Seven integrated actions

What Canada needs to get right in a shifting world

To narrow these gaps, Canada should pursue and track a set of integrated actions that directly improve the country's HPG. There's no time to waste; an aging population, rising chronic disease, and a rapidly shifting technological and geopolitical landscape necessitate urgent action.

The following seven actions aim to rebuild the system around a single organizing idea: in addition to being an individual and social good, health is a productivity asset. The first four restore people's capacity to participate; the next three expand the system's capacity to deliver. Each reinforces the others.

Action 1:

Enroll every Canadian in a Health Home

Action 2:

Make prevention proactive and personalized

Action 3:

Remove barriers to participation

Action 4:

Give individuals financial tools for prevention

Action 5:

Create capacity from what we already have

Action 6:

Meaningfully digitize health infrastructure

Action 7:

Redesign financing and incentives

Action 1: Enroll every Canadian in a Health Home

Canada's system is built around episodes of poor health during which reliable, consistent relationships with medical professionals are sadly lacking. Approximately six million people have no family doctor.31 A Health Home integrates primary care and prevention, giving every person a named care team as their front door to care. The Netherlands shows what universal attachment looks like: more than 95% of residents have a family doctor, sustained by a system that obligates insurers to attach everyone to a practice and keep them enrolled over time.32 That continuity is not just convenient; in Denmark, adults affiliated with the same practice for a decade or more have 21% lower mortality than those recently listed.33

But enrollment alone is not enough; the Canadian model must translate continuity into measurable prevention outcomes. Alongside a named team, a digital health plan, and a funded prevention package, a share of each Health Home’s funding should be tied to defined prevention outcomes. These include: screening and immunization rates, risk-factor control for conditions like hypertension and diabetes, and enrolled-population health gains. All need to be reported transparently and benchmarked from practice to practice. Incentives work; in England's pay-for-performance model, for example, recorded prevention outcomes improved when payments were linked to performance and fell by 11 to 13 percentage points when withdrawn.34 Canada should combine incentives with accountability, rewarding teams that keep people healthy and holding back funding where targets go unmet, so prevention becomes a financed, measured promise rather than an aspiration.

Action 2: Make prevention proactive and personalized

Once prevention is prioritized, it can become more proactive, personalized, and continuous. Canada should move beyond periodic checkups and broad public health campaigns to identify risks earlier and intervene sooner. England's NHS Diabetes Prevention Programme identified people with prediabetes and enrolled them in a behaviour-change course. Participants were 20% less likely to develop type 2 diabetes within three years.35 Canada should move beyond isolated pilot programs and systematically deploy targeted prevention initiatives for major drivers of productivity loss, including diabetes, cardiovascular disease, obesity, mental health, and musculoskeletal conditions.

Technology can help make prevention continuous rather than episodic. In one randomized trial of over 100,000 women, AI-assisted mammography detected 29% more cancers and almost halved radiologists’ workload (44% reduction), without increasing interval cancers.36 Emerging tools go even further: in eye exams, AI reading of a routine retinal photo flags cardiovascular risk with about 91% sensitivity.37 Combined with longitudinal health data, these tools allow care teams to identify people at risk before symptoms emerge and intervene when prevention is most effective.

Action 3: Remove barriers to participation

Good physical health only fosters productivity if people are in a position to act on it. Two groups are systematically held back: caregivers and those with mental health challenges.

Family caregivers would benefit from better support through federal measures, such as broadening the existing EI caregiving benefit beyond its current critical-illness and end-of-life eligibility to include chronic care, paired with respite, home-care hours, and job-protected leave.38 Second, legislate a mental health and substance use parity so these conditions are funded equitably with physical health, and add rapid-access therapy, prevention, and early intervention to every workplace.

Action 4: Give individuals financial tools for prevention

System financing should reach individuals as well as institutions. By establishing a universal Prevention Savings Account (PSA), individuals can access a portable, incentive-linked entitlement to invest in screening, risk-factor management, and healthy behaviours before illness begins. The idea draws on Singapore's account-based model, but the mechanism is Canadian, building on Health Spending Accounts already offered by many employers and extended toward universality through a public seed or match.

Designed as a complement to Medicare, it sits outside the Canada Health Act's insured services and is most workable as a federal tax-and-transfer instrument. Unlike earlier medical savings account proposals framed around cost-containment, its purpose is prevention and productivity, turning prevention from a cost that governments trim into an asset that individuals own.

Action 5: Create capacity from what we already have

Canada should unlock wasted capacity, reinvesting it into Health Homes staffed by interdisciplinary teams with upstream care targets.

Physicians lose about 19.8 million hours a year to unnecessary administration—the equivalent of approximately 9,000 full-time doctors.39 Federal, provincial, municipal, and regulatory bodies should adopt a shared target to cut this burden (for example, by 10% within three years). Each level can act on the levers it controls, from billing and reporting requirements to medical college documentation rules, and deploy AI to reclaim the hours.

Kaiser Permanente’s AI Scribe technology alone saved about 15,800 physician hours in a year, and agentic AI platforms can take over entire back-office functions.40

Hospitals, too, can become capacity engines. Canadian hospitals run at roughly 91% occupancy rate,41 yet 5-10% of inpatients could be safely cared for at home.42 Scaling Ontario’s Hospital-at-Home program nationally would ease that pressure. For example, Bayshore's @home programs, with 13 Ontario hospitals, have freed more than 240,000 alternate-level-of-care bed days, with 94% of patients recommending the program.43

Action 6: Meaningfully digitize health infrastructure

None of this can be scaled up without data that moves with patients. Bill S-5 (the Connected Care for Canadians Act) is proposed to mandate common interoperability standards and prohibits data blocking by health information technology vendors.44 We can move fast and make progress visible through a public scorecard (share of providers exchanging structured data), with the goal of 100% interoperability.

Action 7: Redesign financing and incentives

Make outcomes, not just inputs, the shared measure of success for federal and provincial health funding. Building on existing agreements, federal and provincial governments could link a portion of health transfers to jointly agreed progress measures. Provinces would receive predictable base funding alongside shared-outcome funding tied to improvement against a pan-Canadian productivity scorecard. That scorecard could be co-developed with provinces, anchored in the opportunities identified here, and housed in an arm's-length body such as CIHI to keep metrics credible and independent.