Strong Care, Limited Access: Canada’s Senior Care Trails Behind Global Peers 

March 12, 2026 – While Canada performs reasonably well in the care it delivers, the system struggles to provide timely access for older adults, with most provinces performing below international averages, according to a new C.D. Howe Institute report. 

In “The Seniors’ Care Challenge: How Canada Performs Compared to its Peers,” author Tingting Zhang finds significant gaps in care for older Canadians. Using data from the 2024 Commonwealth Fund International Policy Survey of Older Adults, the report shows that Canada ranks seventh among 10 high-income countries for overall health system performance, ahead only of France, Germany, and Sweden. Canada performs above average in the care process and healthcare outcomes, but ranks last in access to care, suggesting that while care delivery is often effective once patients enter the system, significant barriers remain at the point of entry.  

The report also finds that healthcare performance for seniors varies across Canadian provinces. New Brunswick and Newfoundland and Labrador are among the weakest-performing jurisdictions across most categories, especially in timely access to appointments, quality of care, and healthcare outcomes. While Alberta and Ontario perform slightly above the international average in overall health performance, they also struggle with timeliness. 

“Canada’s biggest problem for seniors is access to care,” says Zhang, Policy Analyst at the C.D. Howe Institute. “While most provinces have made progress on affordability since 2021, many older Canadians still struggle to see a doctor quickly or obtain care outside regular hours.” 

The report finds that more than half a million Canadians aged 65 and older lack a regular doctor or usual place of care. Canada also reports one of the highest rates among peer countries of seniors visiting emergency departments for non-urgent conditions – a sign that gaps in primary care access are pushing patients toward more costly hospital services. As the population ages and chronic disease becomes more common, these pressures will further strain the health system and increase overall costs. 

Zhang’s report emphasizes that strengthening primary care capacity, expanding after-hours services, and adopting lessons from high-performing countries such as the Netherlands and Germany could significantly improve access for older adults. Targeted policy interventions to reduce affordability barriers for prescription drugs and dental care could also help close remaining gaps, particularly for seniors with complex health needs and lower incomes. 

“Canada already spends a significant amount on healthcare, so the challenge is not simply spending more but spending more effectively,” Zhang says. “Improving access to primary care and focusing resources where barriers are greatest would improve outcomes for seniors while reducing unnecessary hospital visits and system costs.” 

Read the Full Report

For more information, contact: Tingting Zhang, Policy Analyst, C.D. Howe Institute; Raquel Schneider, Communications Officer, C.D. Howe Institute, 647-805-3918, rschneider@cdhowe.org. 

The C.D. Howe Institute is an independent not-for-profit research institute whose mission is to raise living standards by fostering economically sound public policies. Widely considered to be Canada’s most influential think tank, the Institute is a trusted source of essential policy intelligence, distinguished by research that is nonpartisan, evidence-based and subject to definitive expert review. 

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