Frustrated with seemingly endless waits for essential medical services, Canadians are updating their passports, opening their wallets, and heading abroad for care they can’t get at home quickly enough, despite having already paid substantial amounts for it through designated healthcare premiums and/or taxes. 

According to a January 2026 report from Canadian think tank the Fraser Institute, at least 105,000 Canadians out of 1.4 million on official medical procedure wait lists left the country in 2025 for treatment appointments abroad. And these figures are likely a substantial undercount in that they reflect only survey responses from specialists reporting their own patient dropouts. The findings, prepared by Mackenzie Moir, Senior Policy Analyst, Nadeem Esmail, Director of Health Policy, and Yanick Labrie, Senior Fellow at the Fraser Institute, noted that residents of Ontario, British Columbia and Alberta “led the pack” of travellers, and the procedures delayed were primarily orthopaedic, urologic, internal medicine, general surgery, and gynaecological. The main data is from the Canadian Institute for Health Information (CIHI), a nonprofit organisation fully funded by the federal government. In effect it’s Canada’s official scorekeeper.

These long waits are especially perplexing because Canada is no small spender among Organisation for Economic Co-operation and Development (OECD) countries, with healthcare spending accounting for 12.7% of gross domestic product (GDP) in 2025, still less than the 17.6% GDP for the US (which does not a have universal care requirement), but in the same league as Germany, Switzerland, and France.

At least 105,000 Canadians out of 1.4 million on official medical procedure wait lists left the country in 2025 for treatment appointments abroad

Canadians, whose most favoured travel destination is the US (Mexico second) are acutely aware that a five-day emergency visit to a hospital in California, New York, Texas, or Florida can easily run into six figures (encompassing two days in ICU and three in recovery); which also accounts for the high travel insurance coverage limits (CA$5 million – $10 million) that Canadian travel insurers offer their clients for trips ‘down south’. And although the US is the closest relief point for them, the medical ‘escapees’ have a broad range of choices more than happy to welcome them.

In the beginning…

Adoption of the Canada Health Act in 1984 (which replaced the original Medical Care Act of 1966) was dedicated to ensuring that residents of all 10 provinces and three northern territories (which are responsible for crafting and administering their own plans) could see a doctor or visit a hospital without worrying about a bill. 

The incentive for individual provinces to minimise private sector services was the availability of federal government grants (which now account for some 22% of total healthcare costs). Coverage benefits and limits differ from province to province, and Canadians are even urged to buy travel insurance when travelling to other provinces to cover such variances as ambulance, dental or eye care: but it’s not a big seller. However, when travelling out of the country, most Canadians know to buy travel insurance – though younger age groups (Gen Z and even some millennials) are becoming less inclined to do so as premiums rise in tandem with coverage costs.

None of the provinces or territories cover out-of-country travel, except for the small amounts they would pay for services in Canadian hospitals. However, that is infinitesimal in a US-based hospital claim – maybe 5–10% at best. And, whereas many European countries share reciprocal medical coverage benefits, Canadians stand ‘bare’ when crossing any international border. Thus, commercial travel insurance is a buoyant industry.

Unlike many Europeans, only 86% of Canadian adults have their own designated doctor or locale for routine medical care. That’s down from 93% since 2016, and well below the level of Canada’s OECD universal healthcare cohorts – the Netherlands at 99%, Germany 96%, Australia 94%, and Switzerland 92%. According to the CIHI, in 2023, only 26% of Canadians were able to get same- or next-day appointments with their doctors. Taking that one step further to Canada’s most vulnerable population group, the elderly, CIHI reports that seniors (65 plus), who account for 19% of Canada’s population, also account for 47% of health costs nationally, and, according to recent Commonwealth Fund data, only one quarter who have a designated primary care provider report they can get same- or next-day appointments – again, the lowest percentage among top 10 cohort countries in the OECD.

Focusing on recent developments in oil-rich Alberta, where faint shouts of secession are being heard, the Fraser Institute’s Esmail and Moir note that, “in universal healthcare countries such as Switzerland, Germany, Sweden, and Australia, patients can choose between public and private settings for medical care, often accessing the same doctors in either system. And in all these countries, patients enjoy far greater access to healthcare. Back in Alberta, due to strict adherence to a failed status quo… Albertans suffer some of the worst access to healthcare in the developed world, despite spending world-leading amounts of money on it.” 

None of the provinces or territories cover out-of-country travel, except for the small amounts they would pay for like services in Canadian hospitals

In sync with the Fraser analyses, one group of emergency room physicians in Alberta recently documented six waiting room deaths, and 30 “near misses” among patients stored (boarded) in hallways and waiting rooms in one 24-hour period. Some physicians described the ERs as “death zones”.

In universal healthcare countries such as Switzerland, Germany, Sweden, and Australia, patients can choose between public and private settings for medical care, often accessing the same doctors in either system

Beyond “reasonable” wait times 

Meanwhile, more than two thousand miles to the east, residents of Canada’s Atlantic provinces must get in line and wait for between 30 and 60 weeks for treatment by neurologists, orthopaedists, otolaryngologists, or gynaecologists. And, according to the Fraser Institute’s latest Waiting Your Turn survey, which it has been publishing annually since 1993, the median wait for medically necessary but not immediately urgent services is 28.6 weeks Canada-wide. Only in Ontario – Canada’s commercial and economic engine – is the wait less than 20 weeks – by a whisker. 

The “waits” referred to in the Fraser reports are based on two segments: referral by a general practitioner to a specialist, and from consultation with a specialist to receipt of treatment. As per this structure, Ontario reported the shortest total waits (19.2 weeks) in 2025, followed by British Columbia (32.2 weeks), and Quebec (32.5 weeks). The longest were in Atlantic Canada: New Brunswick (60.9 weeks), Prince Edward Island (49.7), and Nova Scotia (49 weeks). And among the various specialties, patients nationally waited the longest for neurosurgery (49.9 weeks) and orthopaedic surgery (48.6 weeks). 

“After seeing a specialist… patients waited 4.5 weeks longer than what physicians consider to be clinically reasonable (8.8 weeks),” the 2025 report said. Perhaps in the real world, asking Canadians sitting in airports waiting for flights to hospitals in the US, Mexico, Germany, the Netherlands or Colombia what they consider “reasonable” might be more pertinent.

In an intriguing lead article from the Canadian Medical Association Journal headlined ‘Mass gathering events underscore serious vulnerabilities in health care capacity in Canada’, Deputy Editor Dr Catherine Varner raised some major issues about Canada’s preparedness – or lack of it – for the upcoming FIFA World Cup (football) events, which are expected to attract 300,000 visitors from all corners of the globe to Canada’s two major cities – Toronto and Vancouver – in June. 

She warned that with Toronto and Vancouver hosting 13 matches over four weeks, and the final match coinciding with Toronto’s Pride Festival (the second largest in the world), the mass gatherings “should prompt nearby hospitals to consider increasing staffing” and “initiating targeted public health interventions to reduce substance abuse interventions, alleviating strain on emergency departments”.

The median wait for medically necessary but not immediately urgent services is 28.6 weeks Canada-wide

Dr Varner added: “Yet increasing staff, even for the duration of these events, is likely not feasible since Canadian hospitals and public health systems already face health human resource challenges and budget shortfalls in these years following the Covid-19 pandemic.”  

So now the world is warned: avoid Toronto and Vancouver this summer. “The country does not have enough acute care beds or health care personnel to accommodate a surge in demand for acute care capacity.” 

Perhaps not quite the message Canada’s tourism industry might cherish.