February 28, 2026
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HERE'S MY TAKE
Do Canadians believe in their health care system? Depending on how the question is asked, pollsters routinely rank health care among the top issues of concern; Nanos had it at number-two this week. Still, Canadians also express a strong attachment to universal health care as part of our national identity and values. Most recognize that change is coming. Health care already consumes 30–50 percent of most provincial budgets. Of the total health dollars spent on the average Canadian over a lifetime, nearly a third is typically spent in the last two years of life. Elementary mathematics, combined with demographic realities, makes it clear that maintaining the status quo cannot be the answer.
A lesser-known part of this story is the role of faith-based health care in Canada. The names of prominent hospitals in our major cities offer a hint—to what else do Mount Sinai Hospital in Toronto, the Salvation Army-founded Grace Hospital in Winnipeg, or Hôtel-Dieu de Montréal refer? Yet most Canadians remain unaware of the religious roots of much of our health care infrastructure. A few are hostile to the continuation of faith-based health care provision, but many simply have amnesia regarding their role. Most are surprised to learn that religious communities not only helped establish large parts of Canada’s system, but that even today, in some provinces, faith-based organizations provide up to 15 percent of health care capacity. We need to do a better job of reminding everyone just how critical faith-based organizations are to the healthcare system we all value so much.
The relationship between faith-based providers and the governments with whom they work has always been complex, and in recent years it has become more so, particularly around contentious social and cultural issues. The British Columbia Supreme Court is currently hearing a case involving St. Paul’s Hospital. Strip away the legal details and the case focuses on the question of whether the Catholic hospital’s refusal to provide euthanasia or assisted suicide on site—transferring patients elsewhere—violates the Charter of Rights and Freedoms by causing unnecessary suffering.
My thoughts were sharpened this week when I had the privilege of moderating a discussion among roughly thirty faith-based health care leaders gathered to consider the theme “Renewing Faith in Healthcare.” The Chatham House rule prevents me from reporting specifics, but I can tell you the group was a multi-denominational cross-section of folks from some of the largest providers in the country. Discussion focused on telling their sectoral stories, sharing best practices and innovations, and considering how to protect the integrity of their mission amid pressures from both outside and within.
Nurse-historian Dr. Sonya Grypma (who has given me permission to reference her presentation) offered a history of nursing in Canada. That history struck me as a useful proxy for understanding broader shifts in health care delivery. The first nursing order, the Sisters of the Grey Nuns, was established in 1639. Their work was animated by a faith-based, compassionate response to those in need, especially those unable to afford care, and delivered with an explicit desire to represent their faith in service to their neighbours. Dr. Grypma traced seven phases of evolution over nearly four centuries, the last four phases occurring within many of our lifetimes. The pace of change itself is accelerating. Today, health care is delivered increasingly through a justice-based lens that prioritizes patient rights, autonomy, and choice, with providers positioned primarily as facilitators of those choices.
This evolution is nuanced and complex. Still, it seems we have moved away from a healthcare model in which medicine was a social response to illness, hurt, and suffering, and where providers offered expertise aimed at affirming life, potential, and opportunity. Now, the model focuses on providers who are expected primarily to deploy scientific capacity and personal care needs in service of patient demand. It’s much more transactional. Suffering and vulnerability are to be avoided and minimized, and dealing with them really doesn’t fit into an overarching framework that informs the system. We understand that we will never fully conquer disease and death, but we have framed a system that aims to do so. Faith-based health care provides tools to address these matters, recognizing that how we answer ultimate existential questions affects how we deal with the temporal challenges of vulnerability and brokenness, whether in our bodies, relationships, or souls.
These tensions are not unique to faith-based providers, and there is no monopoly on virtue or expertise in any sector of Canadian health care. These are universal questions that every person has to deal with; saying “no” to religion is as much a matter of faith as saying “yes”. These are both individual and collective questions, and our answers shape the communities and institutions in which we take part. So beyond history and nostalgia, what is the value proposition faith-based institutions offer today?
This week’s conversation prompted me to identify six differentiators. None is exclusive to faith-based institutions, but together they form a distinctive contribution that, when consistently and consciously applied, makes a practical difference.
Motivation – However quaint the origin stories of the Grey Nuns or the Little Sisters of the Poor may seem, they remain very much alive. Across traditions whose theological convictions differ substantially, one shared feature stood out: a missional orientation rooted in the dignity and worth of the human person and a call to respond to vulnerability with compassion and love. Participants readily acknowledged the difficulty of fully living up to these ideals and the challenge of measuring them, but the language of vocation was unmistakable. Those in the room did not see themselves merely as service providers; they were pursuing something deeper. St. Mother Teresa’s reflection on Jesus’ words in Matthew 25 that in serving others “you did it for me,” surfaced repeatedly, both explicitly and implicitly.
Capacity – Reliable national data quantifying religion’s additional contribution beyond tax dollars are difficult to find. But the stories shared in the room pointed to tens of millions of dollars in infrastructure, like buildings, equipment, and capital campaigns, supported by charitable foundations often funded by individuals within religious communities rather than by institutional churches. Add to this the volunteer dimension and the scale becomes titanic. By my rough calculations, using Statistics Canada data and isolating non-family informal care, it’s plausible that faith communities and affiliated providers provide caregiving in the range of $4 billion to $12 billion annually (even using conservative wage assumptions). Losing that would leave a gaping hole in the public system.
Serving the Marginalized – Historically, religious health care emerged as a response to those the market does not easily serve. That legacy continues. Faith-based organizations often pioneer programs for the homeless, prisoners, and those living with mental illness. The motivation is intrinsic to their calling. When authentically lived, it draws attention to those on society’s margins. Stories shared this week moved many to tears. We heard, for example, about homeless people who, like most Canadians, wished to die at home and received hospice space in their final days, thanks to the work of faith communities. Providing a home for those without, not just to live well but also to die well, was a priority. Care “to the least of these” occurs daily in Canada, largely unnoticed.
Holistic Care – Faith-based institutions are explicit in addressing the whole person. While practices vary and there are sensitivities to consider, there is a consistent recognition that spiritual and emotional needs accompany physical ones. Several providers described intentional spiritual care programs for both patients and staff, along with training to equip staff to engage patients about emotional and spiritual realities. This contrasts with how such matters are often handled (or not) in secular settings. It also offers a perspective on suffering and vulnerability that sees them not only as problems to be solved but realities from which both caregivers and patients may learn.
Morale – Burnout and stress among health care providers remain persistently high across the sector, contributing to retention and workforce challenges. Faith-based organizations are not immune, but explicit attention to spiritual formation, meaning, and community can offer tools to help sustain staff in demanding contexts.
Community Ecosystems – Governance structures vary widely, running the gamut from historic Roman Catholic sponsorship to independent, not-for-profit social enterprises. Yet most remain formally or informally connected to broader faith communities and adjacent services such as mental health, home care, and hospice care. These networks can enable more integrated care than is sometimes possible within the formal public system alone.
None of these elements is unique to faith-based health care. Much of it is also provided by well-meaning secular and faith-motivated folk working in secular health spaces. But taken together, explicitly faith-based organizations offer a distinctive value proposition. These organizations serve not only the more than half of Canadians who identify as religious, but also the broader public. As we confront systemic pressures that cannot be resolved by inertia, there is much to learn. Faith-based providers have a lot to offer and their healthcare roles are critical to maintain. However, they will also need to become much more intentional about telling and defending their stories.
WHAT I’M READING
Globe Editorial on MAID
The Globe and Mail is arguably Canada’s newspaper of record, so when it editorializes that Canada’s euthanasia rules need significant tightening it’s worth taking note. The Globe argues that the law on “medical assistance in dying” (MAiD) has gone well beyond what the courts required when striking down the Criminal Code ban on euthanasia and assisted suicide. Consequently, the editorial warns, the current MAiD regime blurs the “critical point” that “the law should not enable people to end their lives when they could otherwise go on to live happily and fruitfully.” The paper goes on to argue, “That should be the fulcrum on which any changes to Canada’s medical assistance in dying laws are balanced.” The federal government is on track to allow MAiD for mental illness on March 17, 2027, and a Parliamentary Committee is currently being set up to conduct hearings regarding Canada’s “readiness” for this implementation. Dying with Dignity Canada will likely press the federal government to proceed with the planned expansion without further delay, arguing that mental illness should be treated on par with physical illness under the law. The organization has been working with medical groups as well through the political and legal process to oppose new restrictions, emphasize autonomy and equality rights, and play a very public role in the parliamentary review process.
108 Words on 108 Minutes
US President Donald Trump delivered the State of the Union address on Tuesday, fulfilling a constitutionally-required presidential duty. At 108 minutes, it was the longest such speech on record. Reaction was predictably split. Supporters praised it as one of his finest performances. Critics struggled to find much to commend. Coverage from Politico helpfully catalogued what was, and was not, said about key policy issues. Yet the address felt less like a platform than a rallying cry, signalling full steam ahead for the administration’s existing agenda as the United States approaches midterm elections this fall, with Congress, voters and other countries watching closely.
CPC, CBC, and USA
Conservative Leader Pierre Poilievre’s speech to the Economic Club on Thursday in Toronto is being widely acknowledged as a constructive, distinct Conservative vision for Canada-US relations in light of US President Donald Trump’s erratic and hostile trade policies. While bluntly stating that Canada can’t simply walk away from its biggest neighbour and customer (notably not labelling the United States a friend while still acknowledging friendships with American people), he gave a bit of an elbows-up sort of message by correcting Mr. Trump’s rhetoric. What I found interesting, beyond the significance of the speech itself, was that CBC was the media outlet given the advance leak of the speech. CBC’s post-speech coverage earned a commending tweet (on X) from the Conservative leaders communications director. There was clearly more going on than just the release of a comprehensive policy position.
The Liberal Version
On the same day, Trade Minister Domenic LeBlanc delivered his own speech at the Canadian Club in Toronto. He noticeably used less direct turns of phrase about the possibility of a renewed Canada-United States-Mexico Agreement on trade, saying he was “not pessimistic” about it and that, behind closed doors, talks with American officials are “not discouraging.”
Alberta Education
Kelden Formosa, a Calgary elementary school teacher, offered his analysis on why Alberta’s independent school defunding citizens’ initiative failed. That initiative, linked to teachers’ unions and education activists, attempted to gather enough signatures to trigger a referendum on repealing the province’s policy of providing up to 70 percent of per-student funding to non-profit independent schools. Writing in The Hub, Formosa effectively summarizes the main arguments of the debate, concluding: “Alberta voters were given the chance to rethink the structure of their education system and narrow the choices available to families. They declined. When other provinces consider reform, they would be wise to pay attention.” Meanwhile, Cardus’s own Catharine Kavanagh writes in Edmonton’s Business that the failure of the defunding petition should lead Alberta’s government “to pursue an ever-more supportive policy environment that will offer and fund more learning choices, not fewer.”
The Last 60 Seconds
Ben Sasse first came onto my radar when he was elected to the US Senate to represent Nebraska in 2014, taking office in January 2015. I’ve since read all of his books and followed his career closely. His 2017 book The Vanishing American Adult: Our Coming-of-Age Crisis — and How to Rebuild a Culture of Self-Reliance diagnoses what he sees as a crisis in civic maturity among young Americans and urges parents to cultivate responsibility and engagement. His 2018 book Them: Why We Hate Each Other — and How to Heal explores the growing polarization in American society and argues for repairing our social and cultural bonds. It was surprising when Sasse left the Senate in January 2023 to become president of the University of Florida, a position he held until July 2024, when he left due to his wife’s health issues. In December 2025, he announced a diagnosis of stage-four pancreatic cancer, which provides the context for a podcast in which he reflects not just on his career, but on mortality and legacy. I listened to his Uncommon Knowledge interview, "Basketball in the Last 60 Seconds: Ben Sasse on Mortality, Meaning, and the Future of America," more than once and found it very moving, as did some Insights readers who forwarded it to me with strong recommendations. It’s a thoughtful, personal, and profound hour, well worth your time.
MEANINGFUL METRICS
Many commentators criticize both Quebec and Alberta politicians for discussing provincial separation from Canada. Sometimes, all the talk of provincial disgruntlement can lead to a frustrated “if they want to go, just let them go” mentality. This week, the Angus Reid Institute released a survey of people outside of those provinces, asking what they would do if they had a vote in the matter. Within the margin of error, around three out of four Canadians would vote to keep both provinces in confederation, showing slightly more love for Alberta than for Quebec. Perhaps that reflects interest in Alberta’s people and natural resources, and the experience of Quebec’s longer history of separation referendums. The data delves into perceptions about national pride and identity, the potential effect of separation on the rest of Canada, and which province “takes more than it gives”—an issue that’s especially relevant in Alberta, given questions there about the fairness of national economic arrangements.
TAKE IT TO-GO
In the end, it wasn’t our turn to light the lamp. The Americans skated away with gold, finishing strong and proving once again that at the Olympic level, the margins are as thin as a skate blade. Credit where is due: they forechecked fiercely, defended with discipline, and buried their chance when it mattered most.
I don’t want to run interference on their victory, but for Canadians, a loss in Olympic hockey always stings. One Connor (McDavid) dazzled only to be shut out by another Connor (Hellebuyck). There’s always a next time. By then, we should have another Connor (Bedard) on our side. But let’s keep perspective. One result, even a gold-medal result, doesn’t put our national game in the penalty box. We tip our helmets to the Americans for earning gold. But Canadians are resilient, and the heart of the game still beats strong from sea to sea—or, more precisely, on backyard rinks, frozen ponds, and in packed arenas in what is decidedly not the 51st state. Some of us even cheer for a team with the maple leaf on its jersey all winter long, not just every four years. Olympic glory may be golden, but our love of the game is evergreen—and no loss can ice that.
See you again next Saturday morning.