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Fraser Institute

Canada’s median health-care wait time hits 30 weeks—longest ever recorded

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From the Fraser Institute

By Mackenzie Moir and Bacchus Barua

Canadian patients in 2024 waited longer than ever for medical treatment, finds a new study released today by the Fraser Institute, an independent, non-partisan Canadian public policy think-tank.

“While most Canadians understand that wait times are a major problem, we’ve now reached an unprecedented and unfortunate milestone for delayed access to care,” said Bacchus Barua, director of health policy studies at the Fraser Institute and co-author of Waiting Your Turn: Wait Times for Health Care in Canada, 2024.

The annual study, based on a survey of physicians across Canada, this year reports a median wait time of 30 weeks from referral by a general practitioner (i.e. family doctor) to consultation with a specialist to treatment, for procedures across 12 medical specialties including several types of surgery.

This year’s median wait (30 weeks) is the longest ever recorded—longer than the 27.7 weeks in 2023 and the 20.9 weeks in 2019 (before the pandemic), and 222 per cent longer than the 9.3 weeks in 1993 when the Fraser Institute began tracking wait times. Among the provinces, Ontario recorded the shortest median wait time (23.6 weeks, up from 21.6 weeks in 2023) while Prince Edward Island recorded the longest (77.4 weeks—although data for P.E.I. should be interpreted with caution due to fewer survey responses compared to other provinces).

Among the various specialties, national median wait times were longest for orthopedic surgery (57.5 weeks) and neurosurgery (46.2 weeks), and shortest for radiation (4.5 weeks) and medical oncology treatments (4.7 weeks). For diagnostic technologies, wait times were longest for CT scans (8.1 weeks), MRIs (16.2 weeks) and ultrasounds (5.2 weeks).

“Long wait times can result in increased suffering for patients, lost productivity at work, a decreased quality of life, and in the worst cases, disability or death,” said Mackenzie Moir, senior policy analyst at the Fraser Institute and study co-author.

Median wait times by province (in weeks)

  • In 2024, physicians across Canada reported a median wait time of 30.0 weeks between a referral from a GP and receipt of treatment. Up from 27.7 in 2023.
  • This is 222% longer than the 9.3 week wait Canadian patients could expect in 1993.
  • Ontario reported the shortest total wait (23.6 weeks), followed by Quebec (28.9 weeks) and British Columbia (29.5 weeks).
  • Patients waited longest in Prince Edward Island (77.4 weeks), New Brunswick (69.4 weeks) and Newfoundland and Labrador (43.2 weeks).
  • Patients waited the longest for Orthopaedic Surgery (57.5 weeks) and Neurosurgery (46.2 weeks).
  • By contrast, patients faced shorter waits for Radiation Oncology (4.5 weeks) and Medical Oncology (4.7 weeks).
  • The national 30 week total wait is comprised of two segments. Referral by a GP to consultation with a specialist: 15.0 weeks. Consultation with a specialist to receipt of treatment: 15.0 weeks.
  • More than 1900 responses were received across 12 specialties and 10 provinces.
  • After seeing a specialist, Canadian patients waited 6.3 weeks longer than what physicians consider to be clinically reasonable (8.6 weeks).
  • Across 10 provinces, the study estimated that patients in Canada were waiting for 1.5 million procedures in 2024.
  • Patients also suffered considerable delays for diagnostic technology: 8.1 weeks for CT scans, 16.2 weeks for MRI scans, and 5.2 weeks for Ultrasound.

 

Mackenzie Moir

Senior Policy Analyst, Fraser Institute

Bacchus Barua

Director, Health Policy Studies, Fraser Institute

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Automotive

Electric cars just another poor climate policy

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From the Fraser Institute

By Bjørn Lomborg

The electric car is widely seen as a symbol of a simple, clean solution to climate change. In reality, it’s inefficient, reliant on massive subsidies, and leaves behind a trail of pollution and death that is seldom acknowledged.

We are constantly reminded by climate activists and politicians that electric cars are cleaner, cheaper, and better. Canada and many other countries have promised to prohibit the sale of new gas and diesel cars within a decade. But if electric cars are really so good, why would we need to ban the alternatives?

And why has Canada needed to subsidize each electric car with a minimum $5,000 from the federal government and more from provincial governments to get them bought? Many people are not sold on the idea of an electric car because they worry about having to plan out where and when to recharge. They don’t want to wait for an uncomfortable amount of time while recharging; they don’t want to pay significantly more for the electric car and then see its used-car value decline much faster. For people not privileged to own their own house, recharging is a real challenge. Surveys show that only 15 per cent of Canadians and 11 per cent of Americans want to buy an electric car.

The main environmental selling point of an electric car is that it doesn’t pollute. It is true that its engine doesn’t produce any CO₂ while driving, but it still emits carbon in other ways. Manufacturing the car generates emissions—especially producing the battery which requires a large amount of energy, mostly achieved with coal in China. So even when an electric car is being recharged with clean power in BC, over its lifetime it will emit about one-third of an equivalent gasoline car. When recharged in Alberta, it will emit almost three-quarters.

In some parts of the world, like India, so much of the power comes from coal that electric cars end up emitting more CO₂ than gasoline cars. Across the world, on average, the International Energy Agency estimates that an electric car using the global average mix of power sources over its lifetime will emit nearly half as much CO₂ as a gasoline-driven car, saving about 22 tonnes of CO₂.

But using an electric car to cut emissions is incredibly ineffective. On America’s longest-established carbon trading system, you could buy 22 tonnes of carbon emission cuts for about $660 (US$460). Yet, Ottawa is subsidizing every electric car to the tune of $5,000 or nearly ten times as much, which increases even more if provincial subsidies are included. And since about half of those electrical vehicles would have been bought anyway, it is likely that Canada has spent nearly twenty-times too much cutting CO₂ with electric cars than it could have. To put it differently, Canada could have cut twenty-times more CO₂ for the same amount of money.

Moreover, all these estimates assume that electric cars are driven as far as gasoline cars. They are not. In the US, nine-in-ten households with an electric car actually have one, two or more non-electric cars, with most including an SUV, truck or minivan. Moreover, the electric car is usually driven less than half as much as the other vehicles, which means the CO₂ emission reduction is much smaller. Subsidized electric cars are typically a ‘second’ car for rich people to show off their environmental credentials.

Electric cars are also 320440 kilograms heavier than equivalent gasoline cars because of their enormous batteries. This means they will wear down roads faster, and cost societies more. They will also cause more air pollution by shredding more particulates from tire and road wear along with their brakes. Now, gasoline cars also pollute through combustion, but electric cars in total pollute more, both from tire and road wear and from forcing more power stations online, often the most polluting ones. The latest meta-study shows that overall electric cars are worse on particulate air pollution. Another study found that in two-thirds of US states, electric cars cause more of the most dangerous particulate air pollution than gasoline-powered cars.

These heavy electric cars are also more dangerous when involved in accidents, because heavy cars more often kill the other party. A study in Nature shows that in total, heavier electric cars will cause so many more deaths that the toll could outweigh the total climate benefits from reduced CO₂ emissions.

Many pundits suggest electric car sales will dominate gasoline cars within a few decades, but the reality is starkly different. A 2023-estimate from the Biden Administration shows that even in 2050, more than two-thirds of all cars globally will still be powered by gas or diesel.

Source: US Energy Information Administration, reference scenario, October 2023
Fossil fuel cars, vast majority is gasoline, also some diesel, all light duty vehicles, the remaining % is mostly LPG.

Electric vehicles will only take over when innovation has made them better and cheaper for real. For now, electric cars run not mostly on electricity but on bad policy and subsidies, costing hundreds of billions of dollars, blocking consumers from choosing the cars they want, and achieving virtually nothing for climate change.

Bjørn Lomborg

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2025 Federal Election

Fixing Canada’s immigration system should be next government’s top priority

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From the Fraser Institute

By John Ibbitson

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.

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