Fraser Institute
Canadians want major health-care reform now
From the Fraser Institute
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.
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Business
Canada’s recent economic growth performance has been awful
From the Fraser Institute
By Ben Eisen and Milagros Palacios
Recently, Statistics Canada released a revision of its calculations of Canada’s gross domestic product (GDP) in recent years. GDP measures the total production in an economy in a given year, and per-person GDP is widely accepted by economists as one of the most useful metrics for assessing quality of life. The new estimate places Canada’s GDP for 2024 at 1.4 per cent larger than previously reported.
By the standards of these sorts of revisions—which are usually quite small—the recent update is significant. But make no mistake, the new numbers do not change the fundamental story of Canada’s economic performance, which has been one of historically weak growth and stagnant living standards for an unusually long stretch of time.
Let’s get into the numbers (all adjusted for inflation, in 2017 dollars) with some historical perspective. The new figures put Canada’s per-person GDP estimate for 2024 at $59,529. By comparison, in 2019 per-person GDP was slightly higher at $59,581. This means there has been no progress at all in Canadian living standards as measured by per-person GDP over the past five years. Even with the revision, five years of flat living standards is an extraordinary result.
This is historically anomalous. From 2000 to 2018—a period that was itself not especially strong by the standards of earlier decades—per-person GDP still grew at a compounded annual rate of just under one per cent. In the 1990s, growth was faster still at roughly 1.8 per cent annually. In both periods, living standards were rising meaningfully, even if the pace varied. The fact that they have completely stagnated for five years is alarming, even if our GDP numbers aren’t quite as bleak as we believed a few weeks ago.
Some pundits determined to view all economic data through a political lens have emphasized that under the new revisions, the overall rate of per-person growth during Justin Trudeau’s time as prime minister is now approximately the same as what occurred during Stephen Harper’s tenure.
However, this is more relevant as a political talking point than an economic insight. The historical data show that at an average annual growth rate of just 0.5 per cent, the Canadian economy’s performance under Harper was weak by long-term standards. This is something that Trudeau himself recognized when he first sought high office, criticizing the Harper government for “having the worst record on economic growth since R.B. Bennett in the depths of the Great Depression.”
Trudeau was right back then that Canadian economic growth during the Harper era was historically weak. As such, a revision showing that Canada’s slow growth has approximately continued for the past decade is hardly cause for celebration. It simply underscores that both governments presided over a long period of weak productivity growth and very slow improvements in living standards—and that in recent years even that sluggish growth has given way to complete stagnation.
Of course, an upward revision to recent GDP calculations is welcome news, but it must not be allowed to distract policymakers or the public from the reality of Canada’s severe long-term growth problem, which in recent years has gone from bad to worse.
Community
Charitable giving on the decline in Canada
From the Fraser Institute
By Jake Fuss and Grady Munro
There would have been 1.5 million more Canadians who donated to charity in 2023—and $755.5 million more in donations—had Canadians given to the same extent they did 10 years prior
According to recent polling, approximately one in five Canadians have skipped paying a bill over the past year so they can buy groceries. As families are increasingly hard-pressed to make ends meet, this undoubtedly means more and more people must seek out food banks, shelters and other charitable organizations to meet their basic necessities.
And each year, Canadians across the country donate their time and money to charities to help those in need—particularly around the holiday season. Yet at a time when the relatively high cost of living means these organizations need more resources, new data published by the Fraser Institute shows that the level of charitable giving in Canada is actually falling.
Specifically, over the last 10 years (2013 to 2023, the latest year of available data) the share of tax-filers who reported donating to charity fell from 21.9 per cent to 16.8 per cent. And while fewer Canadians are donating to charity, they’re also donating a smaller share of their income—during the same 10-year period, the share of aggregate income donated to charity fell from 0.55 per cent to 0.52 per cent.
To put this decline into perspective, consider this: there would have been 1.5 million more Canadians who donated to charity in 2023—and $755.5 million more in donations—had Canadians given to the same extent they did 10 years prior. Simply put, this long-standing decline in charitable giving in Canada ultimately limits the resources available for charities to help those in need.
On the bright side, despite the worrying long-term trends, the share of aggregate income donated to charity recently increased from 0.50 per cent in 2022 to 0.52 per cent in 2023. While this may seem like a marginal improvement, 0.02 per cent of aggregate income for all Canadians in 2023 was $255.7 million.
The provinces also reflect the national trends. From 2013 to 2023, every province saw a decline in the share of tax-filers donating to charity. These declines ranged from 15.4 per cent in Quebec to 31.4 per cent in Prince Edward Island.
Similarly, almost every province recorded a drop in the share of aggregate income donated to charity, with the largest being the 24.7 per cent decline seen in P.E.I. The only province to buck this trend was Alberta, which saw a 3.9 per cent increase in the share of aggregate income donated over the decade.
Just as Canada as a whole saw a recent improvement in the share of aggregate income donated, so too did many of the provinces. Indeed, seven provinces (except Manitoba, Nova Scotia and Newfoundland and Labrador) saw an increase in the share of aggregate income donated to charity from 2022 to 2023, with the largest increases occurring in Saskatchewan (7.9 per cent) and Alberta (6.7 per cent).
Canadians also volunteer their time to help those in need, yet the latest data show that volunteerism is also on the wane. According to Statistics Canada, the share of Canadians who volunteered (both formally and informally) fell by 8 per cent from 2018 to 2023. And the total numbers of hours volunteered (again, both formal and informal) fell by 18 per cent over that same period.
With many Canadians struggling to make ends meet, food banks, shelters and other charitable organizations play a critical role in providing basic necessities to those in need. Yet charitable giving—which provides resources for these charities—has long been on the decline. Hopefully, we’ll see this trend turn around swiftly.
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