A Double Demographic Whammy

Why Healthcare Scarcity Is Likely to Reshape Canadian Politics

The Canadian healthcare system is heading toward a perfect storm—a “double demographic whammy” that will strain health and long-term care and dominate the political agenda for the next 5 to 10 years unless the problem is addressed.

This collision is driven by two inexorable forces: a rapidly aging population and a shrinking supply of family physicians and other healthcare professionals. Together, these trends will amplify healthcare scarcity, transforming it into the defining political issue for Canadians aged 45 and older, much as housing affordability has become central for younger Canadians.

A recent Abacus Data survey of 1,915 Canadian adults I designed and conducted in November underscores this emerging crisis. Here’s what the numbers tell us and why they matter.

Healthcare as the Dominant Concern

Healthcare is not just another political issue; it is one of the most salient issue. Forty-four percent of Canadians list it among their top three concerns, on par with housing and just behind affordability.

Dissatisfaction is palpable: 37% of Canadians rate their provincial healthcare system as “poor,” with significant regional disparities. In Quebec, that number climbs to 41%, and in Atlantic Canada, it reaches 58%. Another 35% describe the system as “acceptable,” a lukewarm endorsement at best.

More troubling is the trajectory: 42% of Canadians believe the healthcare system is getting worse, a sentiment that rises to 47% among baby boomers—the demographic most reliant on it. Meanwhile, 56% of Canadians say their provincial government isn’t spending enough on healthcare, with calls for more investment particularly strong among older Canadians.

Healthcare is no longer just a topic of concern; it is shaping voter behavior. Nearly 60% of Canadians say the performance of the healthcare system will be “very important” or “extremely important” to their vote in future elections. In Ontario, a province likely headed for an election soon, this figure sits at 56%.

This is what scarcity looks like: longer wait times, fewer family doctors, ER overcrowding, and limited access to specialists. These aren’t isolated complaints—they’re a systemic reality.

The demographic and structural pressures on healthcare will define the political and advocacy landscape for the foreseeable future. For those working in advocacy, political management, and policymaking, these shifts demand a fundamental recalibration. This is not business as usual.

1. Advocacy Must Become More Strategic and Persistent

Advocates who can frame healthcare scarcity in personal and urgent terms will have the greatest impact. The broad public concern offers a unique opening, but the issue’s complexity also demands focused, data-driven strategies. Stakeholders must move beyond general appeals for “more funding” to frame specific, actionable demands. For example:

• Articulating the real-life consequences of primary care shortages.

• Highlighting the connection between staffing issues and system failures like ER overcrowding.

• Demonstrating the regional inequities in care delivery.

Advocates will also need to navigate intergovernmental dynamics. Healthcare is a provincial responsibility, but the federal government is a critical funder. Successful campaigns will need to pressure both levels of government while avoiding the blame-shifting that often paralyzes progress.

2. Political Managers Face a High-Stakes Environment

For political managers, healthcare scarcity represents both a risk and an opportunity. The issue will shape voter behaviour in ways that are difficult to predict but impossible to ignore. Campaigns must develop healthcare messaging that resonates with different voter segments:

• Older Canadians: This group will dominate the healthcare conversation. Campaigns must show empathy for their concerns while offering practical solutions. Older voters are less interested in visionary promises and more focused on immediate outcomes.

• Younger Canadians: Although housing remains their top issue, younger voters are increasingly affected by healthcare scarcity, especially as they struggle to find family doctors or deal with aging parents. Campaigns that link healthcare to intergenerational equity could tap into this growing concern.

Ads that highlight healthcare failures will likely dominate political discourse. Parties will need to be proactive, not reactive, in addressing the issue. Leaders who fail to offer credible solutions risk losing trust, particularly as public patience with the system erodes.

If affordability defined politics for the last five years,
I think healthcare could for the next five.

3. Policymakers Need to Rethink Healthcare Systems

For policymakers, the challenge is clear: incrementalism will not suffice. The demographic wave bearing down on Canada demands bold, structural reforms. Policymakers must confront uncomfortable truths, including the system’s inefficiencies, funding gaps, and workforce shortages. The political stakes are high, and the window for action is closing.

But healthcare scarcity is not just a problem to be solved; it’s also a lens through which broader societal priorities must be evaluated. Policymakers should recognize that healthcare intersects with almost every other policy domain, from housing (aging in place) to immigration (addressing workforce shortages). The solutions will require cross-sector collaboration, long-term planning, and—most critically—political courage.

The Risks of Inaction

Failing to address healthcare scarcity will have profound political and societal consequences. Public dissatisfaction is already eroding trust in government institutions. The perception of systemic failure could deepen polarization, with frustrated voters gravitating toward leaders who promise radical solutions, even if those solutions are impractical or unsustainable.

Moreover, healthcare scarcity has the potential to exacerbate regional divides. Provinces like Atlantic Canada and Quebec, where dissatisfaction is highest, could become flashpoints for political discontent. This would further strain the already fragile federal-provincial relationship.

Inaction risks losing momentum on an issue that is increasingly top of mind and salient. It will become even more one of those “doorstep” issues that elected officials - from all levels of government - will hear about.

The Next Five Years

I believe (cause I see it clearly in my polling) the double demographic whammy of an aging population and a shrinking healthcare workforce will dominate Canadian politics for the next five years.

Healthcare scarcity will be for Canadians 45 and older what housing affordability is for those under 45: a defining issue, rooted in scarcity and shaped by urgency.