Terry Burton is a retired veteran of Alberta’s oil and heavy construction industry and a former member of the Alberta Apprenticeship Board.Imagine a grocery store that belongs to everyone. Canadians collectively own it through their taxes, and we are repeatedly told that the shelves are stocked, the food is available to everyone, and nobody will be denied because they cannot afford to pay at the checkout.There is, however, a catch.Before entering the store, you may have to get past a security guard. Then another. And another. You may be told to come back next week, next month, or even next year.Meanwhile, you are hungry, and the pain is getting greater by the day.That, unfortunately, is an increasingly familiar description of Canada's healthcare system.To be fair, Canada's system does work, but not for all. Every day, Canadian doctors, nurses, technicians, therapists, surgeons, and countless other healthcare professionals provide excellent care, often under extraordinary pressure. The problem is not the dedication of the people working in the system. The problem is the system itself: bureaucracy, capacity constraints, shortages of personnel, and, above all, the barriers standing between a patient and timely care.Canada's publicly funded healthcare system is effectively thirteen public grocery stores — ten provincial and three territorial systems — each with its own management, rules, priorities, and capacity. What Canadians experience can therefore depend heavily on where they live.The first security guard is primary care..In 2024, approximately 83% of Canadian adults reported having access to a regular healthcare provider. That sounds encouraging until the other side of the statistic is considered: approximately 5.7 million Canadian adults did not have one.For millions of Canadians, the first door into the healthcare grocery store is therefore already difficult to open.Consider three entirely plausible Canadian patients.Patient One: the person who cannot get through the front door.A 55-year-old Canadian develops persistent symptoms requiring medical assessment but has no family doctor. They begin calling clinics and searching for appointments. Eventually, they find a walk-in clinic.They have technically accessed healthcare.But without continuous primary care, follow-up, referrals, and coordination can become much more difficult. Accessing a doctor once is not necessarily the same thing as having access to a functioning healthcare system.Patient Two: the person who gets inside but is left waiting in an aisle..Another Canadian requires diagnostic imaging. The physician orders an MRI or CT scan. The patient joins another queue.Canadian Institute for Health Information (CIHI) data shows how long these waits can become: one-in-ten Canadians requiring an MRI waited more than 200 days, while one-in-ten waiting for a CT scan waited more than 140 days.The patient cannot simply walk over to another scanner and purchase faster service in the same way they might shop at another grocery store.They wait.And they worry.Patient Three: the person who finally reaches the checkout — only to discover another queue.A third Canadian has severe hip or knee problems and eventually sees a specialist. Surgery is recommended.The difficult part, however, is not necessarily over. The patient now enters another queue.The official surgical waiting period may not capture the entire journey: waiting for primary care, waiting for diagnostic testing, waiting for the specialist, and then waiting for surgery..To government statistics, these may be separate waits.To the patient, they are simply one long wait for treatment.Then there is geography.For someone living in Toronto, Vancouver, Montreal, or in other major metropolitan areas, the healthcare grocery store may be relatively close, with numerous hospitals and specialists nearby. For someone living in a rural, remote, or northern community, the store may be hundreds of kilometres away.A shortage of family doctors, nurses, specialists, and diagnostic services is not merely an inconvenience when the nearest service requires hours of travel. Rural Canadians can face a fundamentally different level of access to the same publicly funded system.And this leads to another uncomfortable question: public versus private care.Canadians are told that medically necessary healthcare is universally available based on need, not ability to pay. Yet Canadians who have the financial means can often obtain faster access to some services outside the public system, depending on the service and provincial rules, or their willingness to travel to another country.This creates an obvious contradiction..If Canadians have the financial capacity, they may have alternatives to some of the queues. Those who cannot afford alternatives remain dependent entirely on the public system.The debate should not be reduced to “public good, private bad” or the reverse. The objective should be timely, safe, and effective care. If additional delivery models can responsibly increase capacity while maintaining universal access, they deserve serious consideration rather than ideological dismissal.And the cost of the existing system cannot be ignored.CIHI estimates that total healthcare spending in Canada will reach approximately $399 billion in 2025, equivalent to $9,626 per Canadian.That is an extraordinary investment in a system that isn't delivering as designed and promised.More money alone cannot be the answer. If billions continue to flow into structures that remain unable to provide sufficient doctors, nurses, diagnostic capacity, specialists, operating rooms, hospital beds, and community care, Canadians will simply have a more expensive grocery store with the same lineups.While they wait, their health does not necessarily stand still. Pain can become chronic. Mobility can deteriorate. Anxiety can increase. Families can become caregivers. People can be unable to work or participate fully in their communities; some may even die..The ultimate measure of a healthcare system is not how much money governments spend on it.It is whether a sick person can get the care they need when they need it.Canada's healthcare grocery store is open. Its shelves contain many excellent products, and its dedicated employees provide remarkable care every day.But too many Canadians are still standing outside.Others are inside, waiting for what they need.And millions are moving from one queue to another — waiting for a doctor, waiting for a test, waiting for a specialist, waiting for a hospital bed, and waiting for an operation.They are not merely waiting for groceries.They are waiting for their lives to get back on track.Canada cannot indefinitely spend close to $400 billion a year on healthcare while accepting a system in which timely access remains so uncertain and costly both financially and in human terms.Canadians deserve more than a healthcare system that promises universal access.They deserve one that actually delivers it.Terry Burton is a retired veteran of Alberta’s oil and heavy construction industry and a former member of the Alberta Apprenticeship Board.
