Alberta
Canada’s health-care wait times hit 27.7 weeks in 2023—longest ever recorded
From the Fraser Institute
By Mackenzie Moir and Bacchus Barua
Canadian patients waited longer than ever this year for medical treatment, finds a new study released by the Fraser Institute, an independent, non-partisan Canadian public policy think-tank.
The study, an annual survey of physicians across Canada, reports a median wait time of 27.7 weeks—the longest ever recorded, longer than the wait of 27.4 weeks reported in 2022—and 198 per cent higher than the 9.3 weeks Canadians waited in 1993, when the Fraser Institute began tracking wait times.
“COVID-19 and related hospital closures have exacerbated, but are not the cause, of Canada’s historic wait times challenges,” said Bacchus Barua, director of the Fraser Institute’s Centre for Health Policy Studies and co-author of Waiting Your Turn: Wait Times for Health Care in Canada, 2023.
“Previous results revealed that patients waited an estimated 20.9 weeks for medically necessary elective care in 2019—long before the pandemic started.”
The study examines the total wait time faced by patients across 12 medical specialties from referral by a general practitioner (i.e. family doctor) to consultation with a specialist, to when the patient ultimately receives treatment.
More than 1,200 responses were received across the 12 specialties and 10 provinces. Among the provinces, Ontario recorded the shortest wait time at 21.6 weeks—still up from 20.3 weeks in 2022. Nova Scotia recorded the longest wait time in Canada at 56.7 weeks.
Among the various specialties, national wait times were longest between a referral by a GP and plastic (52.4 weeks), orthopedic (44.3) neurosurgery (43.5). Wait times were shortest for radiation (4.4 weeks) and medical oncology treatments (4.8 weeks). Patients also experience significant waiting times for various diagnostic technologies. This year, Canadians could expect to wait 6.6 weeks for a computed tomography (CT) scan, 12.9 weeks for a magnetic resonance imaging (MRI) scan, and 5.3 weeks for an ultrasound.
Crucially, physicians report that their patients are waiting over four and a half weeks longer for treatment (after seeing a specialist) than what they consider to be clinically reasonable.
“Excessively long wait times remain a defining characteristic of Canada’s health-care system” said Mackenzie Moir, Fraser Institute policy analyst and co-author of the report. “And they aren’t simply minor inconveniences, they can result in increased suffering for patients, lost productivity at work, a decreased quality of life, and in the worst cases, disability or death.”
Median wait times by province (in weeks)
PROVINCE 2022 2023
British Columbia 25.8 27.7
Alberta 33.3 33.5
Saskatchewan 30.1 31.0
Manitoba 41.3 29.1
Ontario 20.3 21.6
Quebec 29.4 27.6
New Brunswick 43.3 52.6
Nova Scotia 58.2 56.7
P.E.I. 64.7 55.2
Newfoundland and Labrador 32.1 33.3
Each year, the Fraser Institute surveys physicians across twelve specialties and the ten provinces in order to document the queues for visits to specialists and for diagnostic and surgical procedures in Canada. Waiting Your Turn: Wait Times for Health Care in Canada, 2023 Report reports the results of this year’s survey.
In 2023, physicians report a median wait time of 27.7 weeks between a referral from a general practitioner and receipt of treatment. This represents the longest delay in the survey’s history and is 198% longer than the 9.3 weeks Canadian patients could expect to wait in 1993.
Overall, Ontario reports the shortest wait across Canada (21.6 weeks) while Nova Scotia had the longest (56.7 weeks).
The 27.7 week total wait time that patients face can be examined in two consecutive segments:
- referral by a general practitioner to consultation with a specialist: 14.6 weeks;
- consultation with a specialist to receipt of treatment: 13.1 weeks.
After seeing a specialist, Canadian patients were waiting 4.6 weeks longer than what physicians consider clinically reasonable (8.5 weeks).
Across the ten provinces, the study also estimates that there were 1,209,194 procedures for which patients—3% of the Canadian population—were waiting in 2023.
Patients also face considerable delays for diagnostic technology. This year, Canadians could expect to wait 6.6 weeks for a CT scan, 12.9 for an MRI scan, and 5.3 weeks for an ultrasound.
Survey results suggest that, despite provincial strategies to reduce wait times, Canadian patients continue to wait too long for medically necessary treatment.
Data were collected from the week of January 16 to July 1, 2023, longer than the period of collection in years before the COVID19 pandemic. A total of 1,269 responses were received across the 12 specialties surveyed. However, this year’s response rate was 10.3% (lower than in some previous years). As a result, the findings in this report should be interpreted with caution.
Research has repeatedly indicated that wait times for medically necessary treatment are not benign inconveniences. Wait times can, and do, have serious consequences such as increased pain, suffering, and mental anguish. In certain instances, they can also result in poorer medical outcomes—
transforming potentially reversible illnesses or injuries into chronic, irreversible conditions, or even permanent disabilities. In many instances, patients may also have to forgo their wages while they wait for treatment, resulting in an economic cost to the individuals themselves and the economy in general.
The results of this year’s survey indicate that despite provincial strategies to reduce wait times and high levels of health expenditure, it is clear that patients in Canada continue to wait too long to receive medically necessary treatment.
Waiting Your Turn: Wait Times for Health Care in Canada, 2023 Report
By Mackenzie Moir and Bacchus Barua, with Hani Wannamaker
www.fraserinstitute.org
Authors:
Alberta
Alberta’s fiscal update projects budget surplus, but fiscal fortunes could quickly turn
From the Fraser Institute
By Tegan Hill
According to the recent mid-year update tabled Thursday, the Smith government projects a $4.6 billion surplus in 2024/25, up from the $2.9 billion surplus projected just a few months ago. Despite the good news, Premier Smith must reduce spending to avoid budget deficits.
The fiscal update projects resource revenue of $20.3 billion in 2024/25. Today’s relatively high—but very volatile—resource revenue (including oil and gas royalties) is helping finance today’s spending and maintain a balanced budget. But it will not last forever.
For perspective, in just the last decade the Alberta government’s annual resource revenue has been as low as $2.8 billion (2015/16) and as high as $25.2 billion (2022/23).
And while the resource revenue rollercoaster is currently in Alberta’s favor, Finance Minister Nate Horner acknowledges that “risks are on the rise” as oil prices have dropped considerably and forecasters are projecting downward pressure on prices—all of which impacts resource revenue.
In fact, the government’s own estimates show a $1 change in oil prices results in an estimated $630 million revenue swing. So while the Smith government plans to maintain a surplus in 2024/25, a small change in oil prices could quickly plunge Alberta back into deficit. Premier Smith has warned that her government may fall into a budget deficit this fiscal year.
This should come as no surprise. Alberta’s been on the resource revenue rollercoaster for decades. Successive governments have increased spending during the good times of high resource revenue, but failed to rein in spending when resource revenues fell.
Previous research has shown that, in Alberta, a $1 increase in resource revenue is associated with an estimated 56-cent increase in program spending the following fiscal year (on a per-person, inflation-adjusted basis). However, a decline in resource revenue is not similarly associated with a reduction in program spending. This pattern has led to historically high levels of government spending—and budget deficits—even in more recent years.
Consider this: If this fiscal year the Smith government received an average level of resource revenue (based on levels over the last 10 years), it would receive approximately $13,000 per Albertan. Yet the government plans to spend nearly $15,000 per Albertan this fiscal year (after adjusting for inflation). That’s a huge gap of roughly $2,000—and it means the government is continuing to take big risks with the provincial budget.
Of course, if the government falls back into deficit there are implications for everyday Albertans.
When the government runs a deficit, it accumulates debt, which Albertans must pay to service. In 2024/25, the government’s debt interest payments will cost each Albertan nearly $650. That’s largely because, despite running surpluses over the last few years, Albertans are still paying for debt accumulated during the most recent string of deficits from 2008/09 to 2020/21 (excluding 2014/15), which only ended when the government enjoyed an unexpected windfall in resource revenue in 2021/22.
According to Thursday’s mid-year fiscal update, Alberta’s finances continue to be at risk. To avoid deficits, the Smith government should meaningfully reduce spending so that it’s aligned with more reliable, stable levels of revenue.
Author:
Alberta
Premier Smith says Auto Insurance reforms may still result in a publicly owned system
Better, faster, more affordable auto insurance
Alberta’s government is introducing a new auto insurance system that will provide better and faster services to Albertans while reducing auto insurance premiums.
After hearing from more than 16,000 Albertans through an online survey about their priorities for auto insurance policies, Alberta’s government is introducing a new privately delivered, care-focused auto insurance system.
Right now, insurance in the province is not affordable or care focused. Despite high premiums, Albertans injured in collisions do not get the timely medical care and income support they need in a system that is complex to navigate. When fully implemented, Alberta’s new auto insurance system will deliver better and faster care for those involved in collisions, and Albertans will see cost savings up to $400 per year.
“Albertans have been clear they need an auto insurance system that provides better, faster care and is more affordable. When it’s implemented, our new privately delivered, care-centred insurance system will put the focus on Albertans’ recovery, providing more effective support and will deliver lower rates.”
“High auto insurance rates put strain on Albertans. By shifting to a system that offers improved benefits and support, we are providing better and faster care to Albertans, with lower costs.”
Albertans who suffer injuries due to a collision currently wait months for a simple claim to be resolved and can wait years for claims related to more serious and life-changing injuries to addressed. Additionally, the medical and financial benefits they receive often expire before they’re fully recovered.
Under the new system, Albertans who suffer catastrophic injuries will receive treatment and care for the rest of their lives. Those who sustain serious injuries will receive treatment until they are fully recovered. These changes mirror and build upon the Saskatchewan insurance model, where at-fault drivers can be sued for pain and suffering damages if they are convicted of a criminal offence, such as impaired driving or dangerous driving, or conviction of certain offenses under the Traffic Safety Act.
Work on this new auto insurance system will require legislation in the spring of 2025. In order to reconfigure auto insurance policies for 3.4 million Albertans, auto insurance companies need time to create and implement the new system. Alberta’s government expects the new system to be fully implemented by January 2027.
In the interim, starting in January 2025, the good driver rate cap will be adjusted to a 7.5% increase due to high legal costs, increasing vehicle damage repair costs and natural disaster costs. This protects good drivers from significant rate increases while ensuring that auto insurance providers remain financially viable in Alberta.
Albertans have been clear that they still want premiums to be based on risk. Bad drivers will continue to pay higher premiums than good drivers.
By providing significantly enhanced medical, rehabilitation and income support benefits, this system supports Albertans injured in collisions while reducing the impact of litigation costs on the amount that Albertans pay for their insurance.
“Keeping more money in Albertans’ pockets is one of the best ways to address the rising cost of living. This shift to a care-first automobile insurance system will do just that by helping lower premiums for people across the province.”
Quick facts
- Alberta’s government commissioned two auto insurance reports, which showed that legal fees and litigation costs tied to the province’s current system significantly increase premiums.
- A 2023 report by MNP shows
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