Provinces should allow duplicate health insurance

July 03, 2026

Conrad Eder, Associate Researcher at the MEI

Key points from this story:

• Long waits are worsening in Canada
• Healthcare spending 12.7% of GDP in 2025
• 1.4 million procedures pending in 2025
• Average wait time 28.6 weeks
• Denmark reduced surgical wait times 36.7%
• Six provinces ban duplicate private insurance

Waiting weeks, months, and sometimes years to access care. Even with record healthcare spending, these problems are not improving; they are getting worse.

In an Economic Note released this morning, I look at how mixed practice and duplicate health insurance help improve health system performance. These mechanisms can boost system capacity, cut wait times, and improve access for Canadians.

Canada's healthcare system is failing patients despite record government spending. Healthcare spending in Canada represents 12.7% of GDP in 2025, among the highest in the OECD. Despite this, in 2025, 1.4 million procedures were pending and the average wait time from referral to treatment was 28.6 weeks. Increased public spending has not led to a more efficient or accessible system.

Duplicate insurance can ease the pressure on the public healthcare system. It covers medical services that are already included in the public system and lets individuals access care through private facilities. As participation increases, premiums become more stable and predictable. This can help shift demand away from public facilities. As a result, wait times drop for everyone. Data from Denmark shows that along with the expansion of private hospitals and other reforms, this coincided with a 36.7% reduction in average surgical wait times.

This reform, combined with mixed practice, will increase system capacity without drawing physicians away from the public system. In Denmark, physicians engaged in mixed practice provide on average 5.2 additional hours of care per week in the private sector, on top of their public sector work.

Examples from Denmark and Australia suggest potential efficiency gains. Both countries maintain universal, tax-funded healthcare systems while allowing duplicate private insurance and mixed practice. This expands capacity and reduces pressure on the public system. No fewer than 45% of Australians hold private coverage, with monthly premiums starting as low as $84. Private hospitals account for 40% of all hospital admissions, helping to ease pressure on the public system.

However, none of these benefits can be realized unless the government changes course.

Six Canadian provinces ban duplicate private insurance outright. These restrictions go beyond what the Canada Health Act requires. Provinces that do not ban it still struggle, as they have no working market due to regulatory barriers or insufficient market size.

Provinces should allow duplicate private insurance and mixed practice to help improve patient access and unlock private investment in health care. Provinces should also abandon restrictions on mixed practice that prevent physicians from providing additional hours of care in the private sector alongside their public sector work.

You can read the Economic publication https://www.iedm.org/improving-canadian-patients-access-to-care-the-role-of-duplicate-private-health-insurance/

Conrad Eder
Associate Researcher at the MEI