Attempts to solve wait times or the doctor shortage may lead to local reforms, but they will not begin to deal with the larger issue: The Canada Health Act needs to be renewed. Photo by Dylan DesRoches/Getty Images

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Almost a quarter century ago the former head of RBC-Dominion Securities, Tony Fell, delivered a grim assessment of Canada’s national health-care system under the Canada Health Act. In a speech at the Canadian Club in Toronto, titled “Healthcare at the Cossroads,” Fell ran through a long list of inadequacies, failures, challenges and funding problems. His 2002 speech could be delivered at any club meeting today.

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Among the crossroad issues — Fell resisted calling them crises — were doctor and nurse shortages, emergency room backups, shortages of medical equipment, cancer surgery wait times of up to two months, along with average national wait times for an MRI hitting 12 weeks.

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That was 2002. Nothing much has changed since then. The average national wait time for MRI in 2025 was 18 weeks. Canadian health care today has driven past the crossroads and entered crisis territory, a reality that has motivated Fell to take health care reform to a new front.

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Last month, in a full-page advertisement in The Globe and Mail, the now 87-year-old Fell described Canada’s health system as a crisis that requires more than random fiddling by central planners attempting section-by-section repair of the multitude of causes behind health care failures.

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The ad, attributed to “Anthony S. Fell, Citizen of Canada,” states that “Canadians deserve better healthcare. It’s time for solutions, not silence.” The system “was built on compassion. Now it needs renewal.”

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What makes Fell’s proposal different is the idea that the system needs an overall review that rises above the multitude of individual problems and the tendency to impose micro-solutions. Attempts to solve wait times in emergency rooms or the family doctor shortage may lead to local reforms, but they will not begin to deal with the larger issue: The Canada Health Act needs to be renewed.

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Fell calls for the establishment of an “independent, non-partisan Commission to study high-performing healthcare systems and recommend practical solutions.” Members of such a commission should include experts in health care, economics, law and patient experience. They should examine systems in Scandinavia, Germany, the Netherlands, Australia and Singapore. The commission should also engage with Canadian professionals and patient groups.

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Fell does not make this point, but appointees to the commission should exclude representatives of unions, activist groups, associations and institutions that have vested interests in particular structures or outcomes.

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In an interview, Fell recalled that the last formal commission-level review of the Canada Health Act was released a few months after Fell’s Canadian Club speech. The head of the 2002 Commission on the Future of Health Care in Canada was Roy Romanow, who Fell describes was “a full-fledged NDPer and a socialist” who fundamentally opposed forms of private health care.

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In his 340-page one-man report, Building on Values (doesn’t that sound familiar?), Romanow forcefully stated his opposition to forms of private health care. The consensus view of Canadians, Romanow claimed, was that health care should not be a business. “No! Not now, not ever. Canadians view medicare as a moral enterprise, not a business venture.”