Connect with us

Fraser Institute

Bill Maher is right about Canadian health care

Published

4 minute read

From the Fraser Institute

By Mackenzie Moir

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.

Todayville is a digital media and technology company. We profile unique stories and events in our community. Register and promote your community event for free.

Follow Author

2025 Federal Election

Fixing Canada’s immigration system should be next government’s top priority

Published on

From the Fraser Institute

By John Ibbitson

Whichever party forms government after the April 28 election must put Canada’s broken immigration system at the top of the to-do list.

This country has one of the world’s lowest fertility rates. Were it not for immigration, our population would soon start to decline, just as it’s declining in dozens of other low-fertility countries around the world.

To avoid the social and economic tensions of an aging and declining population, the federal government should re-establish an immigration system that combines a high intake with strictly enforced regulations. Once Canadians see that program in place and working, public support for immigration should return.

Canada’s total fertility rate (the number of children, on average, a woman will have in her lifetime) has been declining, with the odd blip here and there, since the 1960s. In 1972, it fell below the replacement rate of 2.1.

According to Statistics Canada, the country’s fertility rate fell to a record low of 1.26 in 2023. That puts us in the company of other lowest-low fertility countries such as Italy (1.21), Japan (1.26) and South Korea (0.82).

Those three countries are all losing population. But Canada’s population continues to grow, with immigrants replacing the babies who aren’t born. The problem is that, in the years that followed the COVID-19 lockdowns, the population grew too much.

The Liberal government was unhappy that the pandemic had forced Canada to restrict immigration and concerned about post-pandemic labour shortages. To compensate, Ottawa set a target of 500,000 new permanent residents for 2025, double the already-high intake of about 250,000 a year that had served as a benchmark for the Conservative government of Stephen Harper and the Liberal governments of Paul Martin and Jean Chrétien.

Ottawa also loosened restrictions on temporary foreign worker permits and the admission of foreign students to colleges and universities. Both populations quickly exploded.

Employers preferred hiring workers from overseas rather than paying higher wages for native-born workers. Community colleges swelled their ranks with international students who were also issued work permits. Private colleges—Immigration Minister Marc Miller called them “puppy mills”—sprang up that offered no real education at all.

At the same time, the number of asylum claimants in Canada skyrocketed due to troubles overseas and relaxed entry procedures, reaching a total of 457,285 in 2024.

On January 1 of this year, Statistics Canada estimated that there were more than three million temporary residents in the country, pushing Canada’s population up above 41.5 million.

Their presence worsened housing shortages, suppressed wages and increased unemployment among younger workers. The public became alarmed at the huge influx of foreign residents.

For the first time in a quarter century, according to an Environics poll, a majority of Canadians believed there were too many immigrants coming into Canada.

Some may argue that the solution to Canada’s demographic challenges lie in adopting family-friendly policies that encourage couples to have children. But while governments improve parental supports and filter policies through a family-friendly lens—for example, houses with backyards are more family-friendly than high-rise towers—no government has been able to reverse declining fertility back up to the replacement rate of 2.1.

The steps to repairing Canada’s immigration mess lie in returning to first principles.

According to Statistics Canada, there were about 300,000 international students at postsecondary institutions when the Liberals came to power in 2015. Let’s return to those levels.

The temporary foreign worker program should be toughened up. The government recently implemented stricter Labour Market Impact Assessments, but even stricter rules may be needed to ensure that foreign workers are only brought in when local labour markets cannot meet employer needs, while paying workers a living wage.

New legislation should ensure that only asylum claimants who can demonstrate they are at risk of persecution or other harm in their home country are given refuge in Canada, and that the process for assessing claims is fair, swift and final. If necessary, the government should consider employing the Constitution’s notwithstanding clause to protect such legislation from court challenges.

Finally, the government should admit fewer permanent residents under the family reunification stream and more from the economic stream. And the total admitted should be kept to around 1 per cent of the total population. That would still permit an extremely robust intake of about 450,000 new Canadians each year.

Restoring public confidence in Canada’s immigration system will take much longer than it took to undermine that confidence. But there can be no higher priority for the federal government. The country’s demographic future is at stake.

Continue Reading

Alberta

Energy sector will fuel Alberta economy and Canada’s exports for many years to come

Published on

From the Fraser Institute

By Jock Finlayson

By any measure, Alberta is an energy powerhouse—within Canada, but also on a global scale. In 2023, it produced 85 per cent of Canada’s oil and three-fifths of the country’s natural gas. Most of Canada’s oil reserves are in Alberta, along with a majority of natural gas reserves. Alberta is the beating heart of the Canadian energy economy. And energy, in turn, accounts for one-quarter of Canada’s international exports.

Consider some key facts about the province’s energy landscape, as noted in the Alberta Energy Regulator’s (AER) 2023 annual report. Oil and natural gas production continued to rise (on a volume basis) in 2023, on the heels of steady increases over the preceding half decade. However, the dollar value of Alberta’s oil and gas production fell in 2023, as the surging prices recorded in 2022 following Russia’s invasion of Ukraine retreated. Capital spending in the province’s energy sector reached $30 billion in 2023, making it the leading driver of private-sector investment. And completion of the Trans Mountain pipeline expansion project has opened new offshore export avenues for Canada’s oil industry and should boost Alberta’s energy production and exports going forward.

In a world striving to address climate change, Alberta’s hydrocarbon-heavy energy sector faces challenges. At some point, the world may start to consume less oil and, later, less natural gas (in absolute terms). But such “peak” consumption hasn’t arrived yet, nor does it appear imminent. While the demand for certain refined petroleum products is trending down in some advanced economies, particularly in Europe, we should take a broader global perspective when assessing energy demand and supply trends.

Looking at the worldwide picture, Goldman Sachs’ 2024 global energy forecast predicts that “oil usage will increase through 2034” thanks to strong demand in emerging markets and growing production of petrochemicals that depend on oil as the principal feedstock. Global demand for natural gas (including LNG) will also continue to increase, particularly since natural gas is the least carbon-intensive fossil fuel and more of it is being traded in the form of liquefied natural gas (LNG).

Against this backdrop, there are reasons to be optimistic about the prospects for Alberta’s energy sector, particularly if the federal government dials back some of the economically destructive energy and climate policies adopted by the last government. According to the AER’s “base case” forecast, overall energy output will expand over the next 10 years. Oilsands output is projected to grow modestly; natural gas production will also rise, in part due to greater demand for Alberta’s upstream gas from LNG operators in British Columbia.

The AER’s forecast also points to a positive trajectory for capital spending across the province’s energy sector. The agency sees annual investment rising from almost $30 billion to $40 billion by 2033. Most of this takes place in the oil and gas industry, but “emerging” energy resources and projects aimed at climate mitigation are expected to represent a bigger slice of energy-related capital spending going forward.

Like many other oil and gas producing jurisdictions, Alberta must navigate the bumpy journey to a lower-carbon future. But the world is set to remain dependent on fossil fuels for decades to come. This suggests the energy sector will continue to underpin not only the Alberta economy but also Canada’s export portfolio for the foreseeable future.

Jock Finlayson

Senior Fellow, Fraser Institute
Continue Reading

Trending

X