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84% of Swiss hospitals and 60% of hospitalizations are in private facilities, and they face much lower wait times

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From the Fraser Institute

By Yanick Labrie

If Canada reformed to emulate Switzerland’s approach to universal health care, including its much greater use of private sector involvement, the country would deliver far better results to patients and reduce wait times, finds a new study published today by the Fraser Institute, an independent, non-partisan Canadian policy think-tank.

“The bane of Canadian health care is lack of access to timely care, so it’s critical to look to countries like Switzerland with more successful universal health care,” said Yanick Labrie, senior fellow at the Fraser Institute and author of Integrating Private Health Care Into Canada’s Public System: What We Can Learn from Switzerland. The study highlights how Switzerland successfully integrates the private sector into their universal health-care system, which consistently outperforms Canada on most health-care metrics, including wait times.

For example, in 2022, the percentage of patients who waited less than two months for a specialist appointment was 85.3 per cent in Switzerland compared to just 48.3 per cent in Canada.

In Switzerland, 84.2 per cent of all hospitals are private (either for-profit or not-for profit) institutions, and the country’s private hospitals provide 60.2 per cent of all hospitalizations, 60.9 per cent of all births, and 67.1 per cent of all operating rooms.

Crucially, Swiss patients can obtain treatment at the hospital of their choice, whether located inside or outside their geographic location, and hospitals cannot discriminate against patients, based on the care required.

“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.

“Based on the success of the Swiss model, provinces can make these reforms now and help improve Canadian health care.”

Integrating Private Health Care into Canada’s Public System: What We Can Learn from Switzerland

  • Access to timely care remains the Achilles’ heel of Canada’s health systems. To reduce wait times, some provinces have partnered with private clinics for publicly funded surgeries—a strategy that has proven effective, but continues to spark debate in Canada.
  • This study explores how Switzerland successfully integrates private health care into a universal public system and considers what Canada can learn from this model.
  • In Switzerland, universal coverage is delivered through a system of managed competition among 44 non-profit private insurers, while decentralized governance allows each of the 26 cantons to coordinate and oversee hospital services in ways that reflect local needs and priorities.
  • Nearly two-thirds of Swiss hospitals are for-profit institutions; they provide roughly half of all hospitalizations, births, and hospital beds across the country.
  • All hospitals are treated equally—regardless of legal status—and funded through the same activity-based model, implemented nationwide in 2012.
  • The reform led to a significant increase in the number of cases treated without a corresponding rise in expenditures per case, suggesting improved efficiency, better use of resources, and expanded access to hospital care.
  • The average length of hospital stay steadily decreased over time and now stands at 4.87 days in for-profit hospitals versus 5.53 days in public ones, indicating faster patient turnover and more streamlined care pathways.
  • Hospital-acquired infection rates are significantly lower in private hospitals (2.7%) than in public hospitals (6.2%), a key indicator of care quality.
  • Case-mix severity is as high or higher in private hospitals, countering the notion that they only take on simpler or less risky cases.
  • Patient satisfaction is slightly higher in private hospitals (4.28/5) than in public ones (4.17/5), reflecting strong user experience across multiple dimensions.
  • Canada could benefit from regulated competition between public and private providers and activity-based funding, without breaching the Canada Health Act.

Yanick Labrie

Senior Fellow, Fraser Institute

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The great policy challenge for governments in Canada in 2026

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From the Fraser Institute

By Ben Eisen and Jake Fuss

According to a recent study, living standards in Canada have declined over the past five years. And the country’s economic growth has been “ugly.” Crucially, all 10 provinces are experiencing this economic stagnation—there are no exceptions to Canada’s “ugly” growth record. In 2026, reversing this trend should be the top priority for the Carney government and provincial governments across the country.

Indeed, demographic and economic data across the country tell a remarkably similar story over the past five years. While there has been some overall economic growth in almost every province, in many cases provincial populations, fuelled by record-high levels of immigration, have grown almost as quickly. Although the total amount of economic production and income has increased from coast to coast, there are more people to divide that income between. Therefore, after we account for inflation and population growth, the data show Canadians are not better off than they were before.

Let’s dive into the numbers (adjusted for inflation) for each province. In British Columbia, the economy has grown by 13.7 per cent over the past five years but the population has grown by 11.0 per cent, which means the vast majority of the increase in the size of the economy is likely due to population growth—not improvements in productivity or living standards. In fact, per-person GDP, a key indicator of living standards, averaged only 0.5 per cent per year over the last five years, which is a miserable result by historic standards.

A similar story holds in other provinces. Prince Edward Island, Nova Scotia, Quebec and Saskatchewan all experienced some economic growth over the past five years but their populations grew at almost exactly the same rate. As a result, living standards have barely budged. In the remaining provinces (Newfoundland and Labrador, New Brunswick, Ontario, Manitoba and Alberta), population growth has outstripped economic growth, which means that even though the economy grew, living standards actually declined.

This coast-to-coast stagnation of living standards is unique in Canadian history. Historically, there’s usually variation in economic performance across the country—when one region struggles, better performance elsewhere helps drive national economic growth. For example, in the early 2010s while the Ontario and Quebec economies recovered slowly from the 2008/09 recession, Alberta and other resource-rich provinces experienced much stronger growth. Over the past five years, however, there has not been a “good news” story anywhere in the country when it comes to per-person economic growth and living standards.

In reality, Canada’s recent record-high levels of immigration and population growth have helped mask the country’s economic weakness. With more people to buy and sell goods and services, the overall economy is growing but living standards have barely budged. To craft policies to help raise living standards for Canadian families, policymakers in Ottawa and every provincial capital should remove regulatory barriers, reduce taxes and responsibly manage government finances. This is the great policy challenge for governments across the country in 2026 and beyond.

Ben Eisen

Senior Fellow, Fraser Institute

Jake Fuss

Director, Fiscal Studies, Fraser Institute
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How convenient: Minnesota day care reports break-in, records gone

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A Minneapolis day care run by Somali immigrants is claiming that a mysterious break-in wiped out its most sensitive records, even as police say officers were never told that anything was actually stolen — a discrepancy that’s drawing sharp attention amid Minnesota’s spiraling child care fraud scandal.

According to the center’s manager, Nasrulah Mohamed, someone forced their way into Nakomis Day Care Center earlier this week by entering through a rear kitchen area, damaging a wall and accessing the office. Mohamed told reporters the intruder made off with “important documentation,” including children’s enrollment records, employee files, and checkbooks tied to the facility’s operations.

But a preliminary report from the Minneapolis Police Department tells a different story. Police say no loss was reported to officers at the time of the call. While the department confirmed the center later contacted police with additional information, an updated report was not immediately available.

Video released by the day care purporting to show damage from the incident depicts a hole punched through drywall inside what appears to be a utility closet, with stacks of cinder blocks visible just behind the wall — imagery that has only fueled skepticism as investigators continue to unravel what authorities have described as one of the largest fraud schemes ever tied to Minnesota’s human services programs.

Mohamed blamed the alleged break-in on fallout from a viral investigation by YouTuber Nick Shirley, who recently toured nearly a dozen Minnesota day care sites while questioning whether they were legitimately operating. Shirley’s video has racked up more than 110 million views. Mohamed insisted the coverage unfairly targeted Somali operators and said his center has since received what he described as hateful and threatening messages.

“This is devastating news, and we don’t know why this is targeting our Somali community,” Mohamed said, calling Shirley’s reporting false. Nakomis Day Care Center was not among the facilities featured in the video.

The break-in claim surfaced as law enforcement and federal officials continue to expose a massive fraud network centered in Minneapolis, involving food assistance, housing, and child care payments. Authorities say at least $1 billion has already been identified as fraudulent, with federal prosecutors warning the total could climb as high as $9 billion. Ninety-two people have been charged so far, 80 of them Somali immigrants.

Late Tuesday, the U.S. Department of Health and Human Services announced it was freezing all federal child care payments to Minnesota unless the state can prove the funds are being used lawfully. The payments totaled roughly $185 million in 2025 alone.

Minnesota Gov. Tim Walz, under intensifying scrutiny for allowing fraud to metastasize for years, responded by attacking the Trump administration rather than addressing the substance of the findings. “This is Trump’s long game,” Walz wrote on X Tuesday night, claiming the administration was politicizing fraud enforcement to defund programs — despite federal officials pointing to documented abuse and ongoing criminal cases.

Meanwhile, questions continue to swirl around facilities already flagged by investigators. Reporters visiting several sites highlighted in Shirley’s video found at least one — Quality “Learing” Center — operating with children inside despite state officials previously saying it had been shut down. The Minnesota Department of Children, Youth, and Families later issued a confusing clarification, saying the center initially reported it would close but later claimed it would remain open.

As Minnesota scrambles to respond to the funding freeze and mounting arrests, the conflicting accounts surrounding the Nakomis Day Care incident underscore a broader problem confronting state leaders: a system so riddled with gaps and contradictions that even basic facts — like whether records were actually stolen — are now in dispute, while taxpayers are left holding the bill.

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