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Fraser Institute

Canada’s median health-care wait time hits 30 weeks—longest ever recorded

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From the Fraser Institute

By Mackenzie Moir and Bacchus Barua

Canadian patients in 2024 waited longer than ever for medical treatment, finds a new study released today by the Fraser Institute, an independent, non-partisan Canadian public policy think-tank.

“While most Canadians understand that wait times are a major problem, we’ve now reached an unprecedented and unfortunate milestone for delayed access to care,” said Bacchus Barua, director of health policy studies at the Fraser Institute and co-author of Waiting Your Turn: Wait Times for Health Care in Canada, 2024.

The annual study, based on a survey of physicians across Canada, this year reports a median wait time of 30 weeks from referral by a general practitioner (i.e. family doctor) to consultation with a specialist to treatment, for procedures across 12 medical specialties including several types of surgery.

This year’s median wait (30 weeks) is the longest ever recorded—longer than the 27.7 weeks in 2023 and the 20.9 weeks in 2019 (before the pandemic), and 222 per cent longer than the 9.3 weeks in 1993 when the Fraser Institute began tracking wait times. Among the provinces, Ontario recorded the shortest median wait time (23.6 weeks, up from 21.6 weeks in 2023) while Prince Edward Island recorded the longest (77.4 weeks—although data for P.E.I. should be interpreted with caution due to fewer survey responses compared to other provinces).

Among the various specialties, national median wait times were longest for orthopedic surgery (57.5 weeks) and neurosurgery (46.2 weeks), and shortest for radiation (4.5 weeks) and medical oncology treatments (4.7 weeks). For diagnostic technologies, wait times were longest for CT scans (8.1 weeks), MRIs (16.2 weeks) and ultrasounds (5.2 weeks).

“Long wait times can result in increased suffering for patients, lost productivity at work, a decreased quality of life, and in the worst cases, disability or death,” said Mackenzie Moir, senior policy analyst at the Fraser Institute and study co-author.

Median wait times by province (in weeks)

  • In 2024, physicians across Canada reported a median wait time of 30.0 weeks between a referral from a GP and receipt of treatment. Up from 27.7 in 2023.
  • This is 222% longer than the 9.3 week wait Canadian patients could expect in 1993.
  • Ontario reported the shortest total wait (23.6 weeks), followed by Quebec (28.9 weeks) and British Columbia (29.5 weeks).
  • Patients waited longest in Prince Edward Island (77.4 weeks), New Brunswick (69.4 weeks) and Newfoundland and Labrador (43.2 weeks).
  • Patients waited the longest for Orthopaedic Surgery (57.5 weeks) and Neurosurgery (46.2 weeks).
  • By contrast, patients faced shorter waits for Radiation Oncology (4.5 weeks) and Medical Oncology (4.7 weeks).
  • The national 30 week total wait is comprised of two segments. Referral by a GP to consultation with a specialist: 15.0 weeks. Consultation with a specialist to receipt of treatment: 15.0 weeks.
  • More than 1900 responses were received across 12 specialties and 10 provinces.
  • After seeing a specialist, Canadian patients waited 6.3 weeks longer than what physicians consider to be clinically reasonable (8.6 weeks).
  • Across 10 provinces, the study estimated that patients in Canada were waiting for 1.5 million procedures in 2024.
  • Patients also suffered considerable delays for diagnostic technology: 8.1 weeks for CT scans, 16.2 weeks for MRI scans, and 5.2 weeks for Ultrasound.

 

Mackenzie Moir

Senior Policy Analyst, Fraser Institute

Bacchus Barua

Director, Health Policy Studies, Fraser Institute

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Fiscal update reveals extent of federal government mismanagement

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From the Fraser Institute

By Jake Fuss and Grady Munro

Following the sudden departure of Chrystia Freeland as finance minister, the Trudeau government released its 2024 fall fiscal update on Monday. Unsurprisingly, spending is up, the deficit has ballooned even higher, and the Trudeau government continues to utterly mismanage Canada’s finances.

Let’s get into the numbers.

For the current fiscal year (2024-25), the update estimates the federal government will spend $543.4 billion while taking in $495.2 billion in revenues. This means the government plans to run a $48.3 billion deficit—$8.5 billion higher than the $39.8 billion deficit that had originally been planned just eight months ago.

The Trudeau government’s incessant need to introduce new spending at every turn has driven this increase in borrowing. Indeed, discretionary spending on programs is now expected to be $6.1 billion higher than initially projected in this year’s budget tabled in April. Revenues have also taken a hit compared to projections from the spring, primarily from the federal government’s new GST holiday.

Not only will the government run a larger deficit this year, but future deficits are also expected to rise. Cumulative deficits from 2025-26 to 2028-29 are now expected to be $14.9 billion higher than projected in the spring budget.

There are costs associated with running deficits and accumulating debt, and Canadians ultimately bear these costs. Just like anyone who takes out a loan at a bank, government must pay interest on the money it borrows. In the case of the federal government, these interest costs will reach an estimated $53.7 billion in 2024-25 alone—more than all revenue collected via the federal GST. In other words, every dollar that Canadians are expected to pay in GST this year will go towards federal debt interest, as opposed to any services or programs. And as the federal government continues to borrow more, all else equal, these interest costs will continue to rise.

While the updated deficits for 2024-25 and beyond are still estimates, the 2024 FES presents what’s likely the final deficit number for the 2023-24 fiscal year. In a remarkable display of fiscal mismanagement, the Trudeau government ran a $61.9 billion deficit last year—$21.9 billion higher than the $40.0 billion deficit projected in the budget.

This means the federal government has broken one of its fiscal rules (a.k.a. guardrails) that help guide policy on spending, taxes and borrowing. One year ago, the Trudeau government established three fiscal rules—including to keep the 2023-24 deficit at or below $40.1 billion. These rules were reaffirmed in the spring budget, and have been a key feature of the Trudeau government’s so-called “responsible economic plan.”

However, there’s nothing responsible about establishing a rule only to break it a year later. Unfortunately, the Trudeau government has made a habit breaking its self-imposed rules. In 2015, the government established its first fiscal rule—balancing the budget by fiscal year 2019-20. But it quickly abandoned this rule in subsequent months and proposed an alternative rule—to reduce federal debt relative to the size of the economy (GDP). But again, this rule became an afterthought, as federal debt increased relative to GDP in 2019-20 and continued to sharply increase during the pandemic and has yet to return to anywhere near pre-COVID levels.

As has happened consistently in the past decade, this year’s fall update reveals that spending and deficits are up compared to the budget plan the government presented just months ago. The Trudeau government is utterly mismanaging the Canada’s finances, which has caused turmoil inside the government while Canadians bear the consequences.

Jake Fuss

Director, Fiscal Studies, Fraser Institute

Grady Munro

Policy Analyst, Fraser Institute
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Massive growth in federal workforce contributes to Ottawa’s red ink

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From the Fraser Institute

By Ben Eisen

At the same time the Trudeau government opened Canada’s borders to historic numbers of immigrants leading to an explosion in population, the federal workforce was growing even faster.. much faster.

Here’s a fact that all Canadians should understand. Prime Minister Justin Trudeau has overseen the seven highest years of federal government spending in Canadian history (on a per-person basis, after adjusting for inflation).

The federal government’s high spending levels have produced a long string of budget deficits and growing mountain of debt. Federal net debt has approximately doubled in nominal terms since 2014/15 (one year before Trudeau took office), rising from $17,800 per person to $34,000 this year.

What’s driving all of this?

There are many factors, including the growth in the number of federal government employees. Our new study published by the Fraser Institute (based on data from the Parliamentary Budget Officer) found that after years of shrinking, the size of the federal government workforce began to grow in the mid-2010s. In fact, it began to grow significantly faster than the Canadian population.

To measure the growth, we used the federal government’s Full Time Equivalents (FTEs), which captures the expected work hours of a fulltime employee and allows for comparisons over time. In 2014/15, there were 340,669 FTE workers working directly for the federal government. By 2022/23 (the latest fiscal year of comparable data), this number had grown to 431,537 or by 26.1 per cent. By comparison, the Canadian population grew 9.1 per cent during this period—still a substantial growth rate, but far slower than the rate of growth of the federal workforce.

Government sector employees

So how much has the rapid growth in federal government jobs cost taxpayers?

In our study, we consider what would have happened had the Trudeau government simply held the rate of growth in federal employment to the rate of population growth. Under this scenario, the federal government’s workforce today would be 57,170 fewer FTE workers than is in fact the case. Given that the average per-FTE cost of federal employment in 2022/23 was $130,583 (which includes salaries and other costs), the savings would have been substantial. Specifically, taxpayers would have saved $7.5 billion in 2022/23 alone. And if this money had not been spent, the federal deficit would have been 21.2 per cent smaller that year.

At all times, but particularly during a period of large deficits, the federal government should scrutinize all areas of spending including government employment. Personnel costs represent approximately half of the federal government’s operating costs, so it’s no surprise that growing employment costs have heavily contributed to Ottawa’s recent string of deficits.

According to the Trudeau government’s latest budget, Ottawa will run deficits for the foreseeable future and in 2029 net federal debt will reach $1.5 trillion. Unless the government reverses its spending trends, the cost of increased government employment will continue to strain federal finances in the years ahead, with taxpayers paying the bill.’

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