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Opinion: Doug Ford hands Donald Trump a trade weapon

Extending 'Buy Ontario' into health care gives the U.S. a big trade talking point and takes chances with Ontarians' health

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Ontario’s health care system is buckling under various pressures right now. More than 2.5 million Ontarians don’t have a family doctor and more than half of Ontario’s family physicians plan to retire in the next five years. After seeing a general practitioner, the average wait time to see a specialist is 15.3 weeks, which is up more than 300 per cent since 1993. If you need an MRI or CT scan, you’ll have to wait for those, as well. The average wait time for a CT scan in Ontario is six weeks, 12 weeks for an MRI.

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If you are being treated at a hospital, there is a growing chance it will be from a stretcher. Since 2018, when Doug Ford became premier, care on stretchers in hallways has risen 140 per cent. Around 2,000 people in the province get hallway treatment every day. All this is happening at a time when Ontario’s finance minister says the growth in health care spending is unsustainable.

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It’s hard enough to believe outcomes are ever going to get better. And now the province’s “Buy Ontario” mandate is going to extend into health care. That’s reason to suppose things will get even worse.

For the province to introduce Trump-style procurement policies is both harmful and hypocritical.

For months, Doug Ford has been a fixture on American cable news delivering stern lectures on the economic self-destruction that is protectionism. His government spent millions in taxpayer dollars on TV ads invoking Ronald Reagan to shame Washington into abandoning its high-tariff agenda. The message was clear, moral and correct: trade barriers hurt everyone. Consumers pay more, economies shrink, almost everyone loses — in fact, maybe literally everyone, since in the long run protectionism reduces the protected industry’s competitiveness.

But then Doug Ford does exactly what he’s been condemning. Extension of his government’s “Buy Ontario” procurement preferences into the medical equipment and health technology sectors is Trump-style economic nationalism wearing an Ontario Red Ensign. Mandating that Ontario hospitals give preference to domestic suppliers of MRI machines, surgical robots, diagnostic software and the like is every bit as self-harming as Trump’s Buy America protectionism. The principle doesn’t change simply because the geography does.

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Beyond the hypocrisy, there is the question of what protectionism does to the availability of medical devices. As things stand, device shortages were up 19 per cent in 2024-2025. Further restricting supply can only worsen the already precarious state of Ontario’s health care. Tilting procurement to Ontario-preferred suppliers does not magically bring better or cheaper medical equipment into existence. Just the opposite: fewer bidders means less price pressure. Less price pressure means higher costs. Higher costs, in a system already running on fumes, means fewer resources for everything else.

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The purpose of competitive procurement is to get the best product at the best price. In health care, the best product is not the one with the most provincial content. It is the one that best serves patient outcomes. The last thing going through a patient’s mind before a pacemaker is installed is “was this gizmo made in Ontario?”

Not every policy should be regarded as a jobs program. Turning health care procurement into one would have real human costs. When a hospital is deciding between a domestic cardiac monitoring system and an internationally sourced one the question should be: which saves more lives? Not: which employs more Ontarians?

To make matters worse, protectionist provincial procurement complicates Canada’s trade position at precisely the moment when coherence is most needed. Provincial procurement walls hand Washington a ready-made grievance and an easy talking point: that Canada’s free-trade commitments are aspirational at the federal level and optional everywhere else.

Every “Buy Ontario” preference in a government contract is an argument the Americans can use against us. Ontario’s premier cannot simultaneously demand that Washington honour its free-trade obligations while his own government undermines the principle provincially.

When you ration competition in medicine, you raise both costs and risk. Patients on the wrong side of a suboptimal procurement decision don’t get to file a complaint. They simply get worse outcomes. Ford is dead right when he stands before American cameras and argues that protectionism is a form of economic self-harm. But he’s not really in a position to be making that argument anymore.

David Clement is North American affairs manager at the Consumer Choice Center.

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