Ontario Votes 2025: Medical Care

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Quick takes for the voting booth

All parties vying to lead Ontario are committed to invest more in medical care, primarily by beefing up efforts to recruit more medical professionals to the province. Only the Ontario Greens complement this focus with the recognition that investments in social, education and environmental supports are also critical for creating and sustaining good health.

It’s true that too many Ontarians don’t have adequate access to primary care. This is an urgent problem that must be fixed. However, a genuine commitment to finding solutions means looking at more than recruiting physicians, because the data show that Ontario already has more doctors relative to the number of residents.

 

Physicians per 100,000 Ontario residents

Family physicians per 100,000 Ontario residents

1976

2015

2022

1976

2015

2022

 Ontario

152

222

234

80

110

115

 Canada

144

230

247

73

116

124

Source: CIHI, Supply, Distribution and Migration of Physicians in Canada, 2022 — Historical Data

Health science has long made clear that health doesn’t begin with medical care – it begins in the conditions where we are born, grow, live, work and age. That’s why clinics and hospitals should be the last stop, not the first stop, in our health system. The first stops for good health are found in our neighbourhoods, jobs, child cares and schools – something the pandemic made painfully clear.

The most important decision any government will make about our health is what share of the budget pie to invest in the building blocks for a healthy society. When this slice falls behind investments in medical care, we are more likely to get sick or injured. In Ontario, parties aren’t finding the right way to divvy up the provincial spending pie.


The starting line: how is Ontario investing in health right now?

The evidence is clear that governments are more likely to improve life expectancy and reduce avoidable mortality and illness when their budgets grow spending on social programs and benefits more urgently than spending on medical care services.

There was a time when Ontario’s budgets regularly aligned with this health science. The table below shows the ratio of social and education spending relative to medical spending for around 1976 (when Canadian provinces were about a decade into their experiment of building a health system) and 2019 (the final year before the COVID pandemic). A ratio above one signals that social and education spending are larger than medical spending in that year. A ratio below one signals the opposite.

 

1976-ish

2019

Change

 Ontario

1.16

0.95

-0.21

 BC

1.22

0.69

-0.53

 Alberta

1.36

0.74

-0.61

 Quebec

1.53

0.78

-0.74

Source: Gen Squeeze calculations based on public accounts data compiled by Dr. Ron Kneebone and Margarita Wilkins at the School of Public Policy, University of Calgary

Around 1976, provinces routinely spent more on social and education investments than on medical care. By 2019, the opposite had become the norm. Ontario had the highest SE/M ratio of the most populous provinces, yet by 2019, annual social and education spending increased by approximately $13 billion and $30.4 billion respectively. In contrast, medical care received an extra $49.2 billion annually.

This doesn’t necessarily mean social and education spending have been cut. Rather, Ontario didn’t invest in these programs with the same level of urgency as medical care. This is a trend Ontario (and other provinces) need to reverse to improve the health of their populations.


What are parties proposing to improve health and wellbeing?

Recruiting more doctors and other health professionals is a top concern for all parties.

The PC’s continue to grow investments in medical education, training and upskilling, and commit to ongoing efforts to connect all Ontarians to primary care. The PC’s also reaffirm efforts to attract medical staff from other jurisdictions by reducing regulatory barriers – a different take on supporting ‘team Canada’. The cumulative price tag for PC efforts isn’t clear. Only relatively small and piecemeal new investments are specified in the platform.

The Liberals propose an additional 3,100 family doctors by 2029. They also promise to bring to Ontario 1,200 internationally trained doctors – though whether this is part of the 3,100 is unclear. Together, these recruitment efforts in combination with other health related promises will add a whopping about $29 billion in new spending over 4 years.

The NDP promise to add 3,500 more doctors, as well as more nurse practitioners, support staff, and northern medical practitioners. Over the next 3 years, the NDP will invest $10.5 billion more in Ontario’s medical system.

The Ontario Greens also aim to recruit 3,500 doctors to reach goal of all Ontarians having access to a physician in 3-4 years. This promise will cost just under $3 billion over four years. Other areas of focus for the Greens include increasing education and training, and attracting international health professionals. Total Green medical care investments between 2025 and 2029 total $6.9 billion (not including mental health).

Where the Green party stands out is in also recognizing the role of “social and environmental determinants of health” (p. 40) in preventing illness. The platform affirms that health doesn’t begin with medical care. Rather:

“The best care is the kind that keeps you out of the emergency room in the first place. That’s why we prioritise a preventative approach to healthcare—our vision is to try to solve problems before they begin. This means helping people access healthy food and a place to call home, and keeping our air and water clean.” (p. 40)

The Green approach includes investments in countering social isolation, housing insecurity and poverty, as well as supporting efforts to ensure communities have access to clean air and water, and healthy local food in all communities.

 

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