Fraser Institute
Dearth of medical resources harms Canadian patients
From the Fraser Institute
The imbalance between high spending and poor access to doctors, hospital beds and vital imaging technology, coupled with untimely access to services, can, and does, have a detrimental impact on patients.
Whether it’s a lack of family physicians or other health-care workers, Canadians know we have a serious health-care labour shortage on our hands. The implications of this shortage aren’t lost on patients (including Ellie O’Brien) who’ve possibly faced delays in accessing organ transplants because potential donors need a regular family doctor to screen them to begin the transplant process.
Given these access issues, coupled with some of the longest recorded wait times for medical procedures on record, is it any wonder that Canadians are dissatisfied with how their provincial governments handle health care?
While one instinct might be to demand governments spend more on health care, it’s not clear we’re getting good value in return for what’s already being spent. In fact, compared to 29 other high-income countries with universal health care, Canada spent the most on health care as a share of the economy at 12.6 per cent in 2021, the latest year of available comparable data (after adjusting for differences in the age structure of each country’s population).
But what do we get in return for this spending?
As far as medical resources go, not a whole lot. In 2021, Canadians had some of the fewest medical resources in the developed world. Out of 30 high-income countries with universal health care, Canada ranked 28th on physician availability at 2.8 per 1,000 people, far behind countries such as seventh-ranked Switzerland (4.5 physicians per 1,000) and tenth-ranked Australia (at 4.3 physicians per 1,000).
But doctors are just one part of the puzzle. Canada also ranked low on available hospital beds (23rd of 29 countries), meaning patients often face delays for hospital care. It can also mean that patients end up being treated for their illness outside a traditional patient room—such as a hospital hallway, a phenomenon that has spread to many provinces.
We also see a low availability of other key medical resources including diagnostic equipment. In 2019, Canada ranked 25th of 29 comparable countries with universal health care on the number of MRIs (10.3 units per million people) compared to top-ranked Japan, which had four times as many MRIs as Canada. And we ranked 26th out of 30 countries on CT scanners (14.9 scanners per million people) compared to second-ranked Australia, which had five times as many CT scanners. It’s also worth noting that a large a portion of Canada’s diagnostic machines are remarkably old.
It’s no accident that countries such as Australia, which actually spend less of its economy on health care compared to Canada, perform better than Canada on measures of resource availability and timeliness of care. Unlike Canada, Australia embraces its private sector as an integral part of its universal health-care system. With 41 per cent of all hospital care in Australia occurring in private hospitals in 2021/22, private hospitals can act as a pressure valve for the entire system, particularly in times of crisis. Indeed, the country outperforms Canada on measures of timely access to family doctor appointments, specialist care and non-emergency surgery, and has done so regularly for years.
The imbalance between high spending and poor access to doctors, hospital beds and vital imaging technology, coupled with untimely access to services, can, and does, have a detrimental impact on patients. For some, this problem can be life threatening. Without genuine reform based on real world lessons from higher performing universal health-care countries including Australia, it’s impossible to reasonably expect our health-care system to improve despite its hefty price tag.
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From the Fraser Institute
By Julio Mejía and Elmira Aliakbari
The resulting reduction in global GHG emissions would amount to a mere four-tenths of one per cent (i.e. 0.004 per cent) with virtually no impact on the climate or any detectable environmental, health or safety benefits.
Last year, when the Trudeau government said it would cap greenhouse gas emissions (GHG) from the oil and gas sector at 35 to 38 per cent below 2019 levels by 2030, it claimed the cap will not affect oil and gas production.
But a report by Deloitte, a leading audit and consulting firm, found that the cap (which would go into effect in 2026) will in fact curtail production, destroy jobs and cost the Canadian economy billions of dollars. Under Trudeau’s cap, Canada must curtail oil production by 626,000 barrels per day by 2030 or by approximately 10.0 per cent of the expected production—and curtail gas production by approximately 12.0 per cent.
According to the report’s estimates, Alberta will be hit hardest, with 3.6 per cent less investment, almost 70,000 fewer jobs, and a 4.5 per cent decrease in the province’s economic output (i.e. GDP) by 2040. Ontario will lose more than 15,000 jobs and $2.3 billion from its economy by 2040. And Quebec will lose more than 3,000 jobs and $0.4 billion from its economy during the same period.
Overall, the whole country will experience an economic loss equivalent to 1.0 per cent of GDP, translating into lower wages, the loss of nearly 113,000 jobs and a 1.3 per cent reduction in government tax revenues. Canada’s real GDP growth in 2023 was a paltry 1.1 per cent, so a 1 per cent reduction would be a significant economic loss.
Deloitte’s findings echo previous studies on the effects of Ottawa’s cap. According to a recent economic analysis by the Conference Board of Canada, the cap could reduce Canada’s GDP by up to $1 trillion between 2030 and 2040, eliminate up to 151,000 jobs by 2030, reduce federal government revenue by up to $151 billion between 2030 and 2040, and reduce Alberta government revenue by up to $127 billion over the same period.
Similarly, another recent study published by the Fraser Institute found that an emissions cap on the oil and gas sector would inevitably reduce production and exports, leading to at least $45 billion in lost economic activity in 2030 alone, accompanied by a substantial drop in government revenue.
Crucially, the huge economic cost to Canadians will come without any discernable environmental benefits. Even if Canada were to entirely shut down its oil and gas sector by 2030, thus eliminating all GHG emissions from the sector, the resulting reduction in global GHG emissions would amount to a mere four-tenths of one per cent (i.e. 0.004 per cent) with virtually no impact on the climate or any detectable environmental, health or safety benefits.
Given the sustained demand for fossil fuels, constraining oil and gas production and exports in Canada would merely shift production to other regions, potentially to countries with lower environmental and human rights standards such as Iran, Russia and Venezuela.
The Trudeau government’s proposed GHG cap will severely damage Canada’s economy for virtually no environmental benefit. The government should scrap the cap and prioritize the economic wellbeing of Canadians over policies that only bring pain with no gain.
Authors:
Economy
If Canadian families spent and borrowed like the federal government, they would be $427,759 in debt
From the Fraser Institute
By Grady Munro and Jake Fuss
If the median Canadian family spent and borrowed like the federal government, they would already be $427,759 in debt and continuing to borrow, finds a new study published today by the Fraser Institute.
“If the median family in Canada spent and borrowed like the federal government, they would be in serious financial trouble,” said Grady Munro, a Fraser Institute policy analyst and co-author of Understanding the Scale of Canada’s Federal Deficit.
The $39.8 billion deficit expected by Ottawa in 2024/25 represents the 17th consecutive annual federal deficit, with continued deficits expected into the foreseeable future, eventually resulting in higher taxes for Canadians.
Continuous annual borrowing by Ottawa to finance increased spending has driven federal total debt from 53.0 per cent of the economy ($1.1 trillion) in 2014/15 up to an expected 69.8 per cent ($2.1 trillion) in 2024/25.
To put this into perspective, the study’s analysis offers an example of what a median family’s household finances would look like if they were to spend and borrow like the federal government in 2024.
The study found that the median Canadian family in 2024 would spend $109,982 while only earning $101,821, meaning that it would borrow $8,161 just to pay for its normal spending. This $8,000-plus in additional debt is on top of the $427,759 in existing debt the family would already hold based on previous borrowing.
Illustrative of the burden of debt, $11,066 of the family’s income, representing almost 11 per cent, would be spent on just the interest costs of existing debt.
“Unlike most households, where debt is often offset by assets such as a home or investments, the federal government has little in the way of assets to offset its enormous debt,” said Jake Fuss, director of fiscal policy at the Fraser Institute and coauthor. “And it’s important to note that this government debt burden on Canadian families does not include the burden of provincial and municipal government debt, which depending on one’s location, can be significant.”
- For many years the federal government’s approach to government finances has relied on spending-driven deficits and a growing debt burden, causing a deterioration in the state of federal finances.
- While deficits can sometimes be justified in certain circumstances, perpetual spending-driven deficits have become the norm rather than a temporary exception for the federal government. The $39.8 billion deficit expected in 2024/25 is the 17th consecutive annual deficit, and deficits are expected to continue into the foreseeable future.
- Deficits have helped drive federal gross debt from 53.0% of the economy ($1.1 trillion) in 2014/15 up to an expected 69.8% ($2.1 trillion) in 2024/25.
- This increase in the level of federal debt comes with costs and will result in higher taxes on Canadians.
- It may be hard to comprehend the scale of the deficits and debt, so to contextualize the current state of federal finances this bulletin provides an example of what a median family’s household budget would look like in 2024 if it managed its finances the way the federal government does.
- The median family earning $101,821 in 2024 would be spending $109,982 if it spent the way the federal government does. To cover the difference, it would put $8,161 on a credit card, despite already being $427,759 in debt.
- Of the total amount spent, $11,066 would go towards interest on the debt his year. Simply put, a Canadian family that chose to spend like the federal government would be in financial trouble.
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