Canada’s public health care system is widely celebrated, and with good reason. Following years of struggle, the problems posed by private health care provision were overcome with the establishment of a universal and public single-payer medicare system in the 1960s. Bernie Sanders and others involved in the inspiring Medicare For All campaign in the United States often point to Canada’s single-payer system as a model to be followed.

However, the experience of the COVID-19 pandemic has reminded us that, for all its strengths, Canada’s health care system still has very real limits. It excludes from its formal scope crucial elements such as pharmacare, dental care, mental health — and also something that has been vital over the past year: long-term care (LTC). The result is a confusing mixture of public, not-for-profit, and for-profit ownership, and delivery in all of these areas. This has led to the growth of for-profit provision throughout the neoliberal period.

The pandemic has revealed just how serious, and even deadly, those exclusions have been. In particular, the catastrophic performance of Canada’s for-profit LTC providers is now widely recognized. The details of one particularly tragic COVID-19 outbreak at a Canadian LTC home in November reveal the human suffering inflicted by profit-hungry LTCs. One of Canada’s largest pension funds owns the LTC in question, raising grave questions about the investment strategies it follows.