Fraser Institute
Bill Maher is right about Canadian health care
From the Fraser Institute
Recently, popular American comedian and talk show host, Bill Maher, took aim at some of Canada’s public policy failings in one of his monologues. In entertaining fashion, Maher highlighted our high housing costs, unemployment rates and “vaunted” health-care system.
Indeed, citing work published by the Fraser Institute, he explained that after adjusting for age, Canada spends 13.3 per cent of our economy on health care (2020), the highest level of spending by a developed country with universal coverage that year. And that Canada has some of the poorest access to timely appointments with family doctors when compared to our peers.
Unfortunately, while that’s where his segment on health care ended, the bad news for the Canadian system doesn’t stop there.
On top of Canada continuing to be one of the most expensive universal health-care systems in the world, we get little in return when it comes to both available medical resources and wait times. For example, among high-income countries with universal health care, Canada has some of the lowest numbers of physicians, hospital beds, MRI machines and CT scanners.
And in Canada, only 38 per cent of patients report seeing a specialist within four weeks (compared to 69 per cent in the Netherlands) and only 62 per cent report receiving non-emergency surgery within four months (compared to 99 per cent in Germany).
Unfortunately, wait times in Canada aren’t simply long compared to other countries, they’re the longest they’ve ever been. Last year the median wait for a Canadian patient seeking non-emergency care reached 27.7 weeks—nearly three times longer than the 9.3 week-wait Canadians experienced three decades ago.
This raises the obvious question. How do other countries outperform Canada’s health-care system while also often spending less as a share of their economies? In short, their approach to universal health care, and in particular their relationship with the private sector, departs drastically from the approach here at home.
Australia, for example, partners with private hospitals to deliver the majority (58.6 per cent) of all non-emergency surgeries within its universal health-care system. Australia also spends less of its total economy (i.e. GDP) on health care but outperforms Canada on every measure of timely care.
Even with restrictions on the private sector, Canada has some limited experience that should encourage policymakers to embrace greater private-sector involvement. Saskatchewan, for example, contracted with private surgical clinics starting in 2010 to deliver publicly-funded services as part of a four-year initiative to reduce wait times, which were among the longest in the country. Between 2010 and 2014, wait times in the province fell from 26.5 weeks to 14.2 weeks. After the initiative ended, the province’s wait times began to grow.

More recently, Quebec, which has some of the shortest wait times for medical services in the country, contracts out one out of every six day-surgeries to private clinics within the publicly-funded health-care system.
Maher’s monologue, which was viewed by millions online, highlighted the key failings of Canada’s health-care system. If policymakers in Ottawa and the provinces want to fix Canadian health care, they must learn from other countries that deliver universal health-care at the same or even lower cost, often with better access and results for patients.
Author:
Business
Carney and other world leaders should recognize world’s dependence on fossil fuels
From the Fraser Institute
By Julio Mejía and Elmira Aliakbari
Simply put, despite trillions invested in the energy transition, the world is more dependent on fossil fuels today than when the United Nations launched its first COP. No wonder that ahead of COP30, leading voices of the net-zero-by-2050 agenda, including Bill Gates, are acknowledging both the vital role of fossil fuels on the planet and the failure of efforts to cut them.
On the heels of his first federal budget, which promises more spending to promote a “green economy,” Prime Minister Carney will soon fly to Brazil for COP30, the 30th United Nations climate summit. Like the former Trudeau government, the Carney government has pledged to achieve “net-zero” emissions in Canada—and compel other countries to pursue net-zero—by 2050. To achieve a net-zero world, it’s necessary to phase out fossil fuels—oil, natural gas, coal—or offset their CO2 emissions with technologies such as “carbon capture” or large-scale tree planting.
But after trillions of dollars spent in pursuit of that goal, it appears more unrealistic than ever. It’s time for world leaders, including Canada’s policymakers, to face reality and be honest about the costly commitments they make on behalf of their citizens.
For starters, carbon capture—the process of trapping and storing carbon dioxide so it’s unable to affect the atmosphere—is a developing technology not yet capable of large-scale deployment. And planting enough trees to offset global emissions would require vast amounts of land, take decades to absorb significant CO2 and risk unpredictable losses from wildfires and drought. Due to these constraints, in their net-zero quest governments and private investors have poured significant resources into “clean energy” such as wind and solar to replace fossil fuels.
According to the International Energy Agency (IEA), from 2015 to 2024, the world’s public and private investment in clean energy totalled and estimated US$14.6 trillion (inflation-adjusted). Yet from 1995 (the first COP year) to 2024, global fossil fuel consumption increased by more than 64 per cent. Specifically, oil consumption grew by 39 per cent, natural gas by 96 per cent and coal by 76 per cent. As of 2024, fossil fuels accounted for 80.6 per cent of global energy consumption, slightly lower than the 85.6 per cent in 1995.
The Canadian case shows an even greater mismatch between Ottawa’s COP commitments and its actual results. Despite billions spent by the federal government on the low-carbon economy (electric vehicle subsidies, tax credits to corporations, etc.), fossil fuel consumption in our country has increased by 23 per cent between 1995 and 2024. Over the same period, the share of fossil fuels in Canada’s total energy consumption climbed from 62.0 to 66.3 per cent.
Simply put, despite trillions invested in the energy transition, the world is more dependent on fossil fuels today than when the United Nations launched its first COP. No wonder that ahead of COP30, leading voices of the net-zero-by-2050 agenda, including Bill Gates, are acknowledging both the vital role of fossil fuels on the planet and the failure of efforts to cut them.
Why has this massive effort, which includes many countries and trillions of dollars, failed to transition humanity away from fossil fuels?
As renowned scholar Vaclav Smil explains, it can take centuries—not decades—for an energy source to become globally predominant. For thousands of years, humanity relied on wood, charcoal, dried dung and other traditional biomass fuels for heating and cooking, with coal only becoming a major energy source around 1900. It took oil 150 years after its introduction into energy markets to account for one-quarter of global fossil fuel consumption, a milestone reached only in the 1950s. And for natural gas, it took about 130 years after its commercial development to reach 25 per cent of global fossil fuel consumption at the end of the 20th century.
Yet, coal, oil and natural gas didn’t completely replace traditional biomass to meet the surging energy demand as the modern world developed. As of 2020, nearly three billion people in developing countries still relied on charcoal, straw and dried dung to supply their basic energy needs. In light of these facts, the most vocal proponents of the global energy transition seem, at the very least, out of touch.
The world’s continued reliance on fossil fuels should prompt world leaders at COP30 to exercise caution before pushing the same unrealistic commitments of the past. And Prime Minister Carney, in particular, should be careful not to keep leading Canadians into costly ventures that lead nowhere near their intended results.
Alberta
Alberta government’s plan will improve access to MRIs and CT scans
From the Fraser Institute
By Nadeem Esmail and Tegan Hill
The Smith government may soon allow Albertans to privately purchase diagnostic screening and testing services, prompting familiar cries from defenders of the status quo. But in reality, this change, which the government plans to propose in the legislature in the coming months, would simply give Albertans an option already available to patients in every other developed country with universal health care.
It’s important for Albertans and indeed all Canadians to understand the unique nature of our health-care system. In every one of the 30 other developed countries with universal health care, patients are free to seek care on their own terms with their own resources when the universal system is unwilling or unable to satisfy their needs. Whether to access care with shorter wait times and a more rapid return to full health, to access more personalized services or meet a personal health need, or to access new advances in medical technology. But not in Canada.
That prohibition has not served Albertans well. Despite being one of the highest-spending provinces in one of the most expensive universal health-care systems in the developed world, Albertans endure some of the longest wait times for health care and some of the worst availability of advanced diagnostic and medical technologies including MRI machines and CT scanners.
Introducing new medical technologies is a costly endeavour, which requires money and the actual equipment, but also the proficiency, knowledge and expertise to use it properly. By allowing Albertans to privately purchase diagnostic screening and testing services, the Smith government would encourage private providers to make these technologies available and develop the requisite knowledge.
Obviously, these new providers would improve access to these services for all Alberta patients—first for those willing to pay for them, and then for patients in the public system. In other words, adding providers to the health-care system expands the supply of these services, which will reduce wait times for everyone, not just those using private clinics. And relief can’t come soon enough. In Alberta, in 2024 the median wait time for a CT scan was 12 weeks and 24 weeks for an MRI.
Greater access and shorter wait times will also benefit Albertans concerned about their future health or preventative care. When these Albertans can quickly access a private provider, their appointments may lead to the early discovery of medical problems. Early detection can improve health outcomes and reduce the amount of public health-care resources these Albertans may ultimately use in the future. And that means more resources available for all other patients, to the benefit of all Albertans including those unable to access the private option.
Opponents of this approach argue that it’s a move towards two-tier health care, which will drain resources from the public system, or that this is “American-style” health care. But these arguments ignore that private alternatives benefit all patients in universal health-care systems in the rest of the developed world. For example, Switzerland, Germany, the Netherlands and Australia all have higher-performing universal systems that provide more timely care because of—not despite—the private options available to patients.
In reality, the Smith government’s plan to allow Albertans to privately purchase diagnostic screening and testing services is a small step in the right direction to reduce wait times and improve health-care access in the province. In fact, the proposal doesn’t go far enough—the government should allow Albertans to purchase physician appointments and surgeries privately, too. Hopefully the Smith government continues to reform the province’s health-care system, despite ill-informed objections, with all patients in mind.
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