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Fraser Institute

Canadians want major health-care reform now

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3 minute read

From the Fraser Institute

By Mackenzie Moir

Tragic stories of multiyear waits for patients are now a Canadian news staple. Is it any wonder, therefore, that a new Navigator poll found almost two-thirds of Canadians experienced (either themselves or a family member) unreasonably long for access to health care. The poll also found that 73 per cent of respondents agree the system needs major reform.

This situation shouldn’t surprise anyone. Last year Canadians could expect a 27.7-week delay for non-emergency treatment. Nearly half this time (13.1 weeks) was spent waiting for treatment after seeing a specialist—that’s more than one month longer than what physicians considered reasonable.

And it’s not as though these unreasonable waits are simple inconveniences for patients; they can have serious consequences including continued pain, psychological distress and disability. For many, there are also economic consequences for waiting due to lost productivity or wages (due to difficulty or inability to work) or for Canadians who pay for care in another country.

Canadians are also experiencing longer delays than their European and Australian universal health-care peers. In 2020, Canadians were the least likely (62 per cent) to report receiving non-emergency surgical treatment in under four weeks compared to Germans (99 per cent) and Australians (72 per cent).

What do they do differently? Put simply, they approach universal care in a different way than we do.

In particular, these countries all have a sizeable and well-integrated private sector that helps deliver universal care including surgical care. For example, in 2021, 45 per cent of hospitals in Germany (a plurality) were private for-profit. And 99 per cent of German hospital beds are accessible to those covered under the country’s mandatory insurance scheme. In Australia, governments regularly contract with private hospitals to provide surgical care, with private facilities handling 41 per cent of all hospital services in 2021/22.

These universal health-care countries also tend to fund their hospitals differently.

Governments in Canada primarily fund hospitals through “global budgets.” With a fixed budget set at the beginning of the year, this funding method is unconnected to the level of services provided. Consequently, patients are treated as costs to be minimized.

In contrast, hospitals in most European countries and Australia are funded on the basis of their activity. As a result, because they are paid for services they actually deliver, hospitals are incentivized to provide higher volumes of care.

The data are clear. Canadian patients are frustrated with their health-care system and have an appetite for change. We stand to learn from other countries who maintain their universal coverage while delivering health care faster than in Canada.

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Business

All politicians—no matter the party—should engage with natural resource industry

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From the Fraser Institute

By Kenneth P. Green

When federal Environment Minister Steven Guilbeault recently criticized Conservative Leader Pierre Poilievre for hosting a fundraiser that included an oil company executive, he raised an interesting question. How should our politicians—of all parties—engage with Canada’s natural resource sector and the industry leaders that drive our natural resource economy?

Consider a recent report by the Chamber of Commerce, entitled Canada’s Natural Wealth, which notes that Canada’s natural resources sector contributed $464 billion to Canada’s economy (measured by real GDP) and supported 3 million jobs in 2023. That represented 21 per cent of the national economy and 15 per cent of employment.

Within the natural resources sector, mining, oil and gas, and pipeline transmission represent 45 per cent of all GDP impact from the sector. Oil and gas production accounted for $71 billion in GDP in 2023. If you throw in the support sector for oil and gas production, and for manufacturing petroleum and coal products, that number reaches nearly $100 billion in GDP.

Shouldn’t any responsible leader want to regularly consult with industry leaders in the natural resource sector to determine how they can facilitate expansion of the sector’s contribution to Canada’s economy?

The Chamber also notes that the natural resource sector is a massive contributor to Canada’s balance of trade, reporting that last year the “sector generated $377 billion in exports, accounting for nearly 50% of Canada’s merchandise exports, and a $228 billion trade surplus (that is, exports over imports) —critical for offsetting trade deficits (more imports than exports) in other sectors.”

Again, shouldn’t all government leaders want to work with industry leaders to promote even more natural resource trade and exports?

The natural resource sector also accounts for one out of every seven jobs in Canada’s economy, and the wages offered in the natural resource sector are higher than the national average—annual wages in the sector were $25,000 above the national average in 2023. And workers in the sector are about 2.5 times more productive, meaning they contribute more to the economy compared to workers in other industries.

One more time—shouldn’t all of Canada’s political leaders, regardless of political stripe, want to work with natural resource producers to create more high-paying jobs for more Canadians?

Finally, the Chamber of Commerce report suggests that some environmental policies require swift reform. Proliferating regulations have made investing in Canada a “riskier and more costly proposition.” The report notes that carbon pricing, Clean Fuel Regulations, proposed Clean Electricity Regulations, proposed federal emissions cap and proposed methane regulations all deter investment in Canada. Which means less economic opportunity for many Canadian workers.

With so much of Canada’s economic prosperity at stake, it’s not improper—as Guilbeault and others suggest—for any politician to meet with and seek political support from Canada’s natural resource industry leaders. Indeed, to not meet with and listen to these leaders would be an act of economic recklessness and constitute imprudent leadership of the worst kind.

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Economy

Federal government’s recent fiscal record includes unprecedented levels of spending and debt

Published on

From the Fraser Institute

By Jake Fuss and Grady Munro

As of 2024, Ottawa’s debt equals $51,467 per Canadian—12.3 per cent more than in 1995 when Canada reached a near-debt crisis.

According to an Angus Reid poll from earlier this year, 59 per cent of Canadians believe the federal government is spending too much and 64 per cent said they’re concerned about the size of the budget deficit. Nanos Research had similar polling results, finding 63 per cent of Canadians want Ottawa to reduce spending. These polling results are not surprising given the alarming state of federal finances.

The Trudeau government has consistently spent at record-high levels before, during and after COVID. In fact, Prime Minister Trudeau is on track to record the seven-highest years of per-person spending in Canadian history between 2018 and 2024. Inflation-adjusted spending (excluding debt interest costs) is expected to reach $11,856 per person this year—10.2 per cent higher than during the 2008-09 financial crisis and 28.7 per cent higher than during the peak of the Second World War.

Consequently, the Trudeau government has posted 10 consecutive deficits since taking office. The projected deficit in 2024/25 is a whopping $39.8 billion. This string of deficits has spurred a dramatic increase in federal debt. From 2014/15 (Prime Minister Harper’s last full year) to 2024/25, total federal debt is expected to have nearly doubled to $2.1 trillion. To make matters worse, the government plans to run more deficits until at least 2028/29 and total debt could rise by an additional $400.1 billion by March 2029.

Indeed, due to reckless decisions, the Trudeau government is on track to record the five-highest years of per-person debt (inflation-adjusted) in Canadian history between 2020 and 2024. As of 2024, Ottawa’s debt equals $51,467 per Canadian—12.3 per cent more than in 1995 when Canada reached a near-debt crisis.

Worse still, that doesn’t include any provincial or municipal debt, so the total government debt burden per Canadian is considerably higher.

Of course, to pay for this sky-high spending, the Trudeau government has borrowed and raised taxes. In addition to recently raising taxes on capital gains—harming entrepreneurship, investment and growth—the government has raised personal income taxes on middle-income families. Today, 86 per cent of middle-income Canadian families pay more in taxes than they did in 2015.

And what has this combination of tax increases and record-high spending and debt delivered for Canadians?

Amid widespread concerns about the rising cost of living, the average Canadian family is spending more on taxes than on food, shelter and clothing combined. Despite a recent federal budget supposedly focused on “fairness for every generation,” younger generations face a disproportionately higher tax burden in the future due to debt accumulated today. Meanwhile, Canadian living standards (as measured by inflation-adjusted GDP per person) are in a historic decline and (as of June 2024) stood 3.2 per cent below 2019 levels.

The current state of federal finances is simply unacceptable. Ottawa can and must do better. Canadians are already feeling the consequences, and it will only continue to get worse for future generations if we don’t constrain spending and return to balanced budgets soon.

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