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Fraser Institute

Canadians want major health-care reform now

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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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Energy

Global fossil fuel use rising despite UN proclamations

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From the Fraser Institute

By Julio Mejía and Elmira Aliakbari

Major energy transitions are slow and take centuries, not decades… the first global energy transition—from traditional biomass fuels (including wood and charcoal) to fossil fuels—started more than two centuries ago and remains incomplete. Nearly three billion people in the developing world still depend on charcoal, straw and dried dung for cooking and heating, accounting for about 7 per cent of the world’s energy supply (as of 2020).

At the Conference of the Parties (COP29) in Azerbaijan, António Guterres, the United Nations Secretary-General, last week called for a global net-zero carbon footprint by 2050, which requires a “fossil fuel phase-out” and “deep decarbonization across the entire value chain.”

Yet despite the trillions of dollars already spent globally pursuing this target—and the additional trillions projected as necessary to “end the era of fossil fuels”—the world’s dependence on fossil fuels has remained largely unchanged.

So, how realistic is a “net-zero” emissions world—which means either eliminating fossil fuel generation or offsetting carbon emissions with activities such as planting trees—by 2050?

The journey began in 1995 when the UN hosted the first COP conference in Berlin, launching a global effort to drive energy transition and decarbonization. That year, global investment in renewable energy reached US$7 billion, according to some estimates. Since then, an extraordinary amount of money and resources have been allocated to the transition away from fossil fuels.

According to the International Energy Agency, between 2015 and 2023 alone, governments and industry worldwide spent US$12.3 trillion (inflation-adjusted) on clean energy. For context, that’s over six times the value of the entire Canadian economy in 2023.

Despite this spending, between 1995 and 2023, global fossil fuel consumption increased by 62 per cent, with oil consumption rising by 38 per cent, coal by 66 per cent and natural gas by 90 per cent.

And during that same 28-year period, despite the trillions spent on energy alternatives, the share of global energy provided by fossil fuels declined by only four percentage points, from 85.6 per cent to 81.5 per cent.

This should come as no surprise. Major energy transitions are slow and take centuries, not decades. According to a recent study by renowned scholar Vaclav Smil, the first global energy transition—from traditional biomass fuels (including wood and charcoal) to fossil fuels—started more than two centuries ago and remains incomplete. Nearly three billion people in the developing world still depend on charcoal, straw and dried dung for cooking and heating, accounting for about 7 per cent of the world’s energy supply (as of 2020).

Moreover, coal only surpassed wood as the main energy source worldwide around 1900. It took more than 150 years from oil’s first commercial extraction for oil to reach 25 per cent of all fossil fuels consumed worldwide. Natural gas didn’t reach this threshold until the end of the 20th century, after 130 years of industry development.

Now, consider the current push by governments to force an energy transition via regulation and spending. In Canada, the Trudeau government has set a target to fully decarbonize electricity generation by 2035 so all electricity is derived from renewable power sources such as wind and solar. But merely replacing Canada’s existing fossil fuel-based electricity with clean energy sources within the next decade would require building the equivalent of 23 major hydro projects (like British Columbia’s Site C) or 2.3 large-scale nuclear power plants (like Ontario’s Bruce Power). The planning and construction of significant electricity generation infrastructure in Canada is a complex and time-consuming process, often plagued by delays, regulatory hurdles and substantial cost overruns.

The Site C project took around 43 years from initial feasibility studies in 1971 to securing environmental certification in 2014. Construction began on the Peace River in northern B.C. in 2015, with completion expected in 2025 at a cost of at least $16 billion. Similarly, Ontario’s Bruce Power plant took nearly two decades to complete, with billions in cost overruns. Given these immense practical, financial and regulatory challenges, achieving the government’s 2035 target is highly improbable.

As politicians gather at high-profile conferences and set ambitious targets for a swift energy transition, global reliance on fossil fuels has continued to increase. As things stand, achieving net-zero by 2050 appears neither realistic nor feasible.

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Energy

Ottawa’s proposed emission cap lacks any solid scientific or economic rationale

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From the Fraser Institute

By Jock Finlayson and Elmira Aliakbari

Forcing down Canadian oil and gas emissions within a short time span (five to seven years) is sure to exact a heavy economic price, especially when Canada is projected to experience a long period of weak growth in inflation-adjusted incomes and GDP per person.

After two years of deliberations, the Trudeau government (specifically, the Environment and Climate Change Canada department) has unveiled the final version of Ottawa’s plan to slash greenhouse gas emissions (GHGs) from the oil and gas sector.

The draft regulations, which still must pass the House and Senate to become law, stipulate that oil and gas producers must reduce emissions by 35 per cent from 2019 levels by between 2030 and 2032. They also would establish a “cap and trade” regulatory regime for the sector. Under this system, each oil and gas facility is allocated a set number of allowances, with each allowance permitting a specific amount of annual carbon emissions. These allowances will decrease over time in line with the government’s emission targets.

If oil and gas producers exceed their allowances, they can purchase additional ones from other companies with allowances to spare. Alternatively, they could contribute to a “decarbonization” fund or, in certain cases, use “offset credits” to cover a small portion of their emissions. While cutting production is not required, lower oil and gas production volumes will be an indirect outcome if the cost of purchasing allowances or other compliance options becomes too high, making it more economical for companies to reduce production to stay within their emissions limits.

The oil and gas industry accounts for almost 31 per cent of Canada’s GHG emissions, while transportation and buildings contribute 22 and 13 per cent, respectively. However, the proposed cap applies exclusively to the oil and gas sector, exempting the remaining 69 per cent of the country’s GHG emissions. Targeting a single industry in this way is at odds with the policy approach recommended by economists including those who favour strong action to address climate change.

The oil and gas cap also undermines the Trudeau government’s repeated claims that carbon-pricing is the main lever policymakers are using to reduce GHG emissions. In its 2023 budget (page 71), the government said “Canada has taken a market-driven approach to emissions reduction. Our world-leading carbon pollution pricing system… is highly effective because it provides a clear economic signal to businesses and allows them the flexibility to find the most cost-effective way to lower their emissions.”

This assertion is vitiated by the expanding array of other measures Ottawa has adopted to reduce emissions—hefty incentives and subsidies, product standards, new regulations and mandates, toughened energy efficiency requirements, and (in the case of oil and gas) limits on emissions. Most of these non-market measures come with a significantly higher “marginal abatement cost”—that is, the additional cost to the economy of reducing emissions by one tonne—compared to the carbon price legislated by the Trudeau government.

And there are other serious problems with the proposed oil and gas emissions gap. For one, emissions have the same impact on the climate regardless of the source; there’s no compelling reason to target a single sector. As a group of Canadian economists wrote back in 2023, climate policies targeting specific industries (or regions) are likely to reduce emissions at a much higher overall cost per tonne of avoided emissions.

Second, forcing down Canadian oil and gas emissions within a short time span (five to seven years) is sure to exact a heavy economic price, especially when Canada is projected to experience a long period of weak growth in inflation-adjusted incomes and GDP per person, according to the OECD and other forecasting agencies. The cap stacks an extra regulatory cost on top of the existing carbon price charged to oil and gas producers. The cap also promises to foster complicated interactions with provincial regulatory and carbon-pricing regimes that apply to the oil and gas sector, notably Alberta’s industrial carbon-pricing system.

The Conference Board of Canada think-tank, the consulting firm Deloitte, and a study published by our organization (the Fraser Institute) have estimated the aggregate cost of the federal government’s emissions cap. All these projections reasonably assume that Canadian oil and gas producers will scale back production to meet the cap. Such production cuts will translate into many tens of billions of lost economic output, fewer high-paying jobs across the energy supply chain and in the broader Canadian economy, and a significant drop in government revenues.

Finally, it’s striking that the Trudeau government’s oil and gas emissions cap takes direct aim at what ranks as Canada’s number one export industry, which provides up to one-quarter of the country’s total exports. We can’t think of another advanced economy that has taken such a punitive stance toward its leading export sector.

In short, the Trudeau government’s proposed cap on GHG emissions from the oil and gas industry lacks any solid scientific, economic or policy rationale. And it will add yet more costs and complexity to Canada’s already shambolic, high-cost and ever-growing suite of climate policies. The cap should be scrapped, forthwith.

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