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

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:

Bacchus Barua and Mackenzie Moir

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Latest shakedown attempt by Canada Post underscores need for privatization

Published on July 2, 2025

Todayville

From the Fraser Institute

By Alex Whalen and Jake Fuss

For the second time in just six months, the Canadian Union of Postal Workers (CUPW) is threatening strike action. As Canadians know all too well, postal strikes can be highly disruptive given the federal government provides Canada Post with a near-monopoly on letter mail across the country. CUPW is well aware of this and uses it to their advantage in negotiations. While CUPW has the right to ask for whatever they like, Canadians should finally be freed from this albatross.

In January, the Trudeau government loaned Canada Post a whopping $1.034 billion to help “maintain its solvency and continue operating.” Since 2018, Canada Post has lost more than $4.6 billion, and according to its latest financial update, lost more than $100 million in the first quarter of 2025 alone. Canadians are on the hook for these losses because the federal government owns Canada Post.

Salaries and other employee costs comprise more than 66 per cent of Canada Post’s expenses, and CUPW and Canada Post management both know they can simply pass any losses on to Canadians. Consequently, there’s less incentive for management to control the bottom line or make reasonable budget requests when negotiating with the government. But if the government privatizes Canada Post, it would impose a proper constraint on costs that doesn’t currently exist. This is only fair given there’s no compelling reason why Canadians should underwrite the inflation of salaries in a money-losing Crown corporation.

Of course, government ownership of Canada Post is archaic. When the organization was founded more than 250 years ago, the world was quite different. In today’s age of Amazon, a plethora of delivery services exist coast-to-coast that serve Canadian consumers. Other countries including the Netherlands, Austria and Germany long ago privatized their postal services. The result was increased competition, which in turn reduced prices and improved quality.

Alongside privatization, the federal government should also eliminate Canada Post’s near-monopoly status on letter mail. This policy is purportedly meant to ensure universal service. But in reality, it prohibits other potential service providers from entering the letter-delivery market (including in remote areas that may experience less Canada Post service post-privatization), deprives Canadians of choice, and crucially, reduces the incentive for Canada Post to improve its service.

Simply put, the federal government should focus on its core responsibilities, and delivering mail is clearly not one of them. Given Canada Post’s latest attempted shakedown of Canadians, it’s never been clearer that it’s time for Canada Post to go the way of Air Canada, de Havilland and CN Rail. Once upon a time, the federal government owned all three of these entities until it became clear there was no reason for the government to own an airline, build planes or deliver goods by train. Why is letter mail any different? Canadians deserve better.

Business

Municipal government per-person spending in Canada hit near record levels

Published on July 1, 2025

Todayville

From the Fraser Institute

By Austin Thompson

Municipal government spending in Canada hit near record levels in recent years, finds a new study by the Fraser Institute, an independent, non-partisan Canadian public policy think-tank.

“In light of record-high spending in municipalities across Canada, residents should consider whether or not crime, homelessness, public transit and other services have actually improved,” said Austin Thompson, senior policy analyst at the Fraser Institute and author of The Expanding Finances of Local Governments in Canada.

From 2000 to 2023, per-person spending (inflation-adjusted) increased by 25.2 per cent, reaching a record-high $5,974 per person in 2021 before declining slightly to $5,851 in 2023, the latest year of available data.

During that same period, municipal government revenue—generated from property taxes and transfers from other levels of government—increased by 33.7 per cent per person (inflation-adjusted).

And yet, among all three levels of government including federal and provincial, municipal government spending (adjusted for inflation) has actually experienced the slowest rate of growth over the last 10 years, underscoring the large spikes in spending at all government levels across Canada.

“Despite claims from municipal policymakers about their dire financial positions, Canadians should understand the true state of finances at city hall so they can decide whether they’re getting good value for their money,” said Jake Fuss, director of fiscal studies at the Fraser Institute.

The Expanding Finances of Local Governments in Canada, 1990–2023

Canada’s local governments have experienced substantial fiscal growth in recent decades.
Revenue and expenditure by local governments—including municipal governments, school boards, and Indigenous governments—have increased faster than population growth and inflation combined. From 1990 to 2023, real per-capita revenue rose by 32.7%, and expenditure by 30.0%.
Local governments represent a significant component of Canada’s broader public sector. In 2023, net of inter-governmental transfers, municipal governments and school boards accounted for 18.6% of total government expenditure and 11.1% of revenue.
Despite this growth, local governments’ share of overall government revenue and expenditure has declined over time—especially since the COVID-19 pandemic—as federal and provincial budgets have expanded even more rapidly.
Nevertheless, between 2008 and 2023 the inflation-adjusted per-capita revenue of municipal governments in-creased by 10.1% and their expenditure by 12.4% , on average across the provinces.
Over the same period, municipal governments recorded above-inflation increases in their combined annual operating surpluses, which contributed to an 88.1% inflation-adjusted rise in their net worth—raising important questions about the allocation of accumulated resources.
In 2023, Ontario recorded the highest per-capita municipal revenue among the provinces ($4,156), while Alberta had the highest per-capita expenditure ($3,750). Prince Edward Island reported the lowest per-capita municipal revenue ($1,635) and expenditure ($1,186).
Wide variation in per-capita municipal revenue and expenditure across the provinces reflects differences in the responsibilities provinces assign to municipalities, as well as possible disparities in the efficiency of service delivery—issues that warrant further scrutiny.