MONTREAL — Canada is projected to spend $433 billion on health in 2026, an increase of 4.8 percent from the previous year, according to new data from the Canadian Institute for Health Information. The figure would bring the health expenditure-to-GDP ratio to 12.8 percent. Real per capita total health spending is expected to rise 2.3 percent in 2026 after accounting for population growth and inflation. Real per capita provincial government health spending is projected to rise 3.2 percent, which is above the annual average of 1.6 percent from 2010 to 2025.
The projections follow nominal spending increases ranging from 5.2 to 8.5 percent over the 2023 to 2025 period. The data suggests a new era of spending increases may be underway, signalling increased investments in health system capacity and care delivery. The numbers for 2026 come after more erratic performance in 2025, especially for provincial government health spending. Real per capita provincial government health spending declined nationally by 0.1 percent in 2025, with Ontario, Quebec and Saskatchewan seeing declines.
In 2026, Newfoundland and Labrador, Prince Edward Island and Ontario are projected to see the largest increases in real per capita provincial government health spending at 9.2, 7.9 and 5.0 percent respectively. The Newfoundland and Ontario increases follow lower growth the previous year. The current year is expected to see strong recoveries in most spending categories except for administration and capital, with the largest increases being for physicians and other health professionals. The long-term drivers of health spending include aging populations, growing populations, access to physicians and technological advances, which are reinforced by backlogs from the pandemic. In 2004, 12.9 percent of the population was aged 65 and older, a figure that grew to 19 percent by 2024. The proportion of provincial-territorial government health spending for those aged 65 and over grew from 45.1 percent in 2005 to 47.5 percent in 2024, confirming that an aging population is associated with more total health spending.
However, an analysis of per capita spending reveals a different trend. Real per capita provincial government health spending is highest for those under age 1 and those aged 75 years and over. The upward shift in per capita spending over the 20-year period from 2004 to 2024 is more noticeable for age categories under 70 to 74. Some of the largest percentage increases in per capita spending are for those under 20 years of age, with large increases also seen for many categories under the age of 60.
Between 2005 and 2024, real per capita spending for the 65 to 69 age group grew just under 8 percent, while for those aged 70 to 74 it grew just under 1 percent. The categories between 75 and 89 years saw real per capita provincial government health spending decline anywhere from 1 to 8 percent. This suggests that, compared to 20 years ago, health spending growth is greater for those under the age of 65 than for those over 65, in real per capita terms. The evidence suggests that moving forward, the mantra that the elderly are responsible for rising health spending may need to be re-examined. The long-term decline in real per capita spending growth rates for the elderly can result from factors including more aggressive cost control by provinces. It is also likely the healthiest generation of seniors in history, with many quite active and relatively fit well into their 70s and 80s, which might be a factor in the moderation of their health spending needs.