Canadians want major health-care reform now

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.

Author:

Mackenzie Moir

Senior Policy Analyst, Fraser Institute

Related Topics:#CanadaHealthCareReform #FraserInstitute #HealthCareWaitTimes #MackenzieMoir #UniversalHealthCare

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Competition Bureau is right—Canada should open up competition in the air

Published on July 16, 2025

Todayville

From the Fraser Institute

By Jake Fuss and Alex Whalen

Here’s a statement few Canadians will disagree with—air travel in Canada is expensive and frustrating. But there’s hope. According to a recent report from the Competition Bureau, a law enforcement agency that reports to the federal government, the key solution is to increase competition among airlines.

And government policies are the primary reason for the lack of airline competition. Specifically, excessive regulatory barriers and restrictions on foreign airlines limit choice and increase ticket prices.

Currently, the federal government prohibits foreign airlines from operating domestic routes within Canada’s borders. For example, a German airline such as Lufthansa is permitted to fly from Frankfurt to Toronto, but is barred from flying passengers from Toronto to another Canadian city. The result? There’s little competitive pressure for Canadian airlines to lower their prices for domestic air travel.

The European Union offers a stark contrast. After the EU removed restrictions for member-state airlines to operate in all EU countries, low-cost carriers such as Ryanair entered the market, flight frequencies increased and airfares dropped 34 per cent.

In fact, the Competition Bureau examined the EU model and said Canada should relax restrictions on foreign airlines to improve service quality and bring down ticket prices. Our recent study similarly suggests the federal government negotiate deals with other countries to allow foreign airlines to operate within Canada in exchange for allowing Canadian airlines to operate in those countries—a win-win for Canadian consumers and Canadian airlines.

But the federal government should not stop there. High taxes and fees comprise a large portion (25 to 35 per cent) of airfare costs, driving up ticket prices. In Canada, fees for airport improvement, security, landing and other charges are all largely uncompetitive with peer countries. And Canadian fuel taxes and sales taxes drive prices up further.

Why are fees so high? While several government policies play a part, Canada’s outdated airport ownership structure remains a key factor. The federal government owns the land upon which our large airports are built and charges the not-for-profit airport authorities rent (as high as 12 per cent of airport revenue). In 2023, the government received $487 million in rent charges from airports. In response, the airports levy fees on passengers to recoup these costs.

Improving the policy environment to reduce taxes and fees to levels more competitive with peer countries should be one lever Ottawa pulls to address sky-high airfares. Moreover, Canada should also—based on the successful airport ownership structures in Europe, Australia and New Zealand—sell its remaining interests in airport leases and allow for-profit organizations to own and operate airports in Canada.

Finally, Ottawa should ease the regulatory burden on the airline industry while maintaining strong safety standards. The United States undertook a successful deregulation effort in the 1970s and 1980s, which helped create more competition and choice, lower airfares and safety improvements.

Canadians face high airfares and have few choices to fly within in Canada, mainly due to bad government policy. It’s past time for Ottawa to make bold reforms to open up competition and reduce travel costs for Canadians.

Fraser Institute

Democracy waning in Canada due to federal policies

Published on July 15, 2025

Todayville

From the Fraser Institute

By Lydia Miljan

In How Democracies Die, Harvard political scientists Steven Levitsky and Daniel Ziblatt argue that while some democracies collapse due to external threats, many more self-destruct from within. Democratic backsliding often occurs not through dramatic coups but through the gradual erosion of institutions by elected leaders—presidents or prime ministers—who subvert the very system that brought them to power. Sometimes this process is swift, as in Germany in 1933, but more often it unfolds slowly and almost imperceptibly.

The book was written during Donald Trump’s first presidential term, when the authors expressed concern about his disregard for democratic norms. Drawing on Juan Linz’s 1978 work The Breakdown of Democratic Regimes, Levitsky and Ziblatt identified several warning signs of democratic decline in Trump’s leadership: rejection of democratic rules, denial of the legitimacy of political opponents, tolerance or encouragement of violence, and a willingness to restrict dissent including criticism from the media.

While Trump is an easy target for such critiques, Levitsky and Ziblatt’s broader thesis is that no democracy is immune to these threats. Could Canada be at risk of democratic decline? In light of developments over the past decade, perhaps.

Consider, for example, the state of free speech and government criticism. The previous Liberal government under Justin Trudeau was notably effective at cultivating a favourable media environment. Following the 2015 election, the media enjoyed a prolonged honeymoon period, often focusing on the prime minister’s image and “sunny ways.” After the 2019 election, which resulted in a minority government, the strategy shifted toward direct financial support. Citing pandemic-related revenue losses, the government introduced “temporary” subsidies for media organizations. These programs have since become permanent and costly, with $325 million allocated for 2024/25. During the 2025 election campaign, Mark Carney pledged to increase this by an additional $150 million.

Beyond the sheer scale of these subsidies, there’s growing concern that legacy media outlets—now financially dependent on government support—may struggle to maintain objectivity, particularly during national elections. This dependency risks undermining the media’s role as a watchdog of democracy.

Second, on April 27, 2023, the Trudeau government passed Bill C-11, an update to the Broadcasting Act that extends CRTC regulation to digital content. While individual social media users and podcasters are technically exempt, the law allows the CRTC to regulate platforms that host content from traditional broadcasters and streaming services—raising concerns about indirect censorship. This move further restricted freedom of speech in Canada.

Third, the government’s invocation of the Emergencies Act to end the Freedom Convoy protest in Ottawa was ruled unconstitutional by Federal Court Justice Richard Mosley who found that the government had not met the legal threshold for such extraordinary powers. The same day of the ruling the government announced it would appeal the 200-page decision, doubling down on its justification for invoking the Act.

In addition to these concerns, federal government program spending has grown significantly—from 12.8 per cent of GDP in 2014/15 to a projected 16.2 per cent in 2023/24—indicating that the government is consuming an increasing share of the country’s resources.

Finally, Bill C-5, the One Canadian Economy Act, which became law on June 26, grants the federal cabinet—and effectively the prime minister—the power to override existing laws and regulations for projects deemed in the “national interest.” The bill’s vague language leaves the definition of “national interest” open to broad interpretation, giving the executive branch unprecedented authority to micromanage major projects.

Individually, these developments may appear justifiable or benign. Taken together, they suggest a troubling pattern—a gradual erosion of democratic norms and institutions in Canada.