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Fraser Institute

One doctor’s battle to put patients ahead of politics

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From the Fraser Institute

By Yanick Labrie

For decades, Canadians have been told that our health-care system is the envy of the world, a symbol of national pride. But the reality, as exposed in the new book My Fight for Canadian Healthcare by Dr. Brian Day, is far less flattering—and far more troubling. Dr. Day’s account of his 30-year battle to put patients first reveals a system bogged down by ideology, political inertia and an aversion to necessary reform. His message is clear: it’s time for Canadians to take off the rose-coloured glasses and demand a system that actually works for patients.

The book is not an argument for dismantling universal health care—it’s a plea for modernization and responsiveness. Dr. Day, an orthopedic surgeon and founder of the Cambie Surgery Centre in Vancouver, offers a front-line perspective on how rationing, administrative inefficiency and outdated policies systematically deny timely care to patients. Through detailed stories and compelling data, he documents the tragic human cost of excessive waiting lists—patients suffering needless pain, enduring irreversible deterioration, and in some cases, dying of preventable deaths.

One of the most disturbing revelations in the book is the deliberate limitation of health-care capacity by provincial governments. Faced with budget constraints, administrators limit operating room time and restrict physician access, effectively forcing patients to suffer on long waiting lists. This isn’t the result of unavoidable resource shortages; it’s a consequence of deliberate policy choices aimed at controlling spending, even if that means denying patients the care they need when they need it.

What makes this all the more unacceptable is that many of the very politicians and bureaucrats who defend this system seek care in private clinics (including Dr. Day’s Cambie Surgery Centre) when their own health is on the line. This double standard—one system for the public, another for the elite—undermines the entire moral justification of Canada’s approach to health care. If the system were truly world-class, those in power would not seek alternatives.

Dr. Day’s legal battle began in 2009 when his clinic became the target of a government lawsuit for allegedly violating an existing prohibition on patients paying with their own money for medically necessary care. This same prohibition had already been found unconstitutional in Quebec by the Supreme Court’s Chaoulli ruling in 2005, on the grounds that it violated fundamental rights to life and security.

The case dragged on for more than a decade, exposing the dysfunction of both the health-care system and the legal process meant to evaluate its constitutionality. Evidence presented in court—including government data showing thousands of patients dying while waiting for care—was damning. Unfortunately for Canadians, the British Columbia Supreme Court ultimately upheld the government’s authority to ration care and forbid patients from seeking private alternatives.

This legal defeat underscores a core truth that Dr. Day has long emphasized—Canadian health care is driven more by ideology than by evidence. The obsession with preserving a government monopoly has become an end in itself, eclipsing the system’s primary purpose: ensuring timely quality care for all. In no other sphere of life would we tolerate this. Imagine being told you couldn’t pay for private tutoring if your child’s public school was failing him. Yet this is precisely what Canadian health-care policy imposes.

Crucially, Dr. Day’s critique is rooted not in theory but in practise. He has seen firsthand the harm caused by delays, the deterioration of patients left waiting months or years for treatment, and the exodus of talented young doctors who leave Canada because the system restricts their ability of practise to their full potential. He has also seen the benefits of mixed public-private models in countries such as Australia, Sweden and Germany—countries with universal care that still allow room for private-sector innovation and competition.

Predictably, critics paint Dr. Day as a champion of privatization at any cost, but this is a gross mischaracterization. His vision is not American-style health care but rather a modernized patient-centred system that retains universal coverage while embracing flexibility, innovation and patient choice. In short, he wants Canada to catch up with the rest of the developed world, where public and private systems work together to ensure patients receive timely care regardless of their financial means.

Perhaps the most sobering aspect of My Fight for Canadian Healthcare is the reminder that reform is not only necessary, but inevitable. Canada’s population is aging, demand for care is rising, and the costs of maintaining the current system are unsustainable. Clinging to outdated structures will only deepen the crisis. The choice is not between public and private care—it’s between a system that works and one that fails.

As Dr. Day argues, the ultimate victims of our broken system are the patients themselves—ordinary Canadians left to suffer while politicians cling to outdated dogma. His fight has been long and costly, but it offers a valuable lesson: health-care reform is not about ideology. It’s about compassion, common sense and the courage to admit when something isn’t working. The time for that honesty is now.

Yanick Labrie

Senior Fellow, Fraser Institute

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Business

Carney government plans to muddy the fiscal waters in upcoming budget

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From the Fraser Institute

By Jake Fuss and Grady Munro

Rather than directly spend money on critical infrastructure such as roads, bridges, ports or even electricity grids—things that traditionally are considered capital investments—the government plans to spend money on subsidies and tax breaks to corporations (i.e. corporate welfare) under the umbrella of “capital investment”

The Carney government’s long-awaited first budget is almost here—expected Nov. 4—but Canadians may not recognize what they get. Early on, the new government promised a new approach to spending. Thanks to a decade of record-breaking spending under Justin Trudeau, the federal deficit sits at a projected $48.3 billion while total debt has eclipsed $2.1 trillion. But the Carney government’s plan announced this week appears to rely on accounting maneuvers rather than any substantive spending reductions.

According to the latest details released by the government, the Carney government will separate spending into two categories: “operating spending” and “capital investment.” Within this framework, the government plans to balance the “operating budget” within three years.

But of course, if the government eventually balances the operating budget, that doesn’t mean it will stop borrowing money to pay forcapital investment”—a new category of spending the government can define and expand whenever it deems necessary.

Currently, according to the government, capital investment will include any spending or tax expenditures (e.g. tax credits and deductions) that “contribute to capital formation”—the creation of assets (such as machinery or equipment) that improve the ability of workers to produce goods and services.

In other words, rather than directly spend money on critical infrastructure such as roads, bridges, ports or even electricity grids—things that traditionally are considered capital investments—the government plans to spend money on subsidies and tax breaks to corporations (i.e. corporate welfare) under the umbrella of “capital investment,” so long as this spending will somehow “encourage” capital formation. But clearly, corporate welfare doesn’t belong in the same category as the expansion of a critical port, for example, and the government shouldn’t pretend that it does.

Put simply, because the term “capital investment” is so broad and malleable, the government can seemingly use it whenever it wants. For example, to meet NATO’s spending target of 2 per cent of GDP, a key point of contention in Carney’s negotiations with President Trump, the Carney government could (inaccurately) categorize some defence spending as capital spending. And in fact, the Parliamentary Budgetary Officer—Ottawa’s fiscal watchdog—views the Carney government’s definition as “overly expansive” and suggests the inclusion of corporate tax breaks and subsidies will “overstate” the government’s actual contribution to the creation of capital.

This approach by the Carney government will not help Canadians understand the true state of federal finances. While Finance Minister François-Philippe Champagne recently said that the “deficit and the debt will be recorded in the same manner as in previous budgets,” on budget day and beyond the government will undoubtedly focus on the operating budget when communicating to Canadians. So, the government will only tell part of the story.

After years of fiscal mismanagement with large increases in spending and debt under the Trudeau government, Canadians need a government willing to make the tough decisions necessary to get federal finances back in shape. But the Carney government appears poised to shirk accountability and use tricks to cloud the true state of federal finances.

Jake Fuss

Director, Fiscal Studies, Fraser Institute

Grady Munro

Policy Analyst, Fraser Institute
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Automotive

Governments continue to support irrational ‘electric vehicle’ policies

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From the Fraser Institute

By Kenneth P. Green

Another day, another electric vehicle (EV) fantasy failure. The Quebec government is “pulling the plug” on its relationship with the Northvolt EV battery company (which is now bankrupt), and will try to recoup some of its $270 million loss on the project. Quebec’s “investment” was in support of a planned $7 billion “megaproject” battery manufacturing facility on Montreal’s South Shore. (As an aside, what normal people would call gambling with taxpayer money, governments call “investments.” But that’s another story.)

Anyway, for those who have not followed this latest EV-burn out, back in September 2023, the Legault government announced plans to “invest” $510 million in the project, which was to be located in Saint-Basile-le-Grand and McMasterville. The government subsequently granted Northvolt a $240 million loan guarantee to buy the land for the plant, then injected another $270 million directly into Northvolt. According to the Financial Post, “Quebec has lost $270 million on its equity investment… but still had a senior secured loan tied to the land acquired to build the plant, which totals nearly $260 million with interest and fees.” In other words, Quebec taxpayers lost big.

But Northvolt is just the latest in a litany of failure by Canadian governments and their dreams of an EV future free of dreaded fossil fuels. I know, politicians say that it’s a battle against climate change, but that’s silly. Canada is such a small emitter of greenhouse gases that nothing it could do, including shutting down the entire national economy, would significantly alter the trajectory of the climate. Anything Canada might achieve would be cancelled out by economic growth in China in a matter of weeks.

So back to the litany of failed or failing EV-dream projects. To date (from about 2020) it goes like this: Ford (2024)Umicore battery (2024)Honda (2025),General Motors CAMI (2025)Lion Electric (2025)Northvolt (2025). And this does not count projects still limping along after major setbacks such as Stellantis and Volkswagen.

One has to wonder how many tombstones of dead EV fantasy projects will be needed before Canada’s climate-obsessed governments get a clue: people are not playing. Car buyers are not snapping up these vehicles as government predicted; the technologies and manufacturing ability are not showing up as government predicted; declining cost curves are not showing up as government predicted; taxpayer-subsidized projects keep dying; the U.S. market for Canada’s EV tech that government predicted has been Trumped out of existence (e.g. the Trump administration has scrapped EV mandates and federal subsidies for EV purchases); and government is taking the money for all these failed predictions from Canadian workers who can’t afford EVs. It really is a policy travesty.

And yet, like a bad dream, Canada’s governments (including the Carney government) are still backing an irrational policy to force EVs into the marketplace. For example, Ottawa stills mandates that all new light-duty vehicle sales be EVs by 2035. This despite Canadian automakers earnest pleas for the government to scrap the mandate.

Canada’s EV policy is quickly coming to resemble something out of dysfunctional-heroic fiction. We are the Don Quixotes, tilting futilely at EV windmills, and Captain Ahabs, trying to slay the dreaded white whale of fossil-fuelled transportation with our EV harpoons. Really, isn’t it time governments took a look at reality and cut their losses? Canada’s taxpayers would surely appreciate the break.

Kenneth P. Green

Senior Fellow, Fraser Institute
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