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Fraser Institute

Ottawa’s health-care deal cements failed status quo in Canada

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From the Fraser Institute

By Mackenzie Moir and Jake Fuss

Canada will reach a projected $244.1 billion in 2023, which translates to $6,205 per person—nearly double the level of per-person spending (inflation-adjusted) three decades ago. And yet, last year Canadians endured the longest median wait time (27.7 weeks) ever recorded for non-emergency surgery.

Last week, as part of Ottawa’s promised $46 billion in additional health-care spending, the Trudeau government agreed to increase Quebec’s share of federal health-care dollars by $900 million annually. Quebec was the last province to reach an agreement with Ottawa before the March 31 deadline. With the closure of this agreement, Canadian taxpayers are on the hook for more health-care spending than ever before. For the same old broken health-care system.

Of course, it ultimately doesn’t matter whether the $46 billion originates from Ottawa or the provinces. In the end, Canadian taxpayers foot the bill. And what do we get in return for our health-care dollars?

In 2021, the latest year of comparable data, Canada’s total health-care spending (as a percentage of the economy) was the highest among 29 other comparable countries with universal health care (after adjusting for differences in population age). This isn’t a new development. Canada has a long history of having one of most expensive systems among high-income universal health-care countries.

Despite this, according to the latest comparable data, Canada ranks among the poorest performing universal health-care countries in key areas such as the number of physicians, hospital beds and diagnostic technology (e.g. MRI machines). Further, according to the Commonwealth Fund, in 2020 Canada ranked dead last on timely access to specialist consultations and non-emergency surgery.

Meanwhile, public health-care spending in Canada will reach a projected $244.1 billion in 2023, which translates to $6,205 per person—nearly double the level of per-person spending (inflation-adjusted) three decades ago. And yet, last year Canadians endured the longest median wait time (27.7 weeks) ever recorded for non-emergency surgery.

In short, Canada’s health-care system is in shambles, but the answer does not lie in simply throwing more money in its general direction. Federal politicians should instead look to the example of welfare reform during the Chrétien era in the 1990s. Those reforms, which reduced federal transfers to provinces and eliminated most of the “strings” attached to federal funding, resulted in increased provincial autonomy, greater policy experimentation, fewer Canadians needing welfare and savings for the federal government (i.e. taxpayers).

This is the opposite of today’s approach to health care, where the existing vehicle for federal funding (the Canada Health Transfer) is connected to the Canada Health Act (CHA), which prevents provincial governments from innovating and experimenting in health care by threatening financial penalties for non-compliance with often vaguely defined federal preferences. The result is a stalemate that satisfies no one and ensures that Canada’s policies remain at odds with the policies of our better-performing universal health-care peers.

While new federal dollars for health care are undoubtedly appealing to premiers, they will not improve the state of health care for Canadians. Until our federal politicians have the courage to reform the CHA and follow the example of 1990s welfare reform to improve outcomes, our health-care system’s unacceptable status quo will continue.

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Automotive

EV fantasy losing charge on taxpayer time

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From the Fraser Institute

By Kenneth P. Green

The vision of an all-electric transportation sector, shared by policymakers from various governments in Canada, may be fading fast.

The latest failure to charge is a recent announcement by Honda, which will postpone a $15 billion electric vehicle (EV) project in Ontario for two years, citing market demand—or lack thereof. Adding insult to injury, Honda will move some of its EV production to the United States, partially in response to the Trump Tariff Wars. But any focus on tariffs is misdirection to conceal reality; failures in the electrification agenda have appeared for years, long before Trump’s tariffs.

In 2023, the Quebec government pledged $2.9 billion in financing to secure a deal with Swedish EV manufacturer NorthVolt. Ottawa committed $1.34 billion to build the plant and another $3 billion worth of incentives. So far, per the CBC, the Quebec government “ invested $270 million in the project and the provincial pension investor, the Caisse de dépôt et placement du Québec (CDPQ), has also invested $200 million.” In 2024, NorthVolt declared bankruptcy in Sweden, throwing the Canadian plans into limbo.

Last month, the same Quebec government announced it will not rescue the Lion Electric company from its fiscal woes, which became obvious in December 2024 when the company filed for creditor protection (again, long before the tariff war). According to the Financial Post, “Lion thrived during the electric vehicle boom, reaching a market capitalization of US$4.2 billion in 2021 and growing to 1,400 employees the next year. Then the market for electric vehicles went through a tough period, and it became far more difficult for manufacturers to raise capital.” The Quebec government had already lost $177 million on investments in Lion, while the federal government lost $30 million, by the time the company filed for creditor protection.

Last year, Ford Motor Co. delayed production of an electric SUV at its Oakville, Ont., plant and Umicore halted spending on a $2.8 billion battery materials plant in eastern Ontario. In April 2025, General Motors announced it will soon close the CAMI electric van assembly plant in Ontario, with plans to reopen in the fall at half capacity, to “align production schedules with current demand.” And GM temporarily laid off hundreds of workers at its Ingersoll, Ontario, plant that produces an electric delivery vehicle because it isn’t selling as well as hoped.

There are still more examples of EV fizzle—again, all pre-tariff war. Government “investments” to Stellantis and LG Energy Solution and Ford Motor Company have fallen flat and dissolved, been paused or remain in limbo. And projects for Canada’s EV supply chain remain years away from production. “Of the four multibillion-dollar battery cell manufacturing plants announced for Canada,” wrote automotive reporter Gabriel Friedman, “only one—a joint venture known as NextStar Energy Inc. between South Korea’s LG Energy Solution Ltd. and European automaker Stellantis NV—progressed into even the construction phase.”

What’s the moral of the story?

Once again, the fevered dreams of government planners who seek to pick winning technologies in a major economic sector have proven to be just that, fevered dreams. In 2025, some 125 years since consumers first had a choice of electric vehicles or internal combustion vehicles (ICE), the ICE vehicles are still winning in economically-free markets. Without massive government subsidies to EVs, in fact, there would be no contest at all. It’d be ICE by a landslide.

In the face of this reality, the new Carney government should terminate any programs that try to force EV technologies into the marketplace, and rescind plans to have all new light-duty vehicle sales be EVs by 2035. It’s just not going to happen, and planning for a fantasy is not sound government policy nor sound use of taxpayer money. Governments in Ontario, Quebec and any other province looking to spend big on EVs should also rethink their plans forthwith.

Kenneth P. Green

Senior Fellow, Fraser Institute
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Business

Switzerland has nearly 65% more doctors and much shorter wait times than Canada, despite spending roughly same amount on health care

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From the Fraser Institute

By Yanick Labrie

Switzerland’s universal health-care system delivers significantly better results than Canada’s in terms of wait times, access to health professionals like doctors and nurses, and patient satisfaction finds a new study published by the Fraser Institute, an independent, non-partisan Canadian policy think-tank.

“Despite its massive price tag, Canada’s health-care system lags behind many other countries with universal health care,” said Yanick Labrie, senior fellow at the Fraser Institute and author of Building Responsive and Adaptive Health-Care Systems in Canada: Lessons from Switzerland.

The study highlights how Switzerland’s universal health-care system consistently outperforms Canada on most metrics tracked by the OECD.

In 2022, the latest year of available data, despite Canada (11.5 per cent of GDP) and Switzerland (11.9 per cent) spending close to the same amount on health care, Switzerland had 4.6 doctors per thousand people compared to 2.8 in Canada. In other words, Switzerland had 64.3 per cent more doctors than Canada (on a per-thousand people basis).

Switzerland also had 4.4 hospital beds per thousand people compared to 2.5 for Canada—Switzerland (8th) outranked Canada (36th) on this metric out of 38 OECD countries with universal health care.

Likewise, 85.3 per cent of Swiss people surveyed by the CWF (Commonwealth Fund) reported being able to obtain a consultation with a specialist within 2 months. By comparison, only 48.3 per cent of Canadians experienced a similar wait time. Beyond medical resources and workforce, patient satisfaction diverges sharply between the two countries, as 94 per cent of Swiss patients report being satisfied with their health-care system compared to just 56 per cent in Canada.

“Switzerland shows that a universal health care system can reconcile efficiency and equity – all while being more accessible and responsive to patients’ needs and preferences,” Labrie said.

“Policymakers in Canada who hope to improve Canada’s broken health-care system should look to more successful universal health-care countries like Switzerland.”

Building Responsive and Adaptive Health Care Systems in Canada: Lessons from Switzerland

  • Canada’s health-care system is increasingly unable to meet patient needs, with wait times reaching record lengths—over 30 weeks for planned care in 2024—despite significantly rising public spending and growing dissatisfaction among patients and providers nationwide.
  • Swiss health care outperforms Canada in nearly all OECD performance indicators: more doctors and nurses per capita, better access to care, shorter wait times, lower unmet needs, and higher patient satisfaction (94% vs. Canada’s 56%).
  • Switzerland ensures universal coverage through 44 competing private, not-for-profit insurers. Citizens are required to enroll but have the freedom to choose insurers and tailor coverage to their needs and preferences, promoting both access and autonomy.
  • Swiss basic insurance coverage is broader than Canada’s, including outpatient care, mental health, prescribed medications, home care, and long-term care—with modest, capped cost-sharing, and exemptions for vulnerable groups, including children, low-income individuals, and the chronically ill.
  • Patient cost participation (deductibles/co-payments) exists, but the system includes robust financial protection: 27.5% of the population receives direct subsidies, ensuring affordability and equity.
  • Risk equalization mechanisms prevent risk selection and guarantee insurer fairness, promoting solidarity across demographic and health groups.
  • Decentralized governance enhances responsiveness; cantons manage service planning, ensuring care adapts to local realities and population needs.
  • Managed competition drives innovation and efficiency: over 75% of the Swiss now choose alternative models (e.g., HMOs, telemedicine, gatekeeping).
  • The Swiss model proves that a universal, pluralistic, and competitive system can reconcile efficiency, equity, access, and patient satisfaction—offering powerful insights for Canada’s stalled health reform agenda.

 

Yanick Labrie

Senior Fellow, Fraser Institute
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