From the Fraser Institute

By Jock Finlayson

Approximately three years have passed since the end of the initial phase of the COVID pandemic that saw large swathes of the economy shuttered for most of the 2020-2021 period. And it’s almost nine years since the 2015 federal election, which resulted in a majority government for Justin Trudeau’s Liberals. So, it’s a good time to do a pulse check on Canadians to see how they’re faring and feeling about the country.

Overall, the news isn’t particularly cheerful, on either front.

Dealing first with economic prosperity, the big story is that Canada’s population has been growing faster than the volume of output produced by the economy (defined as gross domestic product, adjusted for inflation). This means the economy has been shrinking on a per-person basis, prompting some analysts to coin the term “per-person recession” to describe the performance of Canada’s economy since 2022.

The trend has been stark in the last two years, but it started earlier. The absolute level of per-person output is smaller today than in 2018 in seven of 10 provinces including Ontario. More importantly, income and earnings growth has been essentially stagnant for most Canadians over roughly the last decade. Canada has also fallen further behind the best-performing advanced economies on productivity, per-person income and real wages.

What about public attitudes? A recent Ipsos survey finds 70 per cent of Canadians think the country is “broken,” an opinion especially common among young adults. Older Canadians have a more positive view of things. A Statistics Canada survey shows a significant drop in the percentage of Canadians reporting high levels of “life satisfaction.” The same survey shows that 40 per cent of respondents between the ages of 25 and 54 say it’s difficult to meet their financial needs.

The shock delivered by the recent bout of high inflation no doubt has contributed to this gloomy assessment. And it doesn’t help the public mood that housing has never been less affordable, that crime is on the rise, and that basic health-care services are harder to access than they were five or 10 years ago.

Other data paint a more nuanced picture of how Canada is doing. The Organization for Economic Cooperation and Development (OECD)—a collection of mostly rich countries—publishes a “Better Life Index,” which aims to gauge overall citizen wellbeing.  In the most recent iteration of the Index, Canada beats the OECD average on income, employment levels, education attainment, life expectancy at birth, and environmental quality, among other indicators. Our relative ranking has slipped in some areas—a worrisome sign—but overall, Canada puts up a decent score.

Still, stagnant real incomes and an economy that’s expanding more slowly than the population is not an ideal place to land. To do better, Canada will need at least a few years of stronger per-person economic growth. This will require a turnaround in our notably lacklustre productivity record and a sustained pick-up in business investment. Revisiting the federal government’s ambitious immigration targets may also be necessary, as Trudeau government ministers have publicly (albeit somewhat sheepishly) acknowledged.

Getting the economic fundamentals right is essential to making progress on most economic and social indicators. As the OECD notes, “while money may not buy happiness, it is an important means to achieving higher living standards and thus greater well-being.”

From the Fraser Institute

By Mackenzie Moir

Tragic stories of multiyear waits for patients are now a Canadian news staple. Is it any wonder, therefore, that a new Navigator poll found almost two-thirds of Canadians experienced (either themselves or a family member) unreasonably long for access to health care. The poll also found that 73 per cent of respondents agree the system needs major reform.

This situation shouldn’t surprise anyone. Last year Canadians could expect a 27.7-week delay for non-emergency treatment. Nearly half this time (13.1 weeks) was spent waiting for treatment after seeing a specialist—that’s more than one month longer than what physicians considered reasonable.

And it’s not as though these unreasonable waits are simple inconveniences for patients; they can have serious consequences including continued pain, psychological distress and disability. For many, there are also economic consequences for waiting due to lost productivity or wages (due to difficulty or inability to work) or for Canadians who pay for care in another country.

Canadians are also experiencing longer delays than their European and Australian universal health-care peers. In 2020, Canadians were the least likely (62 per cent) to report receiving non-emergency surgical treatment in under four weeks compared to Germans (99 per cent) and Australians (72 per cent).

What do they do differently? Put simply, they approach universal care in a different way than we do.

In particular, these countries all have a sizeable and well-integrated private sector that helps deliver universal care including surgical care. For example, in 2021, 45 per cent of hospitals in Germany (a plurality) were private for-profit. And 99 per cent of German hospital beds are accessible to those covered under the country’s mandatory insurance scheme. In Australia, governments regularly contract with private hospitals to provide surgical care, with private facilities handling 41 per cent of all hospital services in 2021/22.

These universal health-care countries also tend to fund their hospitals differently.

Governments in Canada primarily fund hospitals through “global budgets.” With a fixed budget set at the beginning of the year, this funding method is unconnected to the level of services provided. Consequently, patients are treated as costs to be minimized.

In contrast, hospitals in most European countries and Australia are funded on the basis of their activity. As a result, because they are paid for services they actually deliver, hospitals are incentivized to provide higher volumes of care.

The data are clear. Canadian patients are frustrated with their health-care system and have an appetite for change. We stand to learn from other countries who maintain their universal coverage while delivering health care faster than in Canada.