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Fraser Institute

Here’s your annual bill for public health care

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3 minute read

From the Fraser Institute

By Bacchus Barua

Notably, the amount paid by the average family has increased by 239.7 per cent since 1997 (the first year of available data).

According to a recent survey by Statistics Canada, almost half of Canadians said that rising prices are affecting their ability to meet day-to-day expenses. At the same time, Canadians are increasingly aware of their significant tax burden, with 74 per cent feeling the average family is overtaxed. This is not surprising given the average Canadian family spends more on taxes than food, clothing and shelter combined.

However, one contributor to this growing tax burden remains hidden—the price we pay public health care. You read that right. Public health care is not free—but it’s very difficult to figure out exactly how much we pay for it on an individual or family basis.

This is primarily because our public health-care system is funded through general government revenues. In other words, there’s no dedicated tax that fully funds the system. Our income taxes, sales taxes, business taxes and other taxes get poured into a fiscal vat, from which governments take a generous portion for health care.

While it’s easy enough to gauge total health-care spending by governments ($225.1 billion) or how much was spent per Canadian ($5,614), it remains nearly impossible for Canadian families of different sizes and incomes to calculate how much they contribute towards that vast amount.

But a recent study helps us get a general idea. According to the study, an average family of four (two parents and two children) with an average income of $176,266 will pay an estimated $17,713 (in taxes) for public health care this year. Single Canadians, with an average income of $55,925, will pay $5,629. Of course, these amounts vary by income with the poorest 10 per cent of income earners paying $639 while the top 10 per cent pay $47,071.

Notably, the amount paid by the average family has increased by 239.7 per cent since 1997 (the first year of available data). This increase is 3.1 times greater than the rate of inflation, 2.2 times greater than food cost increases, and 1.6 times greater than housing costs increases. And crucially, the cost of public health care for the average family has increased 1.7 times faster than their average incomes grew during the same period.

These figures are not only important for families who are interested in how their tax dollars are spent, they are one very important side of the equation when trying to understand whether we receive good value for our health-care dollars. Moreover, as politicians continue to promise ever increasing health-care spending to fix our crumbling system, it’s crucial for Canadians to understand exactly how that spending impacts their wallets.

One thing is clear. With nearly an $18,000 price tag for the average family of four, Canada’s public health-care system is anything but free.

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Alberta

Albertans need clarity on prime minister’s incoherent energy policy

Published on

From the Fraser Institute

By Tegan Hill

The new government under Prime Minister Mark Carney recently delivered its throne speech, which set out the government’s priorities for the coming term. Unfortunately, on energy policy, Albertans are still waiting for clarity.

Prime Minister Carney’s position on energy policy has been confusing, to say the least. On the campaign trail, he promised to keep Trudeau’s arbitrary emissions cap for the oil and gas sector, and Bill C-69 (which opponents call the “no more pipelines act”). Then, two weeks ago, he said his government will “change things at the federal level that need to be changed in order for projects to move forward,” adding he may eventually scrap both the emissions cap and Bill C-69.

His recent cabinet appointments further muddied his government’s position. On one hand, he appointed Tim Hodgson as the new minister of Energy and Natural Resources. Hodgson has called energy “Canada’s superpower” and promised to support oil and pipelines, and fix the mistrust that’s been built up over the past decade between Alberta and Ottawa. His appointment gave hope to some that Carney may have a new approach to revitalize Canada’s oil and gas sector.

On the other hand, he appointed Julie Dabrusin as the new minister of Environment and Climate Change. Dabrusin was the parliamentary secretary to the two previous environment ministers (Jonathan Wilkinson and Steven Guilbeault) who opposed several pipeline developments and were instrumental in introducing the oil and gas emissions cap, among other measures designed to restrict traditional energy development.

To confuse matters further, Guilbeault, who remains in Carney’s cabinet albeit in a diminished role, dismissed the need for additional pipeline infrastructure less than 48 hours after Carney expressed conditional support for new pipelines.

The throne speech was an opportunity to finally provide clarity to Canadians—and specifically Albertans—about the future of Canada’s energy industry. During her first meeting with Prime Minister Carney, Premier Danielle Smith outlined Alberta’s demands, which include scrapping the emissions cap, Bill C-69 and Bill C-48, which bans most oil tankers loading or unloading anywhere on British Columbia’s north coast (Smith also wants Ottawa to support an oil pipeline to B.C.’s coast). But again, the throne speech provided no clarity on any of these items. Instead, it contained vague platitudes including promises to “identify and catalyse projects of national significance” and “enable Canada to become the world’s leading energy superpower in both clean and conventional energy.”

Until the Carney government provides a clear plan to address the roadblocks facing Canada’s energy industry, private investment will remain on the sidelines, or worse, flow to other countries. Put simply, time is up. Albertans—and Canadians—need clarity. No more flip flopping and no more platitudes.

Tegan Hill

Tegan Hill

Director, Alberta Policy, Fraser Institute
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Fraser Institute

Long waits for health care hit Canadians in their pocketbooks

Published on

From the Fraser Institute

By Mackenzie Moir

Canadians continue to endure long wait times for health care. And while waiting for care can obviously be detrimental to your health and wellbeing, it can also hurt your pocketbook.

In 2024, the latest year of available data, the median wait—from referral by a family doctor to treatment by a specialist—was 30 weeks (including 15 weeks waiting for treatment after seeing a specialist). And last year, an estimated 1.5 million Canadians were waiting for care.

It’s no wonder Canadians are frustrated with the current state of health care.

Again, long waits for care adversely impact patients in many different ways including physical pain, psychological distress and worsened treatment outcomes as lengthy waits can make the treatment of some problems more difficult. There’s also a less-talked about consequence—the impact of health-care waits on the ability of patients to participate in day-to-day life, work and earn a living.

According to a recent study published by the Fraser Institute, wait times for non-emergency surgery cost Canadian patients $5.2 billion in lost wages in 2024. That’s about $3,300 for each of the 1.5 million patients waiting for care. Crucially, this estimate only considers time at work. After also accounting for free time outside of work, the cost increases to $15.9 billion or more than $10,200 per person.

Of course, some advocates of the health-care status quo argue that long waits for care remain a necessary trade-off to ensure all Canadians receive universal health-care coverage. But the experience of many high-income countries with universal health care shows the opposite.

Despite Canada ranking among the highest spenders (4th of 31 countries) on health care (as a percentage of its economy) among other developed countries with universal health care, we consistently rank among the bottom for the number of doctors, hospital beds, MRIs and CT scanners. Canada also has one of the worst records on access to timely health care.

So what do these other countries do differently than Canada? In short, they embrace the private sector as a partner in providing universal care.

Australia, for instance, spends less on health care (again, as a percentage of its economy) than Canada, yet the percentage of patients in Australia (33.1 per cent) who report waiting more than two months for non-emergency surgery was much higher in Canada (58.3 per cent). Unlike in Canada, Australian patients can choose to receive non-emergency surgery in either a private or public hospital. In 2021/22, 58.6 per cent of non-emergency surgeries in Australia were performed in private hospitals.

But we don’t need to look abroad for evidence that the private sector can help reduce wait times by delivering publicly-funded care. From 2010 to 2014, the Saskatchewan government, among other policies, contracted out publicly-funded surgeries to private clinics and lowered the province’s median wait time from one of the longest in the country (26.5 weeks in 2010) to one of the shortest (14.2 weeks in 2014). The initiative also reduced the average cost of procedures by 26 per cent.

Canadians are waiting longer than ever for health care, and the economic costs of these waits have never been higher. Until policymakers have the courage to enact genuine reform, based in part on more successful universal health-care systems, this status quo will continue to cost Canadian patients.

Mackenzie Moir

Senior Policy Analyst, Fraser Institute
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