Fraser Institute
Canadians want major health-care reform now
From the Fraser Institute
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
Trudeau leaves office with worst economic growth record in recent Canadian history
From the Fraser Institute
By Ben Eisen
In the days following Prime Minister Justin Trudeau’s resignation as leader of the Liberal Party, there has been much ink spilt about his legacy. One effusively positive review of Trudeau’s tenure claimed that his successors “will be hard-pressed to improve on his economic track record.”
But this claim is difficult to square with the historical record, which shows the economic story of the Trudeau years has been one of dismal growth. Indeed, when the growth performance of Canada’s economy is properly measured, Trudeau has the worst record of any prime minister in recent history.
There’s no single perfect measure of economic success. However, growth in inflation-adjusted per-person GDP—an indicator of living standards and incomes—remains an important and broad measure. In short, it measures how quickly the economy is growing while adjusting for inflation and population growth.
Back when he was first running for prime minister in 2015, Trudeau recognized the importance of long-term economic growth, often pointing to slow growth under his predecessor Stephen Harper. On the campaign trail, Trudeau blasted Harper for having the “worst record on economic growth since R.B. Bennett in the depths of the Great Depression.”
And growth during the Harper years was indeed slow. The Harper government endured the 2008/09 global financial crisis and subsequent weak recovery, particularly in Ontario. During Harper’s tenure as prime minister, per-person GDP growth was 0.5 per cent annually—which is lower than his predecessors Brian Mulroney (0.8 per cent) and Jean Chrétien (2.4 per cent).
So, growth was weak under Harper, but Trudeau misdiagnosed the causes. Shortly after taking office, Trudeau said looser fiscal policy—with more spending, borrowing and bigger deficits—would help spur growth in Canada (and indeed around the world).
Trudeau’s government acted on this premise, boosting spending and running deficits—but Trudeau’s approach did not move the needle on growth. In fact, things went from bad to worse. Annual per-person GDP growth under Trudeau (0.3 per cent) was even worse than under Harper.
The reasons for weak economic growth (under Harper and Trudeau) are complicated. But when it comes to performance, there’s no disputing that Trudeau’s record is worse than any long-serving prime minister in recent history. According to our recent study published by the Fraser Institute, which compared the growth performance of the five most recent long-serving prime ministers, annual per-person GDP growth was highest under Chrétien followed by Martin, Mulroney, Harper and Justin Trudeau.
Of course, some defenders will blame COVID for Trudeau’s poor economic growth record, but you can’t reasonably blame the steep but relatively short pandemic-related recession for nearly a decade of stagnation.
There’s no single perfect measure of economic performance, but per-person inflation-adjusted economic growth is an important and widely-used measure of economic success and prosperity. Despite any claims to the contrary, Justin Trudeau’s legacy on economic growth is—in historical terms—dismal. All Canadians should hope that his successor has more success and oversees faster growth in the years ahead.
Business
We need our own ‘DOGE’ in 2025 to unleash Canadian economy
From the Fraser Institute
Canada has a regulation problem. Our economy is over-regulated and the regulatory load is growing. To reverse this trend, we need a deregulation agenda that will cut unnecessary red tape and government bloat, to free up the Canadian economy.
According to the latest “Red Tape” report from the Canadian Federation of Independent Business, government regulations cost Canadian businesses a staggering $38.8 billion in 2020. Together, businesses spent 731 million hours on regulatory compliance—that’s equal to nearly 375,000 fulltime jobs. Canada’s smallest businesses bear a disproportionately high burden of the cost, paying up to five times more for regulatory compliance per-employee than larger businesses. The smallest businesses pay $7,023 per employee annually to comply with government regulation while larger businesses pay $1,237 per employee.
Of course, the Trudeau government has enacted a vast swath of new regulations on large sectors of Canada’s economy—particularly the energy sector—in a quest to make Canada a “net-zero” greenhouse gas (GHG) emitter by 2050 (which means either eliminating fossil fuel generation or offsetting emissions with activities such as planting trees).
For example, the government (via Bill C-69) introduced subjective criteria—including the “gender implications” of projects—into the evaluation process of energy projects. It established EV mandates requiring all new cars be electric vehicles by 2035. And the costs of the government’s new “Clean Electricity Regulations,” to purportedly reduce the use of fossil fuels in generating electricity, remain unknown, although provinces (including Alberta) that rely more on fossil fuels to generate electricity will surely be hardest hit.
Meanwhile in the United States, Donald Trump plans to put Elon Musk and Vivek Ramaswamy in charge of the new Department of Government Efficiency (DOGE), which will act as a presidential advisory commission (not an official government department) for the second Trump administration.
“A drastic reduction in federal regulations provides sound industrial logic for mass head-count reductions across the federal bureaucracy,” the two wrote recently in the Wall Street Journal. “DOGE intends to work with embedded appointees in agencies to identify the minimum number of employees required at an agency for it to perform its constitutionally permissible and statutorily mandated functions. The number of federal employees to cut should be at least proportionate to the number of federal regulations that are nullified: Not only are fewer employees required to enforce fewer regulations, but the agency would produce fewer regulations once its scope of authority is properly limited.”
If Musk and Ramaswamy achieve these goals, the U.S. could leap far ahead of Canada in terms of regulatory efficiency, making Canada’s economy even less competitive than it is today.
That would be bad news for Canadians who are already falling behind. Between 2000 and 2023, Canada’s GDP per person (an indicator of incomes and living standards) lagged far behind the average among G7 countries. Business investment is also lagging. Between 2014 and 2021, business investment per worker (inflation-adjusted, excluding residential construction) in Canada decreased by $3,676 (to $14,687) while it increased by $3,418 (to $26,751) per worker in the U.S. And over-regulation is partly to blame.
For 2025, Canada needs a deregulatory agenda similar to DOGE that will allow Canadian workers and businesses to recover and thrive. And we know it can be done. During a deregulatory effort in British Columbia, which included a minister of deregulation appointed by the provincial government in 2001, there was a 37 per cent reduction in regulatory requirements in the province by 2004. The federal government should learn from B.C.’s success at slashing red tape, and reduce the burden of regulation across the entire Canadian economy.
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