Fraser Institute
Time to finally change the Canada Health Act for the sake of patients

From the Fraser Institute
Back in 1984, the Canada Health Act (CHA) received royal assent and has since reached near iconic status. At the same time, under its purview, the Canadian health-care system has become one of the least accessible—and most expensive—universal health-care systems in the developed world.
Clearly, policymakers should reform the CHA to reflect a more contemporary understanding of how to structure a truly world-class universal health-care system.
Consider for a moment the remarkably poor state of access to health care in Canada today. According to international comparisons of universal health-care systems, we endure some of the lowest access to physicians, medical technologies and hospital beds in the developed world. Wait times for health care in Canada also routinely rank among the longest in the developed world.
None of this is new. Canada’s poor ranking in the availability of services reaches back at least two decades. And wait times for health care have nearly tripled since the early 1990s. Back then, in 1993, Canadians could expect to wait 9.3 weeks for medical treatment after GP referral compared to 30 weeks in 2024.
This is all happening despite Canadians paying for one of the world’s most expensive universal-access health-care systems. And this brings us back to the CHA, which contains the federal government’s requirements for provincial policymaking. To receive their full federal cash transfers for health care from Ottawa, provinces must abide by CHA rules and regulations. And therein lies the rub.
We can find the solutions to our health-care woes in other countries such as Germany, Switzerland, the Netherlands and Australia, which all provide more timely access to quality care. Every one of these countries requires patient cost-sharing for physician and hospital services, and private competition in the delivery of universally accessible services with money following patients to hospitals and surgical clinics. And all these countries allow private purchases of health care, as this reduces the burden on the publicly-funded system and creates a valuable pressure valve for it.
Unfortunately for Canadians, the CHA expressly disallows requiring patients to share the cost of treatment while the CHA’s often vaguely defined terms and conditions have been used by federal governments to discourage a larger role for the private sector in the delivery of health-care services. At the same time, every new federal commitment to fix health care means increased provincial reliance on Ottawa. In 2024-25, federal cash transfers for health care are expected to total $52 billion, which means there’s $52 billion on the line for perceived non-compliance with the CHA. In short, this is why the provinces beholden to a policy approach that’s clearly failing Canadians.
So, what to do?
For starters, Ottawa should learn from its own welfare reforms in the 1990s, which reduced federal transfers and allowed provinces more flexibility with policymaking. The resulting period of provincial policy innovation reduced welfare dependency and government spending on social assistance (i.e. savings for taxpayers). When Ottawa stepped back and allowed the provinces to vary policy to their unique circumstances, Canadians got improved outcomes for fewer dollars.
We need that same approach for health care today, and it begins with the federal government reforming the CHA to expressly allow provinces the ability to explore alternate policy approaches, while maintaining the foundational principles of universality.
Next, the federal government should either hold cash transfers for health care constant (in nominal terms), reduce them or eliminate them entirely with a concordant reduction in federal taxes. By reducing (or eliminating) the pool of cash tied to the strings of the CHA, provinces would have greater freedom to pursue reform policies they consider to be in the best interests of their residents without federal intervention.
After 40 years, it’s high time to remove ambiguity and minimize uncertainty—and the potential for politically motivated interpretations—of the CHA. If federal policymakers want Canadians to finally have access to world-class health care, they should allow the provinces to choose their own set of universal health-care policies. The first step is to fix the 40-year-old legislation that has held the provinces back.
Energy
Next federal government should close widening gap between Canadian and U.S. energy policy

From the Fraser Institute
After accounting for backup, energy storage and associated indirect costs—estimated solar power costs skyrocket from US$36 per megawatt hour (MWh) to as high as US$1,548, and wind generation costs increase from US$40 to up to US$504 per MWh.
At a recent energy conference in Houston, U.S. Energy Secretary Chris Wright said the Trump administration will end the Biden administration’s “irrational, quasi-religious policies on climate change that imposed endless sacrifices on our citizens.” He added that “Natural gas is responsible for 43 per cent of U.S. electricity production,” and beyond the obvious scale and cost problems, there’s “simply no physical way that wind, solar and batteries could replace the myriad uses of natural gas.”
In other words, as a federal election looms, once again the United States is diverging from Canada when it comes to energy policy.
Indeed, wind power is particularly unattractive to Wright because of its “incredibly high prices,” “incredibly huge investment” and “large footprint on the local communities,” which make it unattractive to people living nearby. Globally, Wright observes, “Natural gas currently supplies 25 per cent of raw energy globally, before it is converted into electricity or some other use. Wind and solar only supply about 3 per cent.”
And he’s right. Renewables are likely unable, physically or economically, to replace natural gas power production to meet current or future needs for affordable, abundant and reliable energy.
In a recent study published by the Fraser Institute, for example, we observed that meeting Canada’s predicted electricity demand through 2050 using only wind power (with natural gas discouraged under current Canadian climate policies) would require the construction of approximately 575 wind-power installations, each the size of Quebec’s Seigneurie de Beaupré wind farm, over 25 years. However, with a construction timeline of two years per project, this would equate to 1,150 construction years. This would also require more than one million hectares of land—an area nearly 14.5 times the size of Calgary.
Solar power did not fare much better. According to the study, to meet Canada’s predicted electricity demand through 2050 with solar-power generation would require the construction of 840 solar-power generation stations the size of Alberta’s Travers Solar Project. At a two-year construction time per facility, this adds up to 1,680 construction years to accomplish.
And at what cost? While proponents often claim that wind and solar sources are cheaper than fossil fuels, they ignore the costs of maintaining backup power to counter the unreliability of wind and solar power generation. A recent study published in Energy, a peer-reviewed energy and engineering journal, found that—after accounting for backup, energy storage and associated indirect costs—estimated solar power costs skyrocket from US$36 per megawatt hour (MWh) to as high as US$1,548, and wind generation costs increase from US$40 to up to US$504 per MWh.
The outlook for Canada’s switch to renewables is also dire. TD Bank estimated that replacing existing gas generators with renewables (such as solar and wind) in Ontario could increase average electricity costs by 20 per cent by 2035 (compared to 2021 costs). In Alberta, electricity prices would increase by up to 66 per cent by 2035 compared to a scenario without changes.
Under Canada’s current greenhouse gas (GHG) regulatory regime, natural gas is heavily disfavoured as a potential fuel for electricity production. The Trudeau government’s Clean Electricity Regulations (CER) would begin curtailing the use of natural gas beginning in 2035, leading largely to a cessation of natural gas power generation by 2050. Under CER and Ottawa’s “net-zero 2050” GHG emission framework, Canada will be wedded to a quixotic mission to displace affordable reliable natural gas power-generation with expensive unreliable renewables that are likely unable to meet expected future electricity demand.
With a federal election looming, Canada’s policymakers should pay attention to new U.S. energy policy on natural gas, and pull back from our headlong rush into renewable power. To avoid calamity, the next federal government should scrap the Trudeau-era CER and reconsider the entire “net-zero 2050” agenda.
Economy
Latest dire predictions about Carney’s emissions cap

From the Fraser Institute
According to a new report from the Parliamentary Budget Officer (PBO), the federal government’s proposed oil and gas emissions cap will curtail production, cost a not-so-small fortune and kill a lot of jobs. This news will surprise absolutely no one who’s been paying attention to Ottawa’s regulatory crusade against greenhouse gases over the past few years.
To be precise, according to the PBO’s report of March 2025, under the proposed cap, production for upstream industry oil and gas subsectors must be reduced by 4.9 per cent relative to their projected baseline levels out to 2030/32. Further, required reduction in upstream oil and gas sector production levels will lower GDP (inflation-adjusted) in Canada by an estimated 0.39 per cent in 2032 and reduce nominal GDP by $20.5 billion. And achieving the legal upper bound will reduce economy-wide employment in Canada by an estimated 40,300 jobs and fulltime equivalents by 54,400 in 2032.
The federal government is contesting the PBO’s estimates, with Jonathan Wilkinson, federal minister of Energy and Natural Resources of Canada, claiming that the “PBO wasted their time and taxpayer dollars by analyzing a made up scenario.” Of course, one might observe that using “made up scenarios” is what making forecasts of regulatory costs is all about. No one, including the government, has a crystal ball that can show the future.
But the PBO’s projected costs are only the latest analysis. A 2024 report by Deloitte (and commissioned by the federal Treasury Board) found that the proposed “cap results in a significant decline in GDP in Alberta and the Rest of Canada.” The main impacts of the cap are lower oil and gas activity and output, reduced employment, reduce income, lower returns on investment and a higher price of oil.
Consequently, according to the report, by 2040 Alberta’s GDP will be lower by 4.5 per cent and Canada’s GDP will be lower by 1 per cent compared to a no-cap baseline. Cumulatively over the 2030 to 2040 timeline, Deloitte estimated that real GDP in Alberta will be $191 billion lower, and real GDP in the Rest of Canada will be $91 billion lower compared to the no-cap (business as usual) baseline (in 2017 dollars). Employment also took a hit in the Deloitte report, which found the level of employment in 2040 will be lower by 2 per cent in Alberta and 0.5 per cent in the Rest of Canada compared to a no-cap baseline. Alberta will lose an estimated 55,000 jobs on average (35,000 in the Rest of Canada) between 2030 and 2040 under the cap.
Another 2024 report by the Conference Board of Canada estimated that the “oil and gas productions cuts forecasted lead to a one-time, permanent decline in total Canadian real GDP of between 0.9 per cent (most likely outcome) to 1.6 per cent (least likely outcome) relative to the baseline in 2030. This is equivalent to a loss of $22.8 to $40.4 billion (in 2012 dollars)… In Alberta, real GDP would fall by between $16.3 and $28.5 billion—or by 3.8 per cent and 6.7 per cent, respectively.”
Finally, a report by S&P Global Commodity Insights (and commissioned by the Canadian Association of Petroleum Producers) estimated that a “production cut driven by a stringent 40% emission cap could cause $75 billion lower upstream spend and $247 billion lower GDP contribution (vs. a no cap reference case).”
All of these estimates, by respected economic analysis firms, raise serious questions about the government’s own 2024 Regulatory Impact Analysis, which suggested that the proposed regulations will only have incremental impacts on the economy—namely, $3.3 billion (plus administrative costs to industry and the government, estimated to be $219 million). According to the analysis, the “proposed Regulations are expected to result in a net decrease in labour expenditure in the oil and gas sector of about 1.6% relative to the baseline estimate of employment income over the 2030 to 2032 time frame.”
But according to the new PBO report, the costs of the government’s proposed cap on greenhouse gas emission from Canada’s oil and gas sector will be costly and destructive to the sector, it’s primary province (Alberta), and its employees in Alberta and across Canada. All this in the face of likely-resurgent U.S. oil and gas production.
Now that policymakers in Ottawa have seemingly recognized the unpopularity of the consumer carbon tax, a good next step would be to scrap the cap.
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