As pressure mounts to improve access to the front door of Canada’s health systems, primary care has become a lightning rod. The Canada Health Act (CHA) (1985) has the necessary components to help health systems achieve shared goals, but it has not been sufficient to meet contemporary challenges. Unimaginative and over-restrictive interpretations of this iconic legislation by federal and provincial/territorial governments, as well as opportunistic workarounds of private actors, are pushing health systems away from the vision of the Act’s authors and the expectations of Canadians. Nowhere is this more critical than in primary care. Public expectations of primary care have been profoundly shaped by the CHA, and we suggest leveraging the well-timed and rigorously produced OurCare Standard to guide the path forward. While legislative reform is an option to achieve the Standard and the CHA principles, another is a pan-Canadian health organization mandated to build equity and evidence-informed recommendations for public coverage, bolstering the CHA rather than re-opening it.

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