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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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Business

Ottawa’s so-called ‘Clean Fuel Standards’ cause more harm than good

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From the Fraser Institute

By Kenneth P. Green

To state the obvious, poorly-devised government policies can not only fail to provide benefits but can actually do more harm than good.

For example, the federal government’s so-called “Clean Fuel Regulations” (or CFRs) meant to promote the use of low-carbon emitting “biofuels” produced in Canada. The CFRs, which were enacted by the Trudeau government, went into effect in July 2023. The result? Higher domestic biofuel prices and increased dependence on the importation of biofuels from the United States.

Here’s how it works. The CFRs stipulate that commercial fuel producers (gasoline, diesel fuel) must use a certain share of “biofuels”—that is, ethanol, bio-diesel or similar non-fossil-fuel derived energetic chemicals in their final fuel product. Unfortunately, Canada’s biofuel producers are having trouble meeting this demand. According to a recent report, “Canada’s low carbon fuel industry is struggling,” which has led to an “influx of low-cost imports” into Canada, undermining the viability of domestic biofuel producers. As a result, “many biofuels projects—mostly renewable diesel and sustainable aviation fuel—have been paused or cancelled.”

Adding insult to injury, the CFRs are also economically costly to consumers. According to a 2023 report by the Parliamentary Budget Officer, “the cost to lower income households represents a larger share of their disposable income compared to higher income households. At the national level, in 2030, the cost of the Clean Fuel Regulations to households ranges from 0.62 per cent of disposable income (or $231) for lower income households to 0.35 per cent of disposable income (or $1,008) for higher income households.”

Moreover, “Relative to disposable income, the cost of the Clean Fuel Regulations to the average household in 2030 is the highest in Saskatchewan (0.87 per cent, or $1,117), Alberta (0.80 per cent, or $1,157) and Newfoundland and Labrador (0.80 per cent, or $850), reflecting the higher fossil fuel intensity of their economies. Meanwhile, relative to disposable income, the cost of the Clean Fuel Regulations to the average household in 2030 is the lowest in British Columbia (0.28 per cent, or $384).”

So, let’s review. A government mandate for the use of lower-carbon fuels has not only hurt fuel consumers, it has perversely driven sourcing of said lower-carbon fuels away from Canadian producers to lower-cost higher-volume U.S. producers. All this to the deficit of the Canadian economy, and the benefit of the American economy. That’s two perverse impacts in one piece of legislation.

Remember, the intended beneficiaries of most climate policies are usually portrayed as lower-income folks who will purportedly suffer the most from future climate change. The CFRs whack these people the hardest in their already-strained wallets. The CFRs were also—in theory—designed to stimulate Canada’s lower-carbon fuel industry to satisfy domestic demand by fuel producers. Instead, these producers are now looking to U.S. imports to comply with the CFRs, while Canadian lower-carbon fuel producers languish and fade away.

Poorly-devised government policies can do more harm than good. Clearly, Prime Minister Carney and his government should scrap these wrongheaded regulations and let gasoline and diesel producers produce fuel—responsibly, but as cheaply as possible—to meet market demand, for the benefit of Canadians and their families. A radical concept, I know.

Kenneth P. Green

Senior Fellow, Fraser Institute
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Business

Carney’s ‘major projects’ list no cause for celebration

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From the Fraser Institute

By Alex Whalen

Early in his term, Prime Minister Mark Carney placed great emphasis on the need to think big and move quickly, to make Canada the “world’s leading energy superpower.” Recently, the government announced the first group of projects to be championed by its new Major Projects Office (MPO), which was also recently created to circumvent existing rules and regulations to speed up approvals. Unfortunately, the list of projects is decidedly underwhelming, which highlights the need for a true course correction when it comes to fixing Canada’s investment crisis.

According to the government, the purpose of the Major Projects Office is to fast-track “nation building” projects, with a focus on regulatory approvals and financing. Yet, of the first five projects referred to the MPO, regulatory approvals have largely already been secured and the projects were likely to proceed without any intervention or assistance from Ottawa.

For example, many of the regulatory approvals required for the Darlington Small Nuclear Reactor are already in place, and construction has already begun. The McIlvenna Bay copper mine in Saskatchewan is already half-built.

Other projects, such as LNG Phase 2 and the Red Chris Copper Mine, both in British Columbia, are expansions of existing facilities and are backed by industry-leading firms such as Shell and Rio Tinto, respectively. In general, these projects do not need government assistance or financing since they’re already largely approved.

A further six projects being referred to the MPO are at an earlier stage of development, and for the most part do not yet require regulatory approvals. Carney has referred this list—which includes projects ranging from carbon capture to high speed rail to offshore wind—to the MPO to be matched with government “business development teams” to “advance these concepts.”

These initiatives parallel the approach by the Trudeau government to rely on government-directed projects to foster economic growth, which failed miserably. The Trudeau government’s economic policies featured a much larger role for government in the economy, including a general increase in the size and scope of the federal government, as measured by increased spending and regulation. The result? Under Trudeau, annual growth of per-person GDP (an indicator of living standards) was just 0.3 per cent, the worst track record of any recent prime minister. Net business investment (foreign direct investment in Canada minus Canadian direct investment abroad) declined by $388 billion between 2015 and 2023 (the latest year of available data).

To set Canada on a course to reverse the investment crisis, Carney must abandon the notion of government-directed economic growth. Approving projects already largely approved, while sending other less-certain projects to government business development bureaucrats, will not fix Canada’s problem. Simply put, the government should craft policy to create the right conditions for investment and entrepreneurship for all firms in all sectors of the economy, not simply its chosen winners.

To attract the kinds of major projects that will meaningfully improve Canada’s investment crisis, the Carney government should eliminate a host of regulations and reform those that survive. As other analysts have noted, the list of regulatory hurdles in Canada is long. Canada’s total regulatory load has increased substantially over time and across a wide range of industries including energy, autos, child care, supermarkets and more.

Nowhere is this more evident than the energy industry, which is one of the largest drivers of investment in Canada. Federal Bills C-69 and C-48 (which govern the project approval process and ban oil tankers on the west cost, respectively), alongside the federal greenhouse gas emissions cap, net-zero policies, and a host of other regulation such as new fuel standard have significantly constrained this industry, which is vital to Canada’s economic success.

Canada’s regulatory explosion has effectively decimated the country’s investment climate. While Bill C-5 allows cabinet to circumvent these regulations, it places the cabinet, and more specifically the prime minister, in the position of picking winners and losers. Broad-based tax and regulatory reduction and reform would be a much more effective approach.

Canada continues to struggle amid an investment crisis that’s holding back economic growth and living standards. Our country needs bold changes to the policy environment conducive to attracting more investment. The government’s response to date, through Bill C-5 and the MPO, involves making the government more, not less, involved in the economy. The government should reverse course.

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