From the Fraser Institute

By Bacchus Barua and Mackenzie Moir

Just when you thought Canadian health care had hit rock bottom, wait times in 2024 have hit an all-time high.

According to the latest version of our annual report published by the Fraser Institute, the median wait from referral by a family doctor to treatment (averaged across 10 provinces and 12 medical specialties including surgeries) is now 30 weeks—the longest wait in the report’s history and more than three times longer than the 9.3-week median wait in 1993.

Of course, wait times vary by province, and some provinces are worse than others. In New Brunswick and Prince Edward Island, the median wait is more than one year. And even in Ontario, which reported the shortest wait times in Canada this year, patients faced a 23.6-week wait, the longest in the province’s history.

In fact, compared to last year, wait times grew in every province (except Nova Scotia where patients still faced a median wait just shy of 40 weeks this year).

There’s also considerable variation in wait times depending on the type of care. For example, patients faced the longest waits for orthopedic surgeries (57.5 weeks) and neurosurgery (46.2 weeks) and shorter waits for chemotherapy (4.7 weeks), and radiological cancer treatments (4.5 weeks). In total, the study estimated that Canadian patients were waiting for more than 1.5 million procedures in 2024.

These waits for care are not benign inconveniences. Patients may experience physical pain, psychological distress and worsening physical condition while awaiting care. This year, the 15-week median wait for treatment after seeing a specialist was more than a month and a half longer than what physicians consider a reasonable wait (8.6 weeks). And this doesn’t even include the median 15-week wait to see a specialist in the first place.

Moreover, according to the Commonwealth Fund, a U.S.-based health-care research organization, among nine universal health-care systems worldwide, last year patients in Canada were the second-most likely to report waiting longer than one month for a specialist consultation, and the most likely to report waiting more than two months for surgery. In other words, although long wait times remain a staple of Canadian health care, they are not a necessary trade-off for having universal coverage.

And to be clear, wait times are only one manifestation of the strain on Canada’s health-care system. It’s now also normal to see emergency room closures, health-care worker burnout, and data suggesting millions of Canadians are without access to a regular health-care provider.

What’s the solution to Canada’s crippling health-care wait times?

There are many options for reform. But put simply, if policymakers in Canada want to reduce wait times for patients across the country, they should learn from better-performing universal health-care countries where patients receive more timely care. With wait times this year reaching an all-time high, relief can’t come soon enough.

Bacchus Barua

Director, Health Policy Studies, Fraser Institute

Mackenzie Moir

Senior Policy Analyst, Fraser Institute

In situ oil sands project in northern Alberta. Photo courtesy MEG Energy

From the Canadian Energy Centre

By Deborah Jaremko

‘The oil sands are Canada’s winning lottery ticket’

As Alberta’s oil sands sector reaches a major economic milestone, a new report shows that emissions growth continues to slow.

There is a clear “structural break” for the industry where production growth is beginning to rise faster than emissions growth, according to S&P Global Commodity Insights. While last year’s oil sands production was nine per cent higher than in 2019, total emissions rose by just three per cent.

“It’s not driven solely by slower production growth because production growth has continued. This is a notable, significant change in oil sands emissions,” said Kevin Birn, head of S&P Global’s Centre for Emissions Excellence.

Birn said that in many cases oil sands growth is coming from optimization, where for example instead of companies building new equipment to generate more steam to inject underground, they have found ways to produce more oil with the steam they already have.

Emissions per barrel, or so-called “emissions intensity” is now 28 per cent lower than it was in 2009.

Earlier this year, S&P Global raised its oil sands production outlook, now projecting the sector will reach 3.8 million barrels per day by 2030, compared to 3.2 million barrels per day in 2023.

Analysts continue to expect total oil sands emissions to peak in the next couple of years, absent the federal government’s proposed oil and gas emissions cap.

“Certainly, there’s potential for that to occur later if there’s more volume than we anticipate, but it’s also the time when we start to see the potential for large-scale decarbonizations to emerge towards the end of this decade,” Birn said.

Meanwhile, before the end of this year the oil sands sector will hit approximately $1 trillion of cumulative spending over the last 25 years, according to a joint report by the Macdonald-Laurier Institute and Pathways Alliance.

That is, not profits or dividends, but investment in operations, building new facilities, and government payments including taxes and royalties.

“The oilsands are Canada’s winning lottery ticket,” wrote MLI’s Heather Exner-Pirot and Pathways’ Bryan Remillard.

They noted that oil sands producers have paid more than $186 billion in royalties and taxes to Canadian governments, representing more than the last five years of Canadian defense spending.

“Far from just an Alberta success story, the oilsands are a quintessentially Canadian sector. More than 2,300 companies outside of Alberta have had direct business with the oilsands, including over 1,300 in Ontario and almost 600 in Quebec,” wrote Exner-Pirot and Remillard.

“That juggernaut could keep Canada’s economy prosperous for many more decades, providing the feedstock for chemicals and carbon-based materials whenever global fuel consumption starts to decline.”

That is, unless companies are forced to cut production, which credible analysis has found will happen with Ottawa’s emissions cap – well over one million barrels per day by 2030, which Exner-Pirot and Remillard said would have to come almost entirely from Canada’s exports to the United States.

“If companies are forced to cut their production, they won’t be able to afford to aggressively cut emissions. Nor will they be able to make other investments to maximize and sustain the value of this resource.”