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Fraser Institute

Virtual care will break the Canada Health Act—and that’s a good thing

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From the Fraser Institute

By Bacchus Barua

The leadership of the Canadian Medical Association (CMA) is facing sharp criticism for its recent proposal to effectively ban private payment for virtual care. In a clear example of putting politics before patients, this would only erect additional barriers for those seeking care.

Moreover, it’s a desperate bid to cling to an outdated—and failed—model of health care while underestimating modern-day innovations.

Virtual care—online video doctor consultations—is a private-sector innovation. In response to our government system’s inability to provide timely care, private companies such as Maple have been offering these services to Canadians for almost a decade. In fact, the public system only pushed meaningfully into the virtual space during COVID when it established partnerships with these private companies alongside setting up new fee codes for virtual consultations.

In return for improving access to physician consultations for thousands of Canadians, these virtual care companies have been rewarded with increased government scrutiny and red tape. The weapon of choice? The Canada Health Act (CHA).

Specifically, sections 18 to 21 of the CHA prohibit user fees and extra billing for “medically necessary” services. Further, the insurance plan of a province must be publicly administered and provide “reasonable access” to 100 per cent of insured services. Provinces found in violation are punished by the federal government, which withholds a portion (or all) of federal health-care transfer payments.

Until recently, there had been no obvious conflict between the CHA and privately paid-for virtual care—primarily because the provinces are free to determine what’s medically necessary. Until recently, many provinces did not even have billing codes for virtual care. As virtual services are increasingly provided by the public sector, however, the ability to innovatively provide care for paying patients (either out-of-pocket or through private insurance) becomes restricted further.

Within this context, the CMA recently recommended formally including virtual care services within the public system, alongside measures to ensure “equitable access.” At the same time, it reiterated its recommendation that private insurance to access medically necessary services covered by the CHA be prohibited.

See where this is going?

The kicker is an additional recommendation banning dual practice (i.e. physicians working in both the public and private sector) except under certain conditions. This means doctors in the public system who could otherwise allocate their spare hours to private appointments online would now have to choose to operate exclusively in either the public or private system.

The combined effect of these policies would ensure that innovative private options for virtual care—whether paid for out-of-pocket or though private insurance—will either be overtaken by bureaucracies or disappear entirely.

But what the CMA report fails to recognize is that virtual care has expanded access to services the government fails to provide—there’s little reason to suspect a government takeover of the virtual-care sector will make things better for patients. And even if governments could somehow prevent Canadian doctors and companies providing these services privately, virtual care is not beholden to Canada’s physical borders. Patients with a little bit of technical knowhow will simply bypass the Canadian system entirely by having virtual consultations with doctors abroad. If Canadians can figure out how to access their favourite show in another country, you can be sure they’ll find a way to get a consultation with a doctor in Mumbai instead of Montreal.

Instead of forcing physicians and patients to operate within the crumbling confines of government-run health care, the CMA’s leadership should be grateful for the pressure valve that the private sector has produced. We should celebrate the private innovators who have provided Canadians better access to health care, not finding ways to shut them down in favour of more government control.

Business

Brutal economic numbers need more course corrections from Ottawa

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From the Fraser Institute

By Matthew Lau

Canada’s lagging productivity growth has been widely discussed, especially after Bank of Canada senior deputy governor Carolyn Rogers last year declared it “an emergency” and said “it’s time to break the glass.” The federal Liberal government, now entering its eleventh year in office, admitted in its recent budget that “productivity remains weak, limiting wage gains for workers.”

Numerous recent reports show just how weak Canada’s productivity has been. A recent study published by the Fraser Institute shows that since 2001, labour productivity has increased only 16.5 per cent in Canada vs. 54.7 per cent in the United States, with our underperformance especially notable after 2017. Weak business investment is a primary reason for Canada’s continued poor economic outcomes.

A recent McKinsey study provides worrying details about how the productivity crisis pervades almost all sectors of the economy. Relative to the U.S., our labour productivity underperforms in: mining, quarrying, and oil and gas extraction; construction; manufacturing; transportation and warehousing; retail trade; professional, scientific, and technical services; real estate and rental leasing; wholesale trade; finance and insurance; information and cultural industries; accommodation and food services; utilities; arts, entertainment and recreation; and administrative and support, waste management and remediation services.

Canada has relatively higher labour productivity in just one area: agriculture, forestry, fishing and hunting. To make matters worse, in most areas where Canada’s labour productivity is less than American, McKinsey found we had fallen further behind from 2014 to 2023. In addition to doing poorly, Canada is trending in the wrong direction.

Broadening the comparison to include other OECD countries does not make the picture any rosier—Canada “is growing more slowly and from a lower base,” as McKinsey put it. This underperformance relative to other countries shows Canada’s economic productivity crisis is not the result of external factors but homemade.

The federal Liberals have done little to reverse our relative decline. The Carney government’s proposed increased spending on artificial intelligence (AI) may or may not help. But its first budget missed a clear opportunity to implement tax reform and cuts. As analyses from the Fraser InstituteUniversity of CalgaryC.D. Howe InstituteTD Economics and others have argued, fixing Canada’s uncompetitive tax regime would help lift productivity.

Regulatory expansion has also driven Canada’s relative economic decline but the federal budget did not reduce the red tape burden. Instead, the Carney government empowered cabinet to decide which large natural resource and infrastructure projects are in the “national interest”—meaning that instead of predictable transparent rules, businesses must answer to the whims of politicians.

The government has also left in place many of its Trudeau-era environmental regulations, which have helped push pipeline investors away for years. It is encouraging that a new “memorandum of understanding” between Ottawa and Alberta may pave the way for a new oil pipeline. A memorandum of undertaking would have been better.

Although the government paused its phased-in ban on conventionally-powered vehicle sales in the face of heavy tariff-related headwinds to Canada’s automobile sector, it still insists that all new light-duty vehicle sales by 2035 must be electric. Liberal MPs on the House of Commons Industry Committee recently voted against a Conservative motion calling for repeal of the EV mandate. Meanwhile, Canadian consumers are voting with their wallets. In September, only 10.2 per cent of new motor vehicle sales were “zero-emission,” an ominous18.2 per cent decline from last year.

If the Carney government continues down its current path, it will only make productivity and consumer welfare worse. It should change course to reverse Canada’s economic underperformance and help give living standards a much-needed boost.

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Fraser Institute

Claims about ‘unmarked graves’ don’t withstand scrutiny

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From the Fraser Institute

By Tom Flanagan

The new book Dead Wrong: How Canada Got the Residential School Story So Wrong is a follow-up to Grave Error, published by True North in 2023. Grave Error instantly became a best-seller. People wanted to read the book because it contained well-documented information not readily available elsewhere concerning the history of Canada’s Indian Residential Schools (IRS) and the facts surrounding recent claims about “unmarked graves.”

Why another book? Because the struggle for accurate information continues. Let me share with you a little of what’s in Dead Wrong.

Outrageously, the New York Times, one of the world’s most prestigious newspapers, has never retracted its absurd headline that “mass graves” were uncovered in Kamloops, British Columbia. Jonathan Kay, the North American editor of Quillette, exposes that scandal.

The legacy media were enthused about the so-called documentary Sugarcane, a feature-length film sponsored by National Geographic, which was nominated for an Academy Award. The only reporter to spot the dozens of factual errors in Sugarcane was independent journalist Michelle Stirling; Dead Wrong includes her analysis “The Bitter Roots of Sugarcane.”

In the spring of 2024, the small city of Quesnel, B.C., made national news when the mayor’s wife bought 10 copies of Grave Error for distribution to friends. After noisy protests held by people who had never read the book, Quesnel city council voted to censure Mayor Ron Paull and tried to force him from office. It’s all described in Dead Wrong.

Also not to be forgotten is how the Law Society of B.C. forced upon its members training materials asserting against all evidence that children’s remains have been discovered in Kamloops. As told by James Pew, B.C. MLA Dallas Brodie was expelled from the Conservative caucus for daring to point out the emperor’s lack of clothing.

Then there’s the story of Jim McMurtry, suspended by the Abbotsford District School Board shortly after the 2021 Kamloops announcement about “unmarked graves.” McMurtry’s offence was to tell students the truth that, while some Indigenous students did die in residential schools, the main cause was tuberculosis. His own book The Scarlet Lesson is excerpted here.

Historian Ian Gentles and former IRS teacher Pim Wiebel offer a richly detailed analysis of health and medical conditions in the schools. They show that these were much better than what prevailed in the Indian reserves from which most students came.

Another important contribution to understanding the medical issues is by Dr. Eric Schloss, narrating the history of the Charles Camsell Indian Hospital in Edmonton. IRS facilities usually included small clinics, but students with serious problems were often transferred to Indian Hospitals for more intensive care. Schloss, who worked in the Camsell, describes how it delivered state-of-the-art medicine, probably better than the care available to most children anywhere in Canada at the time.

Rodney Clifton’s contribution, “They would call me a ‘Denier,’” describes his experiences working in two IRS in the 1960s. Clifton does not tell stories of hunger, brutal punishment and suppression of Indigenous culture, but of games, laughter and trying to learn native languages from his Indian and Inuit charges.

Toronto lawyer and historian Greg Piasetzki explains how “Canada Wanted to Close All Residential Schools in the 1940s. Here’s why it couldn’t.” For many Indian parents, particularly single parents and/or those with large numbers of children, the IRS were the best deal available. And they offered paid employment to large numbers of Indians as cooks, janitors, farmers, health-care workers, and even teachers and principals.

Finally, Frances Widdowson analyzes the charge of residential school “denialism” used by true believers in the Kamloops narrative to shut down criticism or questions. Winnipeg Centre MP Leah Gazan in 2022 persuaded the House of Commons to give unanimous consent to a resolution on residential school genocide: “That, in the opinion of the House this government must recognize what happened in Canada’s Indian residential schools as genocide.”

In 2024, Gazan took the next step by introducing a private member’s bill to criminalize dissent about the IRS system. The bill failed to pass, but Gazan reintroduced it in 2025. Had these provisions been in force back in 2021, it might well have become a crime to point out that the Kamloops ground-penetrating radar (GPR) survey had identified soil anomalies, not buried bodies.

While the wheels of legislation and litigation grind and spin, those who wish to limit open discussion of residential schools attack truth-tellers as “denialists,” a term drawn from earlier debates about the Holocaust. As the proponents of the Kamloops narrative fail to provide convincing hard evidence for it, they hope to mobilize the authority of the state to stamp out dissent. One of the main goals of publishing Dead Wrong is to head off this drive toward authoritarianism.

Happily, Dead Wrong, like Grave Error, has already become an Amazon best-seller. The struggle for truth continues.

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