to the report. In 2025, St. Göran topped a national ranking of total hospital quality from the Swedish Perioperative Registry. It also had lower levels of bed overcrowding, managing 1.7 overcrowding events per 100 available beds compared to 5.1 nationally. The report says these savings have clearly not come at the expense of quality care.

The report also examines Switzerland, where nearly two-thirds of hospitals are for-profit institutions providing roughly half of all hospitalizations and beds. It says these hospitals care for similarly complex patients but have much lower hospital-acquired infection rates. Patients in Switzerland enjoy some of the most timely universal access to care in the developed world, according to the report. The same patterns are observed in Germany and the Netherlands, the report says. These countries have similar health spending to Canada but feature a large role for private providers and some of the most timely universal access to care. The authors conclude that if Canada's provinces want to solve the hospital care crisis, they should follow the lead of these higher-performing countries. "If Canada’s provinces want to actually solve the hospital care crisis, they should follow the lead of other higher-performing universal health-care countries and allow private for-profit providers a larger role in the hospital system," the report states. The authors suggest this move, rather than more funding promises or administrative reshuffling, could address overlong emergency room waits, lengthy surgery wait times and lack of access to hospital services.

With files from Todayville