Ontario Budget Increases Access to Health Care Through Increased Private Delivery of Publicly-Covered Services

Premier Doug Ford’s budget presents a test in maintaining federal buy-in for private delivery of publicly-covered health care services. Will this provide a path for other provinces to follow?

Yesterday, the Ford Government tabled Budget 2023, a “stay-the-course” document, with a promise to make health care more accessible to Ontarians, backed by “historic and unprecedented investments” in that field. 

Set as a prudent budget amid uncertain times, Budget 2023 follows a report from the Financial Accountability Office of Ontario, which revealed that Ontario’s health care system would be short $21.3 billion in spending by 2027-28. With Budget 2023, the Ford government pins its hopes on achieving its health care goals by expanding access to publicly covered, medically necessary surgeries and procedures through private clinics.

While the NDP has come out in full-throated opposition to the government’s plans, the third-party Liberals are in a much more delicate position, as their federal counterparts have thus far endorsed Doug Ford’s “innovative” approach to increasing access to health care.

But make no mistake, the federal government will have a keen eye on the delivery model and will not accept any situation where patients are caught paying for services covered under the Canada Health Act. In fact, federal health minister Jean-Yves Duclos recently issued a shot across the bow of any province caught facilitating private, for-profit health care when the Minister levied over $82 million in financial penalties to provinces and territories following evidence that Canadians paid out of pocket for medically necessary services.

The Trudeau and Ford governments have made for strange bedfellows of late, with Ford’s softened rhetoric on health transfers key to Trudeau’s successful Canada Health Transfer Agreement and Trudeau’s endorsement of Ford’s “innovative” health care delivery plans key to Ford’s populist appeal on improving health outcomes.

For better or for worse, the two governments have found it within themselves to cooperate amicably, at least in public, over the years as they sought to maintain their hold on power.

With Budget 2023, the Ford government has endorsed Trudeau’s health priorities by advancing significant initiatives to improve health data and reporting, slashing wait times for surgeries, and announcing plans to make medical records digitally accessible to all Ontarians.

If Ford can maintain Trudeau’s endorsement of key health care delivery policies, the Premier will be in a strong position to pursue a third consecutive mandate by fending off NDP and Liberal wedge accusations of privatizing health care when Ontarians return to the polls in just over three years.

Jon Dugal is Syntax Strategic’s Senior Consultant for Government Relations and Public Affairs. He recently was a senior campaign advisor to a premier of New Brunswick and to the leader of the PEI Liberal Party.