CHSPR Seminar | Medical Budgets in an Aging Canada
Why protecting universal access now requires generationally fair revenue reform
Paul Kershaw, UBC School of Population and Public Health
Tuesday, Jan 20, 2026
12-1 pm PT
SPPH or Zoom (Paul Kershaw will speak in person)
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Over the past half century, the share of Canadians aged 65 and over has doubled, from roughly 10 to 20 per cent. Because the typical senior uses approximately four times as much medical care as a patient under age 50, population aging now exerts substantial pressure on provincial medical budgets. Drawing on CIHI data and new age-adjusted fiscal analysis, Dr Kershaw shows that if Canada had today the same age distribution it had when baby boomers were young, provinces and territories would be spending approximately $66 billion less per year on medical care. The failure to plan for the revenue required to finance this predictable increase in spending now flips nearly all provincial budgets from surplus to deficit. These findings re-engage long-standing debates in health economics. Influential analyses in the 1990s and early 2000s characterized population aging as a “glacial” force, adding roughly one percentage point per year to medical spending, deemed manageable with prudent fiscal planning. At the same time, scholars emphasized rising per-capita service intensity among older patients as an additional driver of cost growth. Kershaw’s study shows that although these pressures were clearly identified in the literature, provinces largely failed to adapt their revenue systems. While the federal government implemented a 68 per cent increase in Canada Pension Plan premiums in the late 1990s, no parallel modernization occurred for medical-care financing. Sustaining universal access to medical care now requires governments to respond by modernizing medical-care financing to reflect the intergenerational distribution of costs. Kershaw proposes a “Better Late Than Never” task force to design this transition.
Paul Kershaw is an associate professor in the UBC School of Public Health, public speaker, regular media contributor, and Founder of Generation Squeeze. He received the UBC President’s Award for Public Education through the Media in 2023, and the 2016 award for Academic of the Year from the Confederation of University Faculty Associations of BC. He has been honoured twice by the Canadian Political Science Association with national prizes for his gender and politics research. Paul and the Gen Squeeze team received BC Housing Central’s Affordable Housing Champion award in 2017, and the Government of Canada 2018 award for excellence in moving ‘Knowledge to Action’ on housing. Paul’s work has contributed directly to historic investments in $10 a day child care across Canada, the first ever tax on empty homes in North America, eliminating limitless rent increases in Ontario for units built before 2019, changes to municipal zoning, approval of dozens of new rental housing developments facing NIMBY’ism, a shift in BC to reduce income taxes by taxing unhealthy home prices more, and the first-ever reporting of age trends in federal public finance. Paul and Gen Squeeze successfully led the Intergenerational Climate Coalition to intervene in Saskatchewan, Ontario and Supreme Courts to defend the constitutionality of pricing pollution on the grounds it is needed to promote population health and intergenerational equity. Most recently, he was a driving force behind the federal government’s decision to organize Budget 2024 around the promise of “Fairness for every generation.”
Register in advance for this seminar. After registering, you will receive a confirmation email containing information about joining the meeting.