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By Dr. Dylan Marando

April 4, 2025

March 11th marked five years since the day the World Health Organization declared COVID-19 a global pandemic. Though overshadowed by other major news stories, the anniversary was an occasion to mourn the tragedies of the crisis, laud the heroism of those who brought us out of the emergency, and reflect on lessons learned.

Pausing on that third category of remembrance, it’s worth underlining the once-chilling prospect of an unreliable health care supply chain and the commitment it took from our public policy leaders to avoid that outcome. In 2020, our immediate priority was to ensure we had the capacity to test, vaccinate, and treat the coronavirus at scale. And, to our great credit, we did a good job on those scores.

Additionally, and encouragingly, as we gained more confidence in our ability to manage the immediate challenge, there was a recognition that we needed to give other corners of our health care economy a more impactful and resilient product pipeline. Being more deliberate and creative about how our systems used, sourced, and built core goods and services was the right thing to do for patients. It was the right thing to do for the sustainability of our fiscal plans. And it had the added and critical benefit of being the smart thing to do for Canada’s massive health care workforce, which carries more than 12% of our national GDP, has long been embedded in both our public and private sectors and, therefore, might be the single most-primed industry for a rapid pivot toward a new kind of leadership in a new kind of global economy. For a moment, there seemed to be a recognition that Canadian health care could be our country’s greatest social andeconomic asset.

Alas, as recent reports have hinted, we never quite delivered on that growth aspiration. The Canadian health care economy remains robust and there are meaningful new success stories popping-up on a regular basis. But, in aggregate, the sector is dragging its feet on important metrics such as AI computing capacity, R&D spending, and commercialization. Whether it was the elongation of the pandemic, the ensuing cost-of-living challenges, or merely the urge to revitalize other domains of our economy, we didn’t get the job done when it came to scaling and diversifying our health care supply chain. Patients and providers continue to feel the strain that results from such a missed opportunity.

Perhaps we fooled ourselves into thinking that the job was going to be easier, or that we could achieve a completely different scale of industrial impact without instituting similarly ambitious reforms to health care delivery. One can be forgiven for a bit of over-ambitiousness at a moment of global upheaval. But, as the proverb says: Fool me once, shame on you. Fool me twice, shame on me. Today, Canadians find themselves in the second half of that maxim — facing yet another international disruption to the flow of goods and services, and yet again determined to assert a new level of economic sovereignty. But this time around, we’ve had five years to understand the dos and don’ts of the exercise. So, if we fail to address the present threat to our supply chain, we might be to blame.

The scaling of the Canadian health care economy isn’t just about patients and providers; it’s also about jobs — many, many, many jobs — in the way that smart economic policy is always about people.

Which begs the question: How do we get the job done? How do we give patients more reliable access to better health care, now and for the long-term? How do we give health care providers the timesaving and cost-saving solutions they need exactly when they need them? How do we make sure the next cohort of international superstar data scientists and biomedical engineers choose to build careers and grow businesses here in Canada? At a moment of geopolitical change, how can we make Canada the world’s health care superpower?

Well, let’s talk about it. There can be a tendency in Canadian health care to avoid big but necessary discussions about structural reform. Too often, we fall into the trap of assuming that change is taboo among Canadians; or, worse yet, we think there’s only one way of managing a universally accessible, publicly-funded, single-payer health insurance system (which, in general, we are right to fiercely protect). To complicate matters, because so many other sectors are now in a precarity mindset as well based on unexpected threats, it is even easier for health care reform to be crowded-out of our economic discourse. But health care leaders have a duty to insert themselves into such debates and to ensure that a central feature of the Canadian identity isn’t neglected at a time of national reimagining.

So, first, let’s talk. And second, let’s act.

Let’s not do what we did last time, or the time before that (see SARS), when we tackled immediate crises with extraordinary skill only to then drift on the underlying health care delivery dynamics that could have accelerated positive patient outcomes. This time, we need to operate with the speed and energy of a crisis manager as well as the thoughtfulness and stamina of a master planner. Fortunately, there are a lot of tools in the box. As I’ve suggested elsewhere, patient-based funding reforms, an expansion of patient-engagement models, a more strategic focus on particular disease-states, greater emphasis on early-stage disease detection, and an all-in commitment to AI in health care, are just a few obvious levers to vigorously pull if we want to reform health care delivery in this country. There are undoubtedly others around the corner in every provincial health care system that we should also be embracing.

Third, on the mission-critical topic of supply chain resiliency, let’s recognize that whatever lever we pull on health care delivery reform will be wrenched with the power to mobilize colossal investments in Canadian production, jobs, and ingenuity. If we have the courage to say that any company who wants to do business with our new and improved health care systems should also have a business in this country, then the growth formula for the Canadian economy starts to look a lot different and a lot rosier. Imagine a Canada where our hospitals, clinics, and health teams are being resourced by firms with a long-term commitment to high-paying Canadian jobs, made-in-Canada manufacturing, local R&D, and partnerships with both domestic suppliers and international customers. Regional economies could be reinvigorated and diversified. Entrepreneurs could act with both a renewed financial and social purpose. And a shock-proof pipeline of goods and services starts to look more and more realistic.

So, it bears loud repeating: The scaling of the Canadian health care economy isn’t just about patients and providers; it’s also about jobs — many, many, many jobs — in the way that smart economic policy is always about people. We shouldn’t be shy to admit that some investments have a double-bottom line. We shouldn’t be shy about saying that now is a time when every decision we make must apply an economic lens. And although there’s always some shiny new industry trending, we need to be honest about the fact that there are few sectors in Canada that can contribute more to a double bottom line than the health care sector.

We need to make bold moves in areas of our economy that can make big pivots fast. The Canadian health care economy can do exactly that. So, let’s get the job done.

Dr. Dylan Marando is Head of Strategy & Government Affairs for Siemens Healthcare Canada, and former Deputy Director of Policy to the Prime Minister of Canada.