Fraser Institute
Bill Maher is right about Canadian health care

From the Fraser Institute
Recently, popular American comedian and talk show host, Bill Maher, took aim at some of Canada’s public policy failings in one of his monologues. In entertaining fashion, Maher highlighted our high housing costs, unemployment rates and “vaunted” health-care system.
Indeed, citing work published by the Fraser Institute, he explained that after adjusting for age, Canada spends 13.3 per cent of our economy on health care (2020), the highest level of spending by a developed country with universal coverage that year. And that Canada has some of the poorest access to timely appointments with family doctors when compared to our peers.
Unfortunately, while that’s where his segment on health care ended, the bad news for the Canadian system doesn’t stop there.
On top of Canada continuing to be one of the most expensive universal health-care systems in the world, we get little in return when it comes to both available medical resources and wait times. For example, among high-income countries with universal health care, Canada has some of the lowest numbers of physicians, hospital beds, MRI machines and CT scanners.
And in Canada, only 38 per cent of patients report seeing a specialist within four weeks (compared to 69 per cent in the Netherlands) and only 62 per cent report receiving non-emergency surgery within four months (compared to 99 per cent in Germany).
Unfortunately, wait times in Canada aren’t simply long compared to other countries, they’re the longest they’ve ever been. Last year the median wait for a Canadian patient seeking non-emergency care reached 27.7 weeks—nearly three times longer than the 9.3 week-wait Canadians experienced three decades ago.
This raises the obvious question. How do other countries outperform Canada’s health-care system while also often spending less as a share of their economies? In short, their approach to universal health care, and in particular their relationship with the private sector, departs drastically from the approach here at home.
Australia, for example, partners with private hospitals to deliver the majority (58.6 per cent) of all non-emergency surgeries within its universal health-care system. Australia also spends less of its total economy (i.e. GDP) on health care but outperforms Canada on every measure of timely care.
Even with restrictions on the private sector, Canada has some limited experience that should encourage policymakers to embrace greater private-sector involvement. Saskatchewan, for example, contracted with private surgical clinics starting in 2010 to deliver publicly-funded services as part of a four-year initiative to reduce wait times, which were among the longest in the country. Between 2010 and 2014, wait times in the province fell from 26.5 weeks to 14.2 weeks. After the initiative ended, the province’s wait times began to grow.
More recently, Quebec, which has some of the shortest wait times for medical services in the country, contracts out one out of every six day-surgeries to private clinics within the publicly-funded health-care system.
Maher’s monologue, which was viewed by millions online, highlighted the key failings of Canada’s health-care system. If policymakers in Ottawa and the provinces want to fix Canadian health care, they must learn from other countries that deliver universal health-care at the same or even lower cost, often with better access and results for patients.
Author:
2025 Federal Election
Fixing Canada’s immigration system should be next government’s top priority

From the Fraser Institute
Whichever party forms government after the April 28 election must put Canada’s broken immigration system at the top of the to-do list.
This country has one of the world’s lowest fertility rates. Were it not for immigration, our population would soon start to decline, just as it’s declining in dozens of other low-fertility countries around the world.
To avoid the social and economic tensions of an aging and declining population, the federal government should re-establish an immigration system that combines a high intake with strictly enforced regulations. Once Canadians see that program in place and working, public support for immigration should return.
Canada’s total fertility rate (the number of children, on average, a woman will have in her lifetime) has been declining, with the odd blip here and there, since the 1960s. In 1972, it fell below the replacement rate of 2.1.
According to Statistics Canada, the country’s fertility rate fell to a record low of 1.26 in 2023. That puts us in the company of other lowest-low fertility countries such as Italy (1.21), Japan (1.26) and South Korea (0.82).
Those three countries are all losing population. But Canada’s population continues to grow, with immigrants replacing the babies who aren’t born. The problem is that, in the years that followed the COVID-19 lockdowns, the population grew too much.
The Liberal government was unhappy that the pandemic had forced Canada to restrict immigration and concerned about post-pandemic labour shortages. To compensate, Ottawa set a target of 500,000 new permanent residents for 2025, double the already-high intake of about 250,000 a year that had served as a benchmark for the Conservative government of Stephen Harper and the Liberal governments of Paul Martin and Jean Chrétien.
Ottawa also loosened restrictions on temporary foreign worker permits and the admission of foreign students to colleges and universities. Both populations quickly exploded.
Employers preferred hiring workers from overseas rather than paying higher wages for native-born workers. Community colleges swelled their ranks with international students who were also issued work permits. Private colleges—Immigration Minister Marc Miller called them “puppy mills”—sprang up that offered no real education at all.
At the same time, the number of asylum claimants in Canada skyrocketed due to troubles overseas and relaxed entry procedures, reaching a total of 457,285 in 2024.
On January 1 of this year, Statistics Canada estimated that there were more than three million temporary residents in the country, pushing Canada’s population up above 41.5 million.
Their presence worsened housing shortages, suppressed wages and increased unemployment among younger workers. The public became alarmed at the huge influx of foreign residents.
For the first time in a quarter century, according to an Environics poll, a majority of Canadians believed there were too many immigrants coming into Canada.
Some may argue that the solution to Canada’s demographic challenges lie in adopting family-friendly policies that encourage couples to have children. But while governments improve parental supports and filter policies through a family-friendly lens—for example, houses with backyards are more family-friendly than high-rise towers—no government has been able to reverse declining fertility back up to the replacement rate of 2.1.
The steps to repairing Canada’s immigration mess lie in returning to first principles.
According to Statistics Canada, there were about 300,000 international students at postsecondary institutions when the Liberals came to power in 2015. Let’s return to those levels.
The temporary foreign worker program should be toughened up. The government recently implemented stricter Labour Market Impact Assessments, but even stricter rules may be needed to ensure that foreign workers are only brought in when local labour markets cannot meet employer needs, while paying workers a living wage.
New legislation should ensure that only asylum claimants who can demonstrate they are at risk of persecution or other harm in their home country are given refuge in Canada, and that the process for assessing claims is fair, swift and final. If necessary, the government should consider employing the Constitution’s notwithstanding clause to protect such legislation from court challenges.
Finally, the government should admit fewer permanent residents under the family reunification stream and more from the economic stream. And the total admitted should be kept to around 1 per cent of the total population. That would still permit an extremely robust intake of about 450,000 new Canadians each year.
Restoring public confidence in Canada’s immigration system will take much longer than it took to undermine that confidence. But there can be no higher priority for the federal government. The country’s demographic future is at stake.
Business
Tariff-driven increase of U.S. manufacturing investment would face dearth of workers

From the Fraser Institute
Since 2015, the number of American manufacturing jobs has actually risen modestly. However, as a share of total U.S. employment, manufacturing has dropped from 30 per cent in the 1970s to around 8 per cent in 2024.
Donald Trump has long been convinced that the United States must revitalize its manufacturing sector, having—unwisely, in his view—allowed other countries to sell all manner of foreign-produced manufactured goods in the giant American market. As president, he’s moved quickly to shift the U.S. away from its previous embrace of liberal trade and open markets as cornerstones of its approach to international economic policy —wielding tariffs as his key policy instrument. Since taking office barely two months ago, President Trump has implemented a series of tariff hikes aimed at China and foreign producers of steel and aluminum—important categories of traded manufactured goods—and threatened to impose steep tariffs on most U.S. imports from Canada, Mexico and the European Union. In addition, he’s pledged to levy separate tariffs on imports of automobiles, semi-conductors, lumber, and pharmaceuticals, among other manufactured goods.
In the third week of March, the White House issued a flurry of news releases touting the administration’s commitment to “position the U.S. as a global superpower in manufacturing” and listing substantial new investments planned by multinational enterprises involved in manufacturing. Some of these appear to contemplate relocating manufacturing production in other jurisdictions to the U.S., while others promise new “greenfield” investments in a variety of manufacturing industries.
President Trump’s intense focus on manufacturing is shared by a large slice of America’s political class, spanning both of the main political parties. Yet American manufacturing has hardly withered away in the last few decades. The value of U.S. manufacturing “output” has continued to climb, reaching almost $3 trillion last year (equal to 10 per cent of total GDP). The U.S. still accounts for 15 per cent of global manufacturing production, measured in value-added terms. In fact, among the 10 largest manufacturing countries, it ranks second in manufacturing value-added on a per-capita basis. True, China has become the world’s biggest manufacturing country, representing about 30 per cent of global output. And the heavy reliance of Western economies on China in some segments of manufacturing does give rise to legitimate national security concerns. But the bulk of international trade in manufactured products does not involve goods or technologies that are particularly critical to national security, even if President Trump claims otherwise. Moreover, in the case of the U.S., a majority of two-way trade in manufacturing still takes place with other advanced Western economies (and Mexico).
In the U.S. political arena, much of the debate over manufacturing centres on jobs. And there’s no doubt that employment in the sector has fallen markedly over time, particularly from the early 1990s to the mid-2010s (see table below). Since 2015, the number of American manufacturing jobs has actually risen modestly. However, as a share of total U.S. employment, manufacturing has dropped from 30 per cent in the 1970s to around 8 per cent in 2024.
U.S. Manufacturing Employment, Select Years (000)* | |
---|---|
1990 | 17,395 |
2005 | 14,189 |
2010 | 14,444 |
2015 | 12,333 |
2022 | 12,889 |
2024 | 12,760 |
*December for each year shown. Source: U.S. Bureau of Labor Statistics |
Economists who have studied the trend conclude that the main factors behind the decline of manufacturing employment include continuous automation, significant gains in productivity across much of the sector, and shifts in aggregate demand and consumption away from goods and toward services. Trade policy has also played a part, notably China’s entry into the World Trade Organization (WTO) in 2001 and the subsequent dramatic expansion of its role in global manufacturing supply chains.
Contrary to what President Trump suggests, manufacturing’s shrinking place in the overall economy is not a uniquely American phenomenon. As Harvard economist Robert Lawrence recently observed “the employment share of manufacturing is declining in mature economies regardless of their overall industrial policy approaches. The trend is apparent both in economies that have adopted free-market policies… and in those with interventionist policies… All of the evidence points to deep and powerful forces that drive the long-term decline in manufacturing’s share of jobs and GDP as countries become richer.”
This brings us back to the president’s seeming determination to rapidly ramp up manufacturing investment and production as a core element of his “America First” program. An important issue overlooked by the administration is where to find the workers to staff a resurgent U.S. manufacturing sector. For while manufacturing has become a notably “capital-intensive” part of the U.S. economy, workers are still needed. And today, it’s hard to see where they will be found. This is especially true given the Trump administration’s well-advertised skepticism about the benefits of immigration.
According to the U.S. Bureau of Labor Statistics, the current unemployment rate across America’s manufacturing industries collectively stands at a record low 2.9 per cent, well below the economy-wide rate of 4.5 per cent. In a recent survey by the National Association of Manufacturers, almost 70 per cent of American manufacturers cited the inability to attract and retain qualified employees as the number one barrier to business growth. A cursory look at the leading industry trade journals confirms that skill and talent shortages remain persistent in many parts of U.S. manufacturing—and that shortages are destined to get worse amid the expected significant jump in manufacturing investment being sought by the Trump administration.
As often seems to be the case with Trump’s stated policy objectives, the math surrounding his manufacturing agenda doesn’t add up. Manufacturing in America is in far better shape than the president acknowledges. And a tariff-driven avalanche of manufacturing investment—should one occur—will soon find the sector reeling from an unprecedented human resource crisis.
Jock Finlayson
Senior Fellow, Fraser Institut
-
Uncategorized1 day ago
Poilievre on 2025 Election Interference – Carney sill hasn’t fired Liberal MP in Chinese election interference scandal
-
2025 Federal Election1 day ago
2025 Federal Election Interference from China! Carney Pressed to Remove Liberal MP Over CCP Bounty Remark
-
Censorship Industrial Complex1 day ago
Welcome to Britain, Where Critical WhatsApp Messages Are a Police Matter
-
Business2 days ago
Cuba has lost 24% of it’s population to emigration in the last 4 years
-
Media1 day ago
Top Five Huge Stories the Media Buried This Week
-
2025 Federal Election1 day ago
2025 Election Interference – CCP Bounty on Conservative Candidate – Carney Says Nothing
-
International2 days ago
Trump signs executive order to make Washington D.C. “safe and beautiful”
-
2025 Federal Election19 hours ago
Chinese Election Interference – NDP reaction to bounty on Conservative candidate