Connect with us

Fraser Institute

Canadians want major health-care reform now

Published

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.

Todayville is a digital media and technology company. We profile unique stories and events in our community. Register and promote your community event for free.

Follow Author

Business

Carney and other world leaders should recognize world’s dependence on fossil fuels

Published on

From the Fraser Institute

By Julio Mejía and Elmira Aliakbari

Simply put, despite trillions invested in the energy transition, the world is more dependent on fossil fuels today than when the United Nations launched its first COP. No wonder that ahead of COP30, leading voices of the net-zero-by-2050 agenda, including Bill Gates, are acknowledging both the vital role of fossil fuels on the planet and the failure of efforts to cut them.

On the heels of his first federal budget, which promises more spending to promote a “green economy,” Prime Minister Carney will soon fly to Brazil for COP30, the 30th United Nations climate summit. Like the former Trudeau government, the Carney government has pledged to achieve “net-zero” emissions in Canada—and compel other countries to pursue net-zero—by 2050. To achieve a net-zero world, it’s necessary to phase out fossil fuels—oil, natural gas, coal—or offset their CO2 emissions with technologies such as “carbon capture” or large-scale tree planting.

But after trillions of dollars spent in pursuit of that goal, it appears more unrealistic than ever. It’s time for world leaders, including Canada’s policymakers, to face reality and be honest about the costly commitments they make on behalf of their citizens.

For starters, carbon capture—the process of trapping and storing carbon dioxide so it’s unable to affect the atmosphere—is a developing technology not yet capable of large-scale deployment. And planting enough trees to offset global emissions would require vast amounts of land, take decades to absorb significant CO2 and risk unpredictable losses from wildfires and drought. Due to these constraints, in their net-zero quest governments and private investors have poured significant resources into “clean energy” such as wind and solar to replace fossil fuels.

According to the International Energy Agency (IEA), from 2015 to 2024, the world’s public and private investment in clean energy totalled and estimated US$14.6 trillion (inflation-adjusted). Yet from 1995 (the first COP year) to 2024, global fossil fuel consumption increased by more than 64 per cent. Specifically, oil consumption grew by 39 per cent, natural gas by 96 per cent and coal by 76 per cent. As of 2024, fossil fuels accounted for 80.6 per cent of global energy consumption, slightly lower than the 85.6 per cent in 1995.

The Canadian case shows an even greater mismatch between Ottawa’s COP commitments and its actual results. Despite billions spent by the federal government on the low-carbon economy (electric vehicle subsidies, tax credits to corporations, etc.), fossil fuel consumption in our country has increased by 23 per cent between 1995 and 2024. Over the same period, the share of fossil fuels in Canada’s total energy consumption climbed from 62.0 to 66.3 per cent.

Simply put, despite trillions invested in the energy transition, the world is more dependent on fossil fuels today than when the United Nations launched its first COP. No wonder that ahead of COP30, leading voices of the net-zero-by-2050 agenda, including Bill Gates, are acknowledging both the vital role of fossil fuels on the planet and the failure of efforts to cut them.

Why has this massive effort, which includes many countries and trillions of dollars, failed to transition humanity away from fossil fuels?

As renowned scholar Vaclav Smil explains, it can take centuries—not decades—for an energy source to become globally predominant. For thousands of years, humanity relied on wood, charcoal, dried dung and other traditional biomass fuels for heating and cooking, with coal only becoming a major energy source around 1900. It took oil 150 years after its introduction into energy markets to account for one-quarter of global fossil fuel consumption, a milestone reached only in the 1950s. And for natural gas, it took about 130 years after its commercial development to reach 25 per cent of global fossil fuel consumption at the end of the 20th century.

Yet, coal, oil and natural gas didn’t completely replace traditional biomass to meet the surging energy demand as the modern world developed. As of 2020, nearly three billion people in developing countries still relied on charcoal, straw and dried dung to supply their basic energy needs. In light of these facts, the most vocal proponents of the global energy transition seem, at the very least, out of touch.

The world’s continued reliance on fossil fuels should prompt world leaders at COP30 to exercise caution before pushing the same unrealistic commitments of the past. And Prime Minister Carney, in particular, should be careful not to keep leading Canadians into costly ventures that lead nowhere near their intended results.

Julio Mejía

Policy Analyst

Elmira Aliakbari

Director, Natural Resource Studies, Fraser Institute
Continue Reading

Alberta

Alberta government’s plan will improve access to MRIs and CT scans

Published on

From the Fraser Institute

By Nadeem Esmail and Tegan Hill

The Smith government may soon allow Albertans to privately purchase diagnostic screening and testing services, prompting familiar cries from defenders of the status quo. But in reality, this change, which the government plans to propose in the legislature in the coming months, would simply give Albertans an option already available to patients in every other developed country with universal health care.

It’s important for Albertans and indeed all Canadians to understand the unique nature of our health-care system. In every one of the 30 other developed countries with universal health care, patients are free to seek care on their own terms with their own resources when the universal system is unwilling or unable to satisfy their needs. Whether to access care with shorter wait times and a more rapid return to full health, to access more personalized services or meet a personal health need, or to access new advances in medical technology. But not in Canada.

That prohibition has not served Albertans well. Despite being one of the highest-spending provinces in one of the most expensive universal health-care systems in the developed world, Albertans endure some of the longest wait times for health care and some of the worst availability of advanced diagnostic and medical technologies including MRI machines and CT scanners.

Introducing new medical technologies is a costly endeavour, which requires money and the actual equipment, but also the proficiency, knowledge and expertise to use it properly. By allowing Albertans to privately purchase diagnostic screening and testing services, the Smith government would encourage private providers to make these technologies available and develop the requisite knowledge.

Obviously, these new providers would improve access to these services for all Alberta patients—first for those willing to pay for them, and then for patients in the public system. In other words, adding providers to the health-care system expands the supply of these services, which will reduce wait times for everyone, not just those using private clinics. And relief can’t come soon enough. In Alberta, in 2024 the median wait time for a CT scan was 12 weeks and 24 weeks for an MRI.

Greater access and shorter wait times will also benefit Albertans concerned about their future health or preventative care. When these Albertans can quickly access a private provider, their appointments may lead to the early discovery of medical problems. Early detection can improve health outcomes and reduce the amount of public health-care resources these Albertans may ultimately use in the future. And that means more resources available for all other patients, to the benefit of all Albertans including those unable to access the private option.

Opponents of this approach argue that it’s a move towards two-tier health care, which will drain resources from the public system, or that this is “American-style” health care. But these arguments ignore that private alternatives benefit all patients in universal health-care systems in the rest of the developed world. For example, Switzerland, Germany, the Netherlands and Australia all have higher-performing universal systems that provide more timely care because of—not despite—the private options available to patients.

In reality, the Smith government’s plan to allow Albertans to privately purchase diagnostic screening and testing services is a small step in the right direction to reduce wait times and improve health-care access in the province. In fact, the proposal doesn’t go far enough—the government should allow Albertans to purchase physician appointments and surgeries privately, too. Hopefully the Smith government continues to reform the province’s health-care system, despite ill-informed objections, with all patients in mind.

Nadeem Esmail

Director, Health Policy, Fraser Institute

Tegan Hill

Director, Alberta Policy, Fraser Institute
Continue Reading

Trending

X