Business
Canadian health care continues to perform poorly compared to other countries

From the Fraser Institute
By Mackenzie Moir and Bacchus Barua
At 30 weeks, this year marked the longest total wait for non-emergency surgery in more than 30 years of measurement.
Our system isn’t just worsening over time, it’s also performing badly compared to our universal health-care peers.
Earlier this year, the U.S.-based Commonwealth Fund (in conjunction with the Canadian Institute for Health Information) released the results of their international health policy survey, which includes nine high-income universal health-care countries—Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland and the United Kingdom. Unfortunately, Canada continued to come in near or dead last on key measures of timely access. Most notably, Canada ranked worst for wait times for specialists and non-emergency surgery.
For example, whereas almost half (46 per cent) of Canadians surveyed indicated they waited two months or more for a specialist appointment, that number was just 15.1 per cent in the Netherlands and 13.2 per cent in Switzerland. And while one in five (19.9 per cent) Canadians reported waiting more than one year for non-emergency surgery, just half a per cent (0.6) of Swiss respondents indicated a similar wait. And no one in the Netherlands reported waiting as long.
What explains the superior performance of these two countries compared to Canada?
Simply put, they do universal health care very differently.
For example, the Netherlands, which ranked first on both indicators, mandates that residents purchase private insurance in a regulated but competitive marketplace. This system allows for private insurance firms to negotiate with health-care providers on prices, but these insurance firms must also accept all applicants and charge their policy holders the same monthly fee for coverage (i.e. they cannot discriminate based on pre-existing conditions).
In Switzerland, which ranked among the top three on both measures, patients must also purchase coverage in a regulated private insurance marketplace and share (10-20 per cent) of the cost of their care (with an annual maximum and protections for the most vulnerable).
Both countries also finance their hospitals based on their activity, which means hospitals are paid for the services they actually provide for each patient, and are incentivized to provide higher volumes of care. Empirical evidence also suggests this approach improves hospital efficiency and potentially lowers wait times. In contrast, governments in Canada provide hospitals with fixed annual budgets (known as “global budgets”) so hospitals treat patients like costs to be minimized and are disincentivized from treating complex cases.
It’s no surprise that in 2022, the latest year of available data, a lot more Swiss (94 per cent) and Dutch (83 per cent) reported satisfaction with their health-care system compared to Canadians (56 per cent).
No matter where you look, evidence on the shortcomings of Canada’s health-care system is clear. Fundamental reform is required for Canadians to have timelier care that matches what’s available in universal health-care countries abroad.
Business
Overregulation is choking Canadian businesses, says the MEI

From the Montreal Economic Institute
The federal government’s growing regulatory burden on businesses is holding Canada back and must be urgently reviewed, argues a new publication from the MEI released this morning.
“Regulation creep is a real thing, and Ottawa has been fuelling it for decades,” says Krystle Wittevrongel, director of research at the MEI and coauthor of the Viewpoint. “Regulations are passed but rarely reviewed, making it burdensome to run a business, or even too costly to get started.”
Between 2006 and 2021, the number of federal regulatory requirements in Canada rose by 37 per cent, from 234,200 to 320,900. This is estimated to have reduced real GDP growth by 1.7 percentage points, employment growth by 1.3 percentage points, and labour productivity by 0.4 percentage points, according to recent Statistics Canada data.
Small businesses are disproportionately impacted by the proliferation of new regulations.
In 2024, firms with fewer than five employees pay over $10,200 per employee in regulatory and red tape compliance costs, compared to roughly $1,400 per employee for businesses with 100 or more employees, according to data from the Canadian Federation of Independent Business.
Overall, Canadian businesses spend 768 million hours a year on compliance, which is equivalent to almost 394,000 full-time jobs. The costs to the economy in 2024 alone were over $51.5 billion.
It is hardly surprising in this context that entrepreneurship in Canada is on the decline. In the year 2000, 3 out of every 1,000 Canadians started a business. By 2022, that rate had fallen to just 1.3, representing a nearly 57 per cent drop since 2000.
The impact of regulation in particular is real: had Ottawa maintained the number of regulations at 2006 levels, Canada would have seen about 10 per cent more business start-ups in 2021, according to Statistics Canada.
The MEI researcher proposes a practical way to reevaluate the necessity of these regulations, applying a model based on the Chrétien government’s 1995 Program Review.
In the 1990s, the federal government launched a review process aimed at reducing federal spending. Over the course of two years, it successfully eliminated $12 billion in federal spending, a reduction of 9.7 per cent, and restored fiscal balance.
A similar approach applied to regulations could help identify rules that are outdated, duplicative, or unjustified.
The publication outlines six key questions to evaluate existing or proposed regulations:
- What is the purpose of the regulation?
- Does it serve the public interest?
- What is the role of the federal government and is its intervention necessary?
- What is the expected economic cost of the regulation?
- Is there a less costly or intrusive way to solve the problem the regulation seeks to address?
- Is there a net benefit?
According to OECD projections, Canada is expected to experience the lowest GDP per capita growth among advanced economies through 2060.
“Canada has just lived through a decade marked by weak growth, stagnant wages, and declining prosperity,” says Ms. Wittevrongel. “If policymakers are serious about reversing this trend, they must start by asking whether existing regulations are doing more harm than good.”
The MEI Viewpoint is available here.
* * *
The MEI is an independent public policy think tank with offices in Montreal, Ottawa, and Calgary. Through its publications, media appearances, and advisory services to policymakers, the MEI stimulates public policy debate and reforms based on sound economics and entrepreneurship.
Business
Canada urgently needs a watchdog for government waste

This article supplied by Troy Media.
By Ian Madsen
From overstaffed departments to subsidy giveaways, Canadians are paying a high price for government excess
Canada’s federal spending is growing, deficits are mounting, and waste is going unchecked. As governments look for ways to control costs, some experts say Canada needs a dedicated agency to root out inefficiency—before it’s too late
Not all the Trump administration’s policies are dubious. One is very good, in theory at least: the Department of Government Efficiency. While that
term could be an oxymoron, like ‘political wisdom,’ if DOGE proves useful, a Canadian version might be, too.
DOGE aims to identify wasteful, duplicative, unnecessary or destructive government programs and replace outdated data systems. It also seeks to
lower overall costs and ensure mechanisms are in place to evaluate proposed programs for effectiveness and value for money. This can, and often does, involve eliminating departments and, eventually, thousands of jobs. Some new roles within DOGE may need to become permanent.
The goal in the U.S. is to reduce annual operating costs and ensure government spending grows more slowly than revenues. Washington’s spending has exploded in recent years. The U.S. federal deficit now exceeds six per cent of gross domestic product. According to the U.S. Treasury Department, the cost of servicing that debt is rising at an unsustainable rate.
Canada’s latest budget deficit of $61.9 billion in fiscal 2023-24 amounts to about two per cent of GDP—less alarming than our neighbour’s situation, but still significant. It adds to the federal debt of $1.236 trillion, about 41 per cent of our estimated $3 trillion GDP. Ottawa’s public accounts show expenses at 17.8 per cent of GDP, up from about 14 per cent just eight years ago. Interest on the growing debt accounted for 9.1 per cent of
revenues in the most recent fiscal year, up from five per cent just two years ago.
The Canadian Taxpayers Federation (CTF) consistently highlights dubious spending, outright waste and extravagant programs: “$30 billion in subsidies to multinational corporations like Honda, Volkswagen, Stellantis and Northvolt. Federal corporate subsidies totalled $11.2 billion in 2022 alone. Shutting down the federal government’s seven regional development agencies would save taxpayers an estimated $1.5 billion annually.”
The CTF also noted that Ottawa hired 108,000 additional staff over the past eight years, at an average annual cost of more than $125,000 each. Hiring based on population growth alone would have added just 35,500 staff, saving about $9 billion annually. The scale of waste is staggering. Canada Post, the CBC and Via Rail collectively lose more than $5 billion a year. For reference, $1 billion could buy Toyota RAV4s for over 25,600 families.
Ottawa also duplicates functions handled by provincial governments, often stepping into areas of constitutional provincial jurisdiction. Shifting federal programs in health, education, environment and welfare to the provinces could save many more billions annually. Poor infrastructure decisions have also cost Canadians dearly—most notably the $33.4 billion blown on what should have been a relatively simple expansion of the Trans Mountain pipeline. Better project management and staffing could have prevented that disaster. Federal IT systems are another money pit, as shown by the $4-billion Phoenix payroll debacle. Then there’s the Green Slush Fund, which misallocated nearly $900 million.
Even more worrying, the rapidly expanding Old Age Supplement and Guaranteed Income Security programs are unfunded, unlike the Canada Pension Plan. Their combined cost is already roughly equal to the federal deficit and could soon become unmanageable.
Canada is sleepwalking toward financial ruin. A Canadian version of DOGE—Canada Accountability, Efficiency and Transparency Team, or CAETT—is urgently needed. The Office of the Auditor General does an admirable job identifying waste and poor performance, but it’s not proactive and lacks enforcement powers. At present, there is no mechanism in place to evaluate or eliminate ineffective programs. CAETT could fill that gap and help secure a prosperous future for Canadians.
Ian Madsen is a senior policy analyst at the Frontier Centre for Public Policy.
The views, opinions, and positions expressed by our columnists and contributors are solely their own and do not necessarily reflect those of our publication.
© Troy Media
Troy Media empowers Canadian community news outlets by providing independent, insightful analysis and commentary. Our mission is to support local media in helping Canadians stay informed and engaged by delivering reliable content that strengthens community connections and deepens understanding across the country.
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