This article endeavours to explain why English Canadians and Quebeckers differ in their opinions about private healthcare options. Data indicates that respondents in the nine predominantly English-speaking provinces are more likely to oppose private hospitals than Quebeckers. No one province or region in “English Canada” drives these results: aversion to private hospitals is consistent across the nine provinces. Research on welfare states slots Canada into the “liberal” category, which is indicative of a preference for market solutions to welfare problems, which makes this finding perplexing. The argument presented here is that universal healthcare has become bound up with the national identity of English Canada, resulting in a general aversion to private healthcare initiatives outside of Quebec.