This week was all about hard choices. From Prime Minister Mark Carney’s $60B infrastructure push to warnings about rising healthcare costs and U.S. drug pricing threats, the Canadian government is walking a fiscal tightrope.
Carney Announces First Five Major Projects for Review by New Major Projects Office
Prime Minister Mark Carney announced the first five major projects that will be fast-tracked under the new Major Projects Office, including LNG Canada Phase 2, the Darlington New Nuclear Project, Contrecœur Terminal expansion, the McIlvenna Bay copper mine, and Red Chris mine expansion. Together worth over $60 billion, the list is part of a broader nation-building agenda aimed at boosting clean energy, critical minerals, and trade.
While some former politicians warned that social programs could face cuts, Carney has pledged to protect pharmacare and dental care, even as he emphasized a new strategy focused on results over objectives and investments over prohibitions.
In Edmonton, Carney reaffirmed his government’s intent on working towards signing more Pharmacare deals “as quickly and as equitably as possible.” This commitment follows speculation that the federal government is backtracking on the program, prompting protesters from the Canadian Health Coalition and other groups to urge the immediate implementation of Pharmacare.
However, the prime minister clarified that the upcoming federal budget reflects “tough decisions” to continue health and social programs, including Pharmacare, dental care, and child care. Carney emphasized that fiscal discipline will be central to balancing social program commitments with rising costs tied to trade disputes and economic pressures.
In response, critics, including Pierre Poilievre and Saskatchewan Energy Minister Jim Reiter, argued that the Major Projects Office adds bureaucracy and noted that uranium projects were not included, while premiers welcomed regional projects.
Bloc Québécois MPs Xavier Barsalou-Duval and Patrick Bonin criticized Carney’s government for using Bill C-5 to push gas and oil projects while bypassing environmental assessments and Quebec’s jurisdiction. They warned that including the Port à Contrecœur project under the law undermines democratic principles and signals further backtracking on Canada’s climate commitments.
However, Alberta Premier Danielle Smith praised the first batch of projects on Ottawa’s fast-track list, highlighting LNG Canada Phase 2 as a key initiative to diversify exports and strengthen Canada’s energy sovereignty, while industry leaders emphasized its role in economic growth and energy security.
Nunavut Premier P.J. Akeeagok expressed optimism about the announcements, noting that while Nunavut’s initiatives were not included in the first round, the Arctic Security Corridor – Gray’s Bay Road and Port is a candidate for future consideration. He highlighted four transformative projects—the Qikiqtarjuaq Deep-Sea Port, Arctic Security Corridor, Kivalliq Hydro-Fibre Link, and Iqaluit Hydroelectric Project—that aim to strengthen Arctic sovereignty, reduce diesel dependence, and create lasting community opportunities.
U.S. Drug Pricing Policy Escalates Pressure on Canada
U.S. President Donald Trump’s “Most Favoured Nation” (MFN) order threatens Canada’s ability to keep prescription drug prices low. The MFN order aims to prevent Americans from paying more than the lowest global prices, impacting countries like Canada, which benefits from discounted drug prices negotiated through mechanisms like the Pan-Canadian Pharmaceutical Alliance.
Andrew Kemle, government and external relations manager of the Graduate Students’ Association at the University of Calgary, argued that Canada must counteract dependency and strengthen its pharmaceutical sector by facilitating the transfer of intellectual property to university spinoffs, thereby encouraging local business investments in university partnerships. Additionally, leveraging graduate students through scholarships to collaborate with domestic businesses could further integrate university-industry interactions.
As Trump’s MFN policy gains traction, the policy is also backed by pressure on pharmaceutical manufacturers to lower prices, marking a strategic approach in reforming how drug prices are set in the U.S.
The industry has shifted blame to pharmacy benefit managers (PBMs), intermediaries that negotiate drug discounts, which contrasts with PBMs’ reported role of saving costs and reducing patients’ expenses. Meanwhile, the PBM Reform Act risks further complicating the situation by hampering PBMs’ negotiation capabilities amid the backdrop of substantial pharmaceutical industry lobbying efforts.
Amid these rising cross-border pressures, Annette Robinson, Chair of the Canadian Pharmacists Association (CPhA), called for the federal government to take immediate action to protect the access and affordability of medications for Canadians. Robinson stressed the potential risks these U.S. policies could pose to Canada’s drug market, highlighting the need for proactive measures to ensure Canadians continue to have reliable access to necessary medications.
In a bid to streamline government and accelerate innovation, Health Canada, the Public Health Agency of Canada (PHAC), and the Treasury Board released nearly 500 initiatives. Health Canada and the PHAC released a report outlining 42 initiatives to reduce regulatory red tape while safeguarding public health and safety. These measures focus on aligning with international standards, enhancing client services, applying risk-based regulation, streamlining outdated rules, and enabling new products and technologies to support innovation and economic growth.
Treasury Board President Shafqat Ali announced that the federal red tape review identified almost 500 initiatives aimed at streamlining services, reducing duplication, and cutting costs. These measures would accelerate access to new drugs, support sectors like transportation and agriculture, improve project review timelines, and enhance collaboration with provinces and trading partners to boost productivity.
Among the nearly 500 proposals, examples include eliminating CBSA requirements for transiting international travellers, allowing drones to transport certain low-risk dangerous goods, and reforming the Canadian Armed Forces grievance system. Ali emphasized that the Red Tape Reduction Office will work with stakeholders and regulators to ensure progress.
The Minister of Finance and National Revenue followed with the Red Tape Review Progress Report, which detailed 33 initiatives across the financial, tax, and public finance sectors. These include simplifying CRA tax filing, reducing compliance burdens for financial institutions, eliminating redundant guidelines, and strengthening collaboration with provinces to promote investment and economic growth.
But not everyone is convinced. Business leaders praised the ambition, while critics argued that the review risks ushering in austerity and cuts to regulatory agencies. They warned that while the government aims to speed up project approvals and stimulate economic growth, weakened oversight could compromise public safety.
Provinces Expand Emergency Services with Major Upgrades
A new Fraser Institute study estimated that in 2025, the average Canadian family will pay between $5,213 and $19,060 for public healthcare insurance, depending on family type. The cost of healthcare has risen much faster than food, shelter, clothing, and even average income since 1997, with families in the lowest 10% of income will pay about $702, while the highest-income families will contribute nearly $59,000.
The study noted that many Canadians underestimate their healthcare costs because payments are embedded in general taxes rather than shown on direct bills.
Ending the week on a proactive note, several provinces have launched initiatives to improve emergency medical services. The Newfoundland and Labrador government has initiated a $561.7 million contract with Medavie Health NL, aiming to integrate the province’s road and air ambulance systems, previously operated separately, under a unified management structure. Furthermore, Medavie will partner with Provincial Aerospace, incorporating subcontractors like Air Borealis to enhance aviation services for coastal communities. N.L. Premier John Hogan is set to announce an update on the provincial ambulance system integration on September 9 at the Charles S. Curtis Memorial Hospital in St. Anthony.
Saskatchewan has also upgraded its air ambulance services, with a Saskatchewan Air Ambulance aircraft being enhanced with a larger entry door and advanced patient support systems, aimed at facilitating the transport of patients with complex medical needs across the province, including remote and northern regions.
Similarly, Ontario Deputy Premier and Minister of Health Sylvia Jones has announced close to $5.5 million in funding to increase the availability of paramedics and ambulances, enhancing emergency care service in the community. Additionally, a pilot program at Sault Area Hospital is allowing non-urgent patients to wait virtually at home before receiving treatment, potentially reducing congestion in emergency rooms.
This week’s stories paint a picture of a government treading the line between vision and constraint. As Ottawa maps out a future of major infrastructure, ambitious healthcare goals, and economic headwinds, the stakes are high—and so are the expectations.
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