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

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

Director, Alberta Policy, Fraser Institute