Canada’s healthcare system, long heralded for its universality, is increasingly failing those who need it most. Behind the illusion of equal access lie deep and growing disparities, especially among low-income, Indigenous, racialized, and unhoused populations. This white paper synthesizes over a decade of scholarship and system innovation led by Dr. Andrew Boozary, who reframes these inequities not as unfortunate outcomes, but as structural failures of policy, design, and investment.
Drawing from evidence across peer-reviewed publications, institutional models, and public policy commentary, this paper explores the cognitive, clinical, and systemic impacts of poverty and structural exclusion. It analyzes the rise of “social admissions” as a symptom of health–social policy disintegration and presents a blueprint for restructuring Canadian healthcare through the lens of social medicine.
The paper culminates in concrete policy recommendations — expanding public coverage, embedding peer and community health workers, dismantling policy silos, and reframing evaluation metrics around equity and dignity. Dr. Boozary’s social medicine model, tested and scaled at the University Health Network in Toronto, offers a compelling prototype for transformation. This white paper invites policymakers, practitioners, and citizens to confront the moral and systemic incoherence at the heart of Canadian healthcare and co-create a system where equity is no longer optional.
