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Fraser Institute

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

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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.

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Economy

Solar and Wind Power Are Expensive

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From the Fraser Institute

By Bjørn Lomborg

Politicians—supported by powerful green energy interests and credulous journalists—keep gaslighting voters claiming green energy is cheaper than fossil fuels.

Global evidence is clear: Adding more solar and wind to the energy supply pushes up the price of electricity for consumers and businesses. Families in Ontario know this already from their bitter experience: from 2005, the Ontario government began phasing out coal energy and dived headlong into subsidizing wind and solar generation.

Those green policies led to a sharp hike in electricity prices. From 2005 to 2020 the average, inflation-adjusted cost of electricity doubled from 7.7 cents to 15.3 cents. Since 2019 the Ontario government has subsidized these high costs through a slew of programs like the “Renewable Cost Shift”, lowering the direct pain to ratepayers but simply moving the increasing costs onto the government coffers. Today, this policy costs Ontario more than $6 billion annually, four-times what was being spent in 2018.

A relatively small amount of wind energy costs Ontarians over a billion dollars each year. One peer-reviewed study finds that the economic costs of wind are at least three times their benefits. Only the owners of wind power make any money, whereas the “losers are primarily the electricity consumers followed by the governments.”

Yet, politicians—supported by powerful green energy interests and credulous journalists—keep gaslighting voters claiming green energy is cheaper than fossil fuels.

They argue fundamentally that the green transition is not just cheap but even that it makes money, because wind and solar are cheaper than fossil fuels.

At best, this is only true when the sun is shining and the wind is blowing. At all other times, their cost is significantly higher. Modern societies need around-the-clock power. The intermittency of solar and wind energy means backup is required, often delivered by fossil fuels. That means citizens end up paying for two power systems: renewables and their backup. Moreover, much more transmission is needed to ensure wind and solar reach users, and backup fossil fuels, as they are used less, have even fewer hours to earn back their capital costs. Both increase costs further.

This intermittency can be huge, as when solar power in the Yukon delivered a massive 150 times more electricity to the grid in May 2022 than it did in December 2022. It is also the reason that the real energy costs of solar and wind are far higher than green campaigners claim. Just look around the world to see how that plays out.

One study shows that in China, when including the cost of backup power, the real cost of solar power becomes twice as high as that of coal. Similarly, a peer-reviewed study of Germany and Texas shows that the real costs of solar and wind are many times more expensive than fossil fuels. Germany, the U.K., Spain, and Denmark, all of which increasingly rely on solar and wind power, have some of the world’s most expensive electricity.

Source: IEA.org energy prices data set

This is borne out by the actual costs paid across the world. The International Energy Agency’s latest data from nearly 70 countries from 2022 shows a clear correlation between more solar and wind and higher average household and business energy prices. In a country with little or no solar and wind, the average electricity cost is about 16 cents per kilowatt-hour. For every 10 per cent increase in solar and wind share, the electricity cost increases by nearly 8 cents per kWh. The results are substantially similar for 2019, before the impacts of Covid and the Ukraine war.

In Germany, electricity costs 43 cents per kWh—much more than twice the Canadian cost, and more than three-times the Chinese price. Germany has installed so much solar and wind that on sunny and windy days, renewable energy satisfies close to 70 per cent of Germany’s needs—a fact the press eagerly reports. But the press hardly mentions dark and still days, when these renewables deliver almost nothing. Twice in the past couple of months, when it was cloudy and nearly windless, solar and wind delivered less than 4 per cent of the daily power Germany needed.

Current battery technology is insufficient. Germany’s entire battery storage runs out in about 20 minutes. That leaves more than 23 hours of energy powered mostly by fossil fuels. Last month, with cloudy skies and nearly no wind, Germany faced the costliest power prices since the energy crisis caused by Russia’s invasion of Ukraine in 2022, with wholesale prices reaching a staggering $1.40 per kWh.

Canada is blessed with plentiful hydro, powering 58 per cent of its electricity. This means that there has been less drive to develop wind and solar, which deliver just 7 per cent. But the urge to virtue signal remains. Indeed, the federal government’s 2023 vision for the electricity system declares that shifting away from fossil fuels is a “scientific and moral imperative” and “the greatest economic opportunity of our lifetime”.

Yet the biggest take-away from the global evidence is that among all the nations in the world—many with very big, green ambitions—there is not one that gets much of its power from solar and wind and has low electricity costs. The lower-right of the chart is simply empty.

Instead, there are plenty of nations with lots of green energy and exorbitantly high costs.

Bjørn Lomborg

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Energy

Next federal government should close widening gap between Canadian and U.S. energy policy

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From the Fraser Institute

By Kenneth P. Green

After accounting for backup, energy storage and associated indirect costs—estimated solar power costs skyrocket from US$36 per megawatt hour (MWh) to as high as US$1,548, and wind generation costs increase from US$40 to up to US$504 per MWh.

At a recent energy conference in Houston, U.S. Energy Secretary Chris Wright said the Trump administration will end the Biden administration’s “irrational, quasi-religious policies on climate change that imposed endless sacrifices on our citizens.” He added that “Natural gas is responsible for 43 per cent of U.S. electricity production,” and beyond the obvious scale and cost problems, there’s “simply no physical way that wind, solar and batteries could replace the myriad uses of natural gas.”

In other words, as a federal election looms, once again the United States is diverging from Canada when it comes to energy policy.

Indeed, wind power is particularly unattractive to Wright because of its “incredibly high prices,” “incredibly huge investment” and “large footprint on the local communities,” which make it unattractive to people living nearby. Globally, Wright observes, “Natural gas currently supplies 25 per cent of raw energy globally, before it is converted into electricity or some other use. Wind and solar only supply about 3 per cent.”

And he’s right. Renewables are likely unable, physically or economically, to replace natural gas power production to meet current or future needs for affordable, abundant and reliable energy.

In a recent study published by the Fraser Institute, for example, we observed that meeting Canada’s predicted electricity demand through 2050 using only wind power (with natural gas discouraged under current Canadian climate policies) would require the construction of approximately 575 wind-power installations, each the size of Quebec’s Seigneurie de Beaupré wind farm, over 25 years. However, with a construction timeline of two years per project, this would equate to 1,150 construction years. This would also require more than one million hectares of land—an area nearly 14.5 times the size of Calgary.

Solar power did not fare much better. According to the study, to meet Canada’s predicted electricity demand through 2050 with solar-power generation would require the construction of 840 solar-power generation stations the size of Alberta’s Travers Solar Project. At a two-year construction time per facility, this adds up to 1,680 construction years to accomplish.

And at what cost? While proponents often claim that wind and solar sources are cheaper than fossil fuels, they ignore the costs of maintaining backup power to counter the unreliability of wind and solar power generation. A recent study published in Energy, a peer-reviewed energy and engineering journal, found that—after accounting for backup, energy storage and associated indirect costs—estimated solar power costs skyrocket from US$36 per megawatt hour (MWh) to as high as US$1,548, and wind generation costs increase from US$40 to up to US$504 per MWh.

The outlook for Canada’s switch to renewables is also dire. TD Bank estimated that replacing existing gas generators with renewables (such as solar and wind) in Ontario could increase average electricity costs by 20 per cent by 2035 (compared to 2021 costs). In Alberta, electricity prices would increase by up to 66 per cent by 2035 compared to a scenario without changes.

Under Canada’s current greenhouse gas (GHG) regulatory regime, natural gas is heavily disfavoured as a potential fuel for electricity production. The Trudeau government’s Clean Electricity Regulations (CER) would begin curtailing the use of natural gas beginning in 2035, leading largely to a cessation of natural gas power generation by 2050. Under CER and Ottawa’s “net-zero 2050” GHG emission framework, Canada will be wedded to a quixotic mission to displace affordable reliable natural gas power-generation with expensive unreliable renewables that are likely unable to meet expected future electricity demand.

With a federal election looming, Canada’s policymakers should pay attention to new U.S. energy policy on natural gas, and pull back from our headlong rush into renewable power. To avoid calamity, the next federal government should scrap the Trudeau-era CER and reconsider the entire “net-zero 2050” agenda.

Kenneth P. Green

Senior Fellow, Fraser Institute
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