Fraser Institute
Canadians are ready for health-care reform—Australia shows the way

From the Fraser Institute
By Bacchus Barua and Mackenzie Moir
Australia offers real-world examples of how public/private partnerships can be successfully integrated in a universal health-care framework. Not only does Australia prove it can be done without sacrificing universal coverage for all, Australia spends less money (as a share of its economy) than Canada and enjoys more timely medical care.
Canada’s health-care system is crumbling. Long wait times, hallway health care and burned-out staff are now the norm. Unsurprisingly, a new poll finds that the majority of Canadians (73 per cent) say the system needs major reform.
As noted in a recent editorial in the Globe and Mail, we can learn key lessons from Australia.
There are significant similarities between the two countries with respect to culture, the economy and even geographic characteristics. Both countries also share the goal of ensuring universal health coverage. However, Australia outperforms Canada on several key health-care performance metrics.
After controlling for differences in age (where appropriate) between the two countries, our recent study found that Australia’s health-care system outperformed Canada’s on 33 (of 36) performance measures. For example, Australia had more physicians, hospital beds, CT scanners and MRI machines per person compared to Canada. And among the 30 universal health-care countries studied, Canada ranked in the bottom quartile for the availability of these critical health-care resources.
Australia also outperforms Canada on key measures of wait times. In 2023 (the latest year of available data), 39.5 per cent of patients in Australia were able to make a same or next day appointment when they were sick compared to only 22.3 per cent in Canada. And 9.6 per cent of Canadians reported waiting more than one year to see a specialist compared to only 4.5 per cent of Australians. Similarly, almost one-in-five (19.9 per cent) Canadians reported waiting more than one year for non-emergency surgery compared to only 11.8 per cent of Australians.
So, what does Australia do differently to outperform Canada on these key measures?
Although the Globe and Mail editorial touches on the availability of private insurance in Australia, less attention is given to the private sector’s prominent role in the delivery of health care.
In 2016 (the latest year of available data) almost half of all hospitals in Australia (48.5 per cent) were private. And in 2021/22 (again, the latest year of available data), 41 per cent of all hospital care took place in a private facility. That percentage goes up to 70.3 per cent when only considering hospital admissions for non-emergency surgery.
But it’s not only higher-income patients who can afford private insurance (or those paying out of pocket) who get these surgeries. The Australian government encourages the uptake of private insurance and partially subsidizes private care (at a rate of 75 per cent of the public fee), and governments in Australia also regularly contract out publicly-funded care to private facilities.
In 2021/22, more than 300,000 episodes of publicly-funded care occurred in private facilities in Australia. Private hospitals also delivered 73.5 per cent of care funded by Australia’s Department of Veterans’ Affairs. And in 2019/20, government sources (including the federal government) paid for almost one-third (32.8 per cent) of private hospital expenditures.
Which takes us back to the new opinion poll (by Navigator), which found that 69 per cent of Canadians agree that health-care services should include private-sector involvement. While defenders of the status quo continue to criticize this approach, Australia offers real-world examples of how public/private partnerships can be successfully integrated in a universal health-care framework. Not only does Australia prove it can be done without sacrificing universal coverage for all, Australia spends less money (as a share of its economy) than Canada and enjoys more timely medical care.
While provincial governments remain stubbornly committed to a failed model, Canadians are clearly expressing their desire for health-care reforms that include a prominent role for private partners in the delivery of universal care.
Australia is just one example. Public/private partnerships are the norm in several more successful universal health-care systems (such as Germany and Switzerland). Instead of continuing to remain an outlier, Canada should follow the examples of Australia and other countries and engage with the private sector to fulfill the promise of universal health care.
Authors:
2025 Federal Election
Housing starts unchanged since 1970s, while Canadian population growth has more than tripled

From the Fraser Institute
By: Austin Thompson and Steven Globerman
The annual number of new homes being built in Canada in recent years is virtually the same as it was in the 1970s, despite annual population growth
now being three times higher, finds a new study published today by the Fraser Institute, an independent, non-partisan Canadian public policy think tank.
“Despite unprecedented levels of immigration-driven population growth following the COVID-19 pandemic, Canada has failed to ramp up homebuilding sufficiently to meet housing demand,” said Steven Globerman, Fraser Institute senior fellow and co-author of The Crisis in Housing Affordability: Population Growth and Housing Starts 1972–2024.
Between 2021 and 2024, Canada’s population grew by an average of 859,473 people per year, while only 254,670 new housing units were started annually. From 1972 to 1979, a similar number of new housing units were built—239,458—despite the population only growing by 279,975 people a year.
As a result, more new residents are competing for each new home than in the past, which is driving up housing costs.
“The evidence is clear—population growth has been outpacing housing construction for decades, with predictable results,” Globerman said.
“Unless there is a substantial acceleration in homebuilding, a slowdown in population growth, or both, Canada’s housing affordability crisis is unlikely to improve.”
The Crisis in Housing Affordability: Population Growth and Housing Starts 1972–2024
- Canada experienced unprecedented population growth following the COVID-19 pandemic without a commensurately large increase in new homebuilding.
- The imbalance between population growth and new housing construction is reflected in a significant gap between housing demand and supply, which is driving up housing costs.
- Canada’s population grew by a record 1.23 million new residents in 2023 almost entirely due to immigration. That growth was more than double the pre-pandemic record set in 2019.
- Population growth slowed to 951,517 in 2024, still well above any year before 2023.
- Nationally, construction began on about 245,367 new housing units in 2024, down from a recent high of 271,198 starts in 2021—Canada’s annual number of housing starts peaked at 273,203 in 1976.
- Canada’s annual number of housing starts regularly exceeded 200,000 in past decades, when absolute population growth was much lower.
- In 2023, Canada added 5.1 new residents for every housing unit started, which was the highest ratio over the study’s timeframe and well above the average rate of 1.9 residents for every unit started observed over the study period (1972–2024).
- This ratio improved modestly in 2024, with 3.9 new residents added per housing start. However, the ratio remains far higher than at any point prior to the COVID-19 pandemic.
- These national trends are broadly mirrored across all 10 provinces, where annual population growth relative to housing starts is, to varying degrees, elevated when compared to long-run averages.
- Without an acceleration in homebuilding, a slowdown in population growth, or both, Canada’s housing affordability crisis will likely persist.
Austin Thompson
Education
Schools should focus on falling math and reading skills—not environmental activism

From the Fraser Institute
In 2019 Toronto District School Board (TDSB) trustees passed a “climate emergency” resolution and promised to develop a climate action plan. Not only does the TDSB now have an entire department in their central office focused on this goal, but it also publishes an annual climate action report.
Imagine you were to ask a random group of Canadian parents to describe the primary mission of schools. Most parents would say something along the lines of ensuring that all students learn basic academic skills such as reading, writing and mathematics.
Fewer parents are likely to say that schools should focus on reducing their environmental footprints, push students to engage in environmental activism, or lobby for Canada to meet the 2016 Paris Agreement’s emission-reduction targets.
And yet, plenty of school boards across Canada are doing exactly that. For example, the Seven Oaks School Division in Winnipeg is currently conducting a comprehensive audit of its environmental footprint and intends to develop a climate action plan to reduce its footprint. Not only does Seven Oaks have a senior administrator assigned to this responsibility, but each of its 28 schools has a designated climate action leader.
Other school boards have gone even further. In 2019 Toronto District School Board (TDSB) trustees passed a “climate emergency” resolution and promised to develop a climate action plan. Not only does the TDSB now have an entire department in their central office focused on this goal, but it also publishes an annual climate action report. The most recent report is 58 pages long and covers everything from promoting electric school buses to encouraging schools to gain EcoSchools certification.
Not to be outdone, the Vancouver School District (VSD) recently published its Environmental Sustainability Plan, which highlights the many green initiatives in its schools. This plan states that the VSD should be the “greenest, most sustainable school district in North America.”
Some trustees want to go even further. Earlier this year, the British Columbia School Trustees Association released its Climate Action Working Group report that calls on all B.C. school districts to “prioritize climate change mitigation and adopt sustainable, impactful strategies.” It also says that taking climate action must be a “core part” of school board governance in every one of these districts.
Apparently, many trustees and school board administrators think that engaging in climate action is more important than providing students with a solid academic education. This is an unfortunate example of misplaced priorities.
There’s an old saying that when everything is a priority, nothing is a priority. Organizations have finite resources and can only do a limited number of things. When schools focus on carbon footprint audits, climate action plans and EcoSchools certification, they invariably spend less time on the nuts and bolts of academic instruction.
This might be less of a concern if the academic basics were already understood by students. But they aren’t. According to the most recent data from the Programme for International Student Assessment (PISA), the math skills of Ontario students declined by the equivalent of nearly two grade levels over the last 20 years while reading skills went down by about half a grade level. The downward trajectory was even sharper in B.C., with a more than two grade level decline in math skills and a full grade level decline in reading skills.
If any school board wants to declare an emergency, it should declare an academic emergency and then take concrete steps to rectify it. The core mandate of school boards must be the education of their students.
For starters, school boards should promote instructional methods that improve student academic achievement. This includes using phonics to teach reading, requiring all students to memorize basic math facts such as the times table, and encouraging teachers to immerse students in a knowledge-rich learning environment.
School boards should also crack down on student violence and enforce strict behaviour codes. Instead of kicking police officers out of schools for ideological reasons, school boards should establish productive partnerships with the police. No significant learning will take place in a school where students and teachers are unsafe.
Obviously, there’s nothing wrong with school boards ensuring that their buildings are energy efficient or teachers encouraging students to take care of the environment. The problem arises when trustees, administrators and teachers lose sight of their primary mission. In the end, schools should focus on academics, not environmental activism.
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