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Fraser Institute

Bill Maher is right about Canadian health care

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From the Fraser Institute

By Mackenzie Moir

Recently, popular American comedian and talk show host, Bill Maher, took aim at some of Canada’s public policy failings in one of his monologues. In entertaining fashion, Maher highlighted our high housing costs, unemployment rates and “vaunted” health-care system.

Indeed, citing work published by the Fraser Institute, he explained that after adjusting for age, Canada spends 13.3 per cent of our economy on health care (2020), the highest level of spending by a developed country with universal coverage that year. And that Canada has some of the poorest access to timely appointments with family doctors when compared to our peers.

Unfortunately, while that’s where his segment on health care ended, the bad news for the Canadian system doesn’t stop there.

On top of Canada continuing to be one of the most expensive universal health-care systems in the world, we get little in return when it comes to both available medical resources and wait times. For example, among high-income countries with universal health care, Canada has some of the lowest numbers of physicians, hospital beds, MRI machines and CT scanners.

And in Canada, only 38 per cent of patients report seeing a specialist within four weeks (compared to 69 per cent in the Netherlands) and only 62 per cent report receiving non-emergency surgery within four months (compared to 99 per cent in Germany).

Unfortunately, wait times in Canada aren’t simply long compared to other countries, they’re the longest they’ve ever been. Last year the median wait for a Canadian patient seeking non-emergency care reached 27.7 weeks—nearly three times longer than the 9.3 week-wait Canadians experienced three decades ago.

This raises the obvious question. How do other countries outperform Canada’s health-care system while also often spending less as a share of their economies? In short, their approach to universal health care, and in particular their relationship with the private sector, departs drastically from the approach here at home.

Australia, for example, partners with private hospitals to deliver the majority (58.6 per cent) of all non-emergency surgeries within its universal health-care system. Australia also spends less of its total economy (i.e. GDP) on health care but outperforms Canada on every measure of timely care.

Even with restrictions on the private sector, Canada has some limited experience that should encourage policymakers to embrace greater private-sector involvement. Saskatchewan, for example, contracted with private surgical clinics starting in 2010 to deliver publicly-funded services as part of a four-year initiative to reduce wait times, which were among the longest in the country. Between 2010 and 2014, wait times in the province fell from 26.5 weeks to 14.2 weeks. After the initiative ended, the province’s wait times began to grow.

More recently, Quebec, which has some of the shortest wait times for medical services in the country, contracts out one out of every six day-surgeries to private clinics within the publicly-funded health-care system.

Maher’s monologue, which was viewed by millions online, highlighted the key failings of Canada’s health-care system. If policymakers in Ottawa and the provinces want to fix Canadian health care, they must learn from other countries that deliver universal health-care at the same or even lower cost, often with better access and results for patients.

Economy

We’re Getting Poorer: GDP per Capita in Canada and the OECD

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From the Fraser Institute

By Alex Whalen and Milagros Palacios and Lawrence Schembri

Canada lost ground compared to key allies and trading partners such as the United States, United Kingdom, New Zealand, and Australia between 2014 and 2022.

Canada had the third-lowest growth in GDP per person from 2014 to 2022 among 30 advanced economies, finds a new study published by the Fraser Institute, an independent, non-partisan Canadian public policy think-tank.

“In terms of GDP per person, a broad measure of living standards, Canada’s performance has weakened substantially in recent years,” said Alex Whalen, director of the Fraser Institute’s Atlantic Canada Prosperity Initiative and co-author of We’re Getting Poorer: GDP per Capita in Canada and the OECD, 2002–2060.

The study, which examines Canada’s historic and projected GDP per capita growth compared to similar OECD countries, finds that from 2002 to 2014, Canadian income growth as measured by GDP per person roughly kept pace with the rest of the OECD, but from 2014 to 2022 Canada’s growth rate stagnated.

In 2002, Canada’s GDP per capita was higher than the OECD average by US$3,141. By 2022, it had fallen well below the OECD average by US$231. Canada lost ground compared to key allies and trading partners such as the United
States, United Kingdom, New Zealand, and Australia between 2014 and 2022.

For example, Canadian GDP per person in 2014 was $44,710 (80.4 per cent of the US total of $55,605) but by 2022, Canada was only at $46,035 versus $63,685 in the US. In other words, the gap had grown from $10,895 to $17,649 by 2022 (all measures in inflation-adjusted US dollars).

“Canada has been experiencing a collapse in investment, low productivity growth, and a large and growing government sector, all of which contribute to reduced growth in living standards compared to our peer countries in the OECD,” said Lawrence Schembri, a senior fellow with the Fraser Institute and co-author.

  • This research bulletin examines historical and projected trends in the growth of Canada’s GDP per capita, and compares these trends to those in peer countries in the OECD.
  • Canadians have been getting poorer relative to residents of other countries in the OECD. From 2002 to 2014, Canadian income growth as measured by GDP per capita roughly kept pace with the rest of the OECD. From 2014 to 2022, however, Canada’s position declined sharply, ranking third-lowest among 30 countries for average growth over the period.
  • Between 2012 and 2022, Canada lost ground compared to key allies and trading partners such as the United States, United Kingdom, New Zealand, and Australia, with Canadian GDP per capita declining from 80.4% of the US level in 2012 to 72.3% in 2022.
  • Looking forward to 2060, Canada’s projected average annual growth rate for GDP per capita (0.78%) is the lowest among 30 OECD countries.
  • Canada’s GDP per capita (after adjusting by inflation), which exceeded the OECD average by US$3,141 in 2002 and was roughly equivalent to the OECD average in 2022, is projected to fall below the OECD average by US$8,617 in 2060.
  • The root cause of Canada’s declining long-term growth in GDP per capita—recent and projected—is very low or negative growth in labour productivity reflecting weak investment in physical and human capital per worker.
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Censorship Industrial Complex

New federal legislation should remind Canadians of Orwell’s 1984

Published on

From the Fraser Institute

By Jake Fuss and Alex Whalen

The legislation seeks to punish citizens not just for what the governments deems as “hate speech” but also grants the state power to bring Canadians before tribunals on suspicion that they might say something hateful in the future.

This year marks the 75th anniversary of George Orwell’s classic novel 1984 (and it’s been 40 years since the actual year 1984). In the novel, Orwell explains the dangers of totalitarianism by exploring what happens when government exercises extreme levels of control over citizens including censoring and controlling language. While Canada is a relatively free country in 2024, there are aspects of Orwell’s world reflected in government policy today.

The Human Freedom Index, published annually by the Fraser Institute and Cato Institute, defines freedom as a social concept that recognizes the dignity of individuals by the absence of coercive constraint. In a free society, citizens are free to do, say or think almost anything they want, provided it does not infringe on the right of others to do the same.

Canada currently fares relatively well compared to other countries on the Human Freedom Index, placing 13th out of 165 countries. However, our score has dropped six spots on the index since 2008 when Canada recorded its highest ever rank.

This is not surprising given the Trudeau government’s recent efforts to control and manage the free exchange of ideas. The recent Online Streaming Act imposes various content rules on major streaming services such as Netflix, and requirements to extract funds to be redirected toward favoured groups. The Act seemingly seeks to bring the entire Internet under the regulation of a government body.

In another piece of recent legislation, the Online News Act, the government attempted to force certain social media platforms to pay other legacy news outlets for carrying content. In response, the social media platforms chose simply not to allow content from those news providers on their platforms, resulting in a dramatic reduction of Canadians’ access to news.

Now, a new piece of federal legislation—Bill C-63, the Online Harms Act—seeks to control language and grant government power to punish citizens for what the government deems to be unfavourable speech.

The government has sold Bill C-63 as a way to promote the online safety of Canadians, reduce harms, and ensure the operators of social media services are held accountable. In reality, however, the bill is Orwell’s Big Brother concept brought to life, where government controls information and limits free exchange. The legislation seeks to punish citizens not just for what the governments deems as “hate speech” but also grants the state power to bring Canadians before tribunals on suspicion that they might say something hateful in the future. Not surprisingly, many have raised concerns about the constitutionality of the Bill, which will surely be tested in court.

Put differently, the Bill dictates that citizens may not only be punished for speech crimes, but also punished when another person or group of individuals believes they are likely to commit such a crime. The legislation outlines punishment mechanisms at the government’s disposal, including electronic monitoring devices, house arrest or jail time. Frighteningly, if the government doesn’t like what you say or even suspects they won’t like what you might say, then you could face serious repercussions.

That sounds eerily similar to Orwell’s concept of the Thought Police. In 1984, a secret police force investigates and punishes “thoughtcrimes,” which are personal and political thoughts unapproved by the state. The Thought Police monitor citizens and arrest anyone who engages in such crimes, to prevent personal autonomy and freedom of thought, thus providing the state with immense power and control over the populace.

The big government approach inherent in the Online Harms Act and others is antithetical to the idea of personal freedom. Famed English philosopher J.S. Mill was particularly observant in recognizing the perils of controlling and punishing speech government officials deem “dangerous.” In his book On Liberty, Mill stated “If any opinion is compelled to silence, that opinion may, for aught we can certainly know, be true. To deny this is to assume our own infallibility. Secondly, though the silenced opinion be an error, it may, and very commonly does, contain a portion of the truth; and since the general of prevailing opinion on any subject is rarely or never the whole truth, it is only by the collision of adverse opinions that the remainder of the truth has any chance of being supplied.”

Orwell’s famous novel provides a guidebook for what governments should avoid doing at all costs. Unfortunately, hints of 1984 have seeped into government policy in Canada today. The erosion of personal freedom is not something we should take for granted anymore.

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