Chapter 06 · Health

Healthcare You Can Depend On

Healthcare that's there when you need it: a family doctor, an ER that doesn't take twelve hours, and the doctor-training capacity to keep up with the people who live here.

Net investment · $3.8B–$4.8B3 goals24 commitments
At a glance

The goals

Goal 1

No More Waiting Forever

Guarantee access to care through neighbourhood health networks and more trained doctors.

Goal 2

Modernize Healthcare Administration

Reduce bureaucracy and use existing capacity better.

Goal 3

Lead The World In Health Innovation

Build world-leading health innovation, life sciences, and clinical trials capacity.

The case

Why this, why now

Healthcare was supposed to be the thing Ontarians never had to worry about. For roughly two and a half million people in this province without a family doctor, that promise is already broken. For anyone who has spent twelve hours in an emergency room, or waited months for a scan that should take days, it is breaking in real time.

This did not happen overnight. Ontario stopped training enough doctors twenty years ago and never caught back up to its own population, while the layers of administration around the front line kept growing.

This section rebuilds care starting at the front line. It gives every Ontarian a local health network with a real way in, trains the doctors we should have started training a generation ago, puts around-the-clock urgent care alongside every emergency room, and builds the diagnostic capacity to bring the waits down. It also modernizes how the system is run, so more of each dollar reaches patients instead of paperwork. Care you can count on is not a luxury. It is the basic promise of public healthcare, and we intend to keep it.

The plan

What we'll do

No More Waiting Forever9 commitments · ($3.8B) to ($6.0B)

Attach every Ontarian to a local care network, train more doctors, pair every ER with 24-hour urgent care, and build the diagnostic capacity to cut wait times in half. Make care available when it's needed, not months later.

Attach every Ontarian to a neighbourhood health network. Build local care networks with a single point of access for family medicine, nurse practitioners, mental health, diagnostics, referrals, and home care. Patients keep their existing family doctor if they have one.
Train more doctors by expanding medical schools and residencies. Build new medical schools in Waterloo, Windsor, and Brock at St. Catharines/Niagara, expand the Northern Ontario School of Medicine, and grow residency spaces across the province.
Open a direct family medicine education stream. Allow students committed to family medicine to enter medical school without completing a full four-year undergraduate degree first.
Pair emergency rooms with 24-hour urgent care. Co-locate urgent care with hospital ERs where it makes sense, and tie nearby standalone urgent care and minor-injury units into the same triage, so low-acuity patients can be triaged, redirected, and treated faster.
Build rapid diagnostic centres to cut diagnostic wait times in half. Launch new CT, MRI, ultrasound, and bloodwork centres with the goal of doubling provincial MRI and CT capacity and creating meaningful access in every regional catchment.
Expand secure mental health and addictions treatment capacity. Add detox, stabilization, residential treatment, psychiatric, and supportive recovery beds. Take pressure off ERs and give people in crisis a real path to recovery.
Expand the use of accredited independent providers under OHIP. Follow the BC and Quebec model to deliver more publicly funded surgeries, diagnostics, and routine services outside hospitals while keeping care covered through OHIP. Pay the same service fees as public hospitals and fund providers' capital costs separately, so fees track care rather than facility overhead.
Expand pharmacy-led care for routine services. Let pharmacists take on more routine prescriptions, renewals, testing, monitoring, vaccines, minor ailments, and chronic-disease supports that don't need a doctor or ER visit.
Make generic Ozempic universal. GLP-1s are proving to be one of the most important chronic disease treatments in decades, with benefits for weight loss, diabetes, cardiovascular risk, and the prevention of costly long-term complications. At generic prices, Ontario should make it broadly available to patients whose doctors prescribe it.
Modernize Healthcare Administration10 commitments · +$250M to +$2.3B

Pay providers in ways that reward access and outcomes. Build the digital, administrative, and procurement backbones that frontline care depends on, and use existing capacity more intelligently.

Offer doctors more practice and payment models. Open salary, blended, team-based, hospitalist, and community clinic models so physicians can work in settings that fit their practice while improving access for patients. Fund incentive bonuses for doctors who choose to practise in remote and underserved communities.
Refine hospital funding to reward both throughput and complexity. Ontario already funds most hospital care by activity and population, so the opportunity is to use those models better, rewarding completed care and shorter waits while weighting payments for how complex a hospital's patients are. The hospitals carrying the hardest cases should be funded fairly, not penalized for them.
Reform doctor billing to reduce overhead. Work with doctors to simplify fee codes, support team-based care, and create payment models that better reward access, prevention, productivity, and patient complexity.
Build a universal referral and centralized waitlist system. Replace faxed referrals and opaque waitlists with centralized booking, live wait-time data, and digital status updates. Route referrals to the first appropriate available provider while preserving patient choice.
Deliver a universal digital health record that actually works. Set province-wide interoperability expectations for EHR providers, standardize workflows, and reduce paperwork for clinicians within a single term.
Build shared back-office services for hospitals. Consolidate procurement, payroll, IT, scheduling, referrals, and diagnostics booking across hospitals and health providers. Shift resources from administration to frontline care.
Let clinicians practise at full scope. Expand microcredentialed support roles, clinical assistants, care coordinators, scribes, technicians, and supervised support workers so doctors and nurses can focus on work only they can do.
Strengthen preventive care incentives. Pay doctors and primary-care teams for completing physicals, bloodwork, screenings, vaccinations, and follow-up. Offer patients an annual preventive-care credit for staying up to date on recommended care.
Upload municipal healthcare costs to the province. Move responsibility for healthcare infrastructure and rural practice incentives, including hospitals, healthcare facilities, and local doctor recruitment, from municipal to provincial budgets.
Capture the avoided-cost dividend from primary care attachment. Track the savings from attaching unattached patients to primary care and from preventive screening, which CIHI evidence consistently shows reduces ER visits and admissions. Better front-line care lowers downstream hospital costs.
Lead The World In Health Innovation5 commitments · ($280M) to ($1.1B)

Make Ontario the fastest place in North America to launch a clinical trial, scale a health technology, or commercialize medical research. Stop letting world-leading discovery happen here and get monetized elsewhere.

Build a provincial healthcare innovation and procurement pathway. Allow promising technologies to be evaluated centrally, purchased collectively, and scaled across hospitals and health providers. End the one-hospital-at-a-time procurement that blocks adoption.
Establish an Ontario Advanced Clinical Trials and Access Office. Make Ontario the fastest place in North America to launch clinical trials. Coordinate ethics and hospital approvals, support expanded-access trials, and connect patients to promising therapies.
Expand evidence-generating access to promising therapies. Allow eligible patients with serious, rare, or life-threatening conditions to access late-stage investigational treatments where early safety evidence is strong and conventional options are unavailable. Track outcomes through the health system.
Build a life sciences scale-up strategy. Turn Ontario's research strengths in hospitals, universities, AI, regenerative medicine, nuclear medicine, biotechnology, diagnostics, and medical devices into globally competitive companies.
Use provincial procurement to scale proven Ontario health innovations. Move successful drugs, devices, diagnostics, digital tools, and care technologies from pilot projects into province-wide adoption faster.
What it costs

The fiscal picture

GoalLowerUpper
Total — Healthcare You Can Depend On($3.8B)($4.8B)
No More Waiting Forever($3.8B)($6.0B)
Modernize Healthcare Administration+$250M+$2.3B
Lead The World In Health Innovation($280M)($1.1B)

Net budgetary impact over the Ontario Budget 2026 baseline. Negative numbers represent net new provincial spending; positive numbers represent net savings or revenue.

Financial assumptions — how every number was derived Line-by-line derivations for each estimate

Detail on how each cost or savings estimate was derived. All figures represent net budgetary impact over the Ontario Budget 2026 baseline.

No More Waiting Forever · ($3.8B) to ($6.0B)
IdeaLowerUpperHow it was estimated
Attach every Ontarian to a neighbourhood health network.($500M)($1.0B)2.5 million Ontarians have no family doctor. At $300-500 per newly attached patient plus intake, coordination, and digital tools, this runs $500M-$1B/yr, partly recovered through the patient-attachment savings counted in administration.
Train more doctors by expanding medical schools and residencies.($500M)($1.0B)New schools cost $500M-$1.5B over ten years ($50-200M/yr); operating them adds $150-400M/yr and extra residencies $100-300M/yr, totalling $500M-$1B/yr at scale. New doctors enter practice 5 to 8 years after launch.
Open a direct family medicine education stream.$0$0A curriculum change within existing medical school capacity, so no new cost. The new schools above should build these streams in from day one.
Pair emergency rooms with 24-hour urgent care.($1.0B)($1.5B)About 150 hospitals have ERs. At $5-10M/yr per site for staffing, equipment, and modest construction, 24-hour urgent care at each runs $1-1.5B/yr, partly offset by reduced ER crowding and faster throughput.
Build rapid diagnostic centres to cut diagnostic wait times in half.($1.0B)($1.5B)Ontario has about 150 MRI and 250 CT scanners. Doubling MRI capacity at $2-3M per machine plus operating costs, and adding regional ultrasound and bloodwork hubs, runs $1-1.5B/yr including equipment. This cuts non-urgent MRI waits now running 60 to 90 days or more.
Expand secure mental health and addictions treatment capacity.($750M)($1.0B)This funds 5,000 to 8,000 new beds across detox, stabilization, residential, psychiatric, and recovery care at $100,000-200,000 per bed a year plus construction, totalling $750M-$1B/yr. It takes substantial pressure off ERs, the justice system, and shelters.
Expand the use of accredited independent providers under OHIP.$0$0Independent surgical centres deliver routine procedures at 10 to 20 percent lower cost per case, though higher volume offsets the per-case savings. Quebec and BC run this at break-even or modest savings, so provincial spending is unchanged.
Expand pharmacy-led care for routine services.$0$0The current pharmacy budget absorbs the modest minor-ailment prescribing fees, and the resulting drop in ER and walk-in visits means this costs nothing or saves money.
Make generic Ozempic universal.$0$0Diabetes alone costs close to 1 percent of Ontario's economy, before obesity-related heart disease, kidney disease, strokes, and long-term care. At generic prices, widely available semaglutide is a prevention investment that pays for itself and likely saves money.
Modernize Healthcare Administration · +$250M to +$2.3B
IdeaLowerUpperHow it was estimated
Offer doctors more practice and payment models.$0$0Changes how doctors are paid within the existing OHIP budget rather than adding to it, so no cost. More efficient practice models may yield modest savings over time.
Refine hospital funding to reward both throughput and complexity.$0$0Most hospital funding is already activity- and population-based; this expands procedure-based funding where it clears backlogs. The gain comes from running existing capacity harder, so no cost.
Reform doctor billing to reduce overhead.$0$0Simplifies fee codes and supports team-based care through OMA negotiations, keeping total OHIP spending flat. It reorganizes billing rather than adding cost.
Build a universal referral and centralized waitlist system.($50M)($50M)A single provincial system to replace faxed referrals and hidden waitlists, costing $30-50M to build and about $50M/yr to run, with regional waitlists folded in. It saves clinician time and reduces how much wait times vary by place.
Deliver a universal digital health record that actually works.($200M)($200M)Ontario already spends about $400M/yr on digital health. An added $200M/yr enforces common standards so records work across systems, manages vendors, and improves how the tools fit clinicians' day, with some funded by reprioritizing existing spending.
Build shared back-office services for hospitals.+$500M+$1.0BOntario hospitals spend $3-4B/yr on administration. Combining purchasing, IT, scheduling, and back-office work across 145-plus hospitals can cut 15 to 25 percent over 3 to 5 years, saving $500M-$1B/yr, in line with the UK NHS shared-services model.
Let clinicians practise at full scope.$0$0A change to the rules on who can do what, within the existing health workforce, so no cost. It lets the staff Ontario already has deliver more care per dollar.
Strengthen preventive care incentives.($500M)($500M)Pays doctors $50-100 per completed cycle of preventive care, plus credits for patients who stay up to date, totalling $500M/yr. The downstream savings are well documented and counted in the avoided-cost line below.
Upload municipal healthcare costs to the province.$0$0The province takes on what municipalities now spend on healthcare, so total public cost is unchanged. This also appears in the Housing and Municipal section.
Capture the avoided-cost dividend from primary care attachment.+$500M+$2.0BAttaching half of the 2.5 million unattached Ontarians saves about $400 per person a year in avoided ER visits and admissions, or $500M/yr, showing up in years 3 to 5. Attaching everyone plus broader preventive screening brings savings to $2B/yr at full scale.
Lead The World In Health Innovation · ($280M) to ($1.1B)
IdeaLowerUpperHow it was estimated
Build a provincial healthcare innovation and procurement pathway.($250M)($500M)A central unit to evaluate, buy, and scale new technologies, modelled on the UK's health technology assessment body and innovation accelerator, costing $50-100M/yr to run plus $200-400M/yr for initial bulk purchases. It cuts hospital purchasing costs over time.
Establish an Ontario Advanced Clinical Trials and Access Office.($20M)($50M)A coordinating office, more ethics-review capacity, hospital integration, and patient support, costing $20-50M/yr once established. The economic upside is large as Ontario captures more of the roughly $70B global clinical trial market.
Expand evidence-generating access to promising therapies.$0($500M)Cost depends on how many patients qualify and take part: near zero if industry partnerships and the federal Special Access Program cover most of it, up to $500M/yr if Ontario subsidizes access for otherwise-unfunded conditions. Outcomes are tracked throughout.
Build a life sciences scale-up strategy.($10M)($20M)Funds strategy coordination and modest program spending at $10-20M/yr, with larger commitments later contingent on co-investment from federal innovation programs, private capital, and pension funds. A life sciences tax tool, like the one used in mining, is worth adding.
Use provincial procurement to scale proven Ontario health innovations.$0$0Uses Ontario's existing $30-40B in health purchasing to favour Ontario-developed innovations that meet performance and price standards, rather than a direct subsidy, so no cost.
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