Other countries with universal health care don’t have Canada’s long wait times

Todayville

Published

2 months ago

5 minute read

From the Fraser Institute

Unfortunately it’s now very common to see stories about how long provincial wait times for medical care are driving patients to seek care elsewhere, often at great personal cost. Take the recent case of the Milburns in Manitoba who, after waiting years for a knee surgery, are now considering selling their home and moving to Alberta just to get on a potentially shorter public wait list.

Patients in Manitoba could expect to wait a median of 29 weeks to see an orthopedic specialist after a referral from a family physician, then they still faced a median 24.4 week wait to get treatment. In other words, the total typical wait for orthopedic surgery in the province is more than one year at 53.4 weeks. Remember, that’s a median measure, which means some patients wait much longer.

Unfortunately, the Milburns are unlikely to get more timely care on the public wait list in Alberta. At 64.1 weeks, the total median wait for orthopedic care in Alberta was actually longer than in Manitoba. And this doesn’t include the time it takes for provincial coverage to activate for a new provincial resident, or the time it will take to find a new family doctor and get the necessary tests, scans and referrals.

To get more timely care, the Milburns are left with unenviable options. Because they’re insured by Manitoba’s public health-care plan, paying for covered care out of pocket is restricted. They can, however, pay for and receive care privately in other provinces as uninsured visitors (i.e. not move there permanently). Specifically, certain provinces have “exemptions” that allow physicians to charge out-of-province patients directly to provide these procedures privately.

Alternatively, the Milburns could leave Canada and travel even further from home to receive timely care abroad.

But it doesn’t have to be this way.

Long wait times are not the necessary price Canadians must pay for universal coverage. In fact, Canada is one of 30 high-income countries with universal health care. Other countries such as Switzerland, the Netherlands, Germany and Australia have much shorter wait times. For example, only 62 per cent of Canadians reported access to non-emergency surgery in less than four months in 2020 compared to 99 per cent of Germans, 94 per cent of Swiss and 72 per cent of Australians.

The difference? These countries approach health care in a fundamentally different way than us. One notable difference is their attitude towards the private sector.

In Germany, patients can seek private care while still insured by the public system or can opt out and purchase regulated private coverage. These approaches (universal, privately paid or privately insured) are able to deliver rapid access to care. The Swiss simply mandate that patients purchase private insurance in a regulated-but-competitive marketplace as part of their universal scheme. Lower-income families receive a subsidy so they can participate on a more equal footing in the competitive marketplace to obtain the insurance that best fits their needs.

Perhaps the most direct comparator to Canada is Australia—not just geographically, but because it also primarily relies on a tax-funded universal health-care system. However, unlike Canada, individuals can purchase private insurance to cover (among other things) care received as a private patient in a public or private hospital, or simply pay for their private care directly if they choose. In 2021/22 more than two-thirds (70 per cent) of non-emergency admissions to a hospital involving surgery (both publicly and privately funded) took place in a private facility.

Of course, these faster-access countries share other differences in attitudes to universal health-care policy including requirements to share the cost of care for patients and funding hospitals on the basis of activity (instead of Canada’s outdated bureaucratically-determined budgets). A crucial difference, however, is that patients are not generally prevented from paying privately for health care in their home province (or canton or state) in any of these countries.

Without fundamental reform, and as provincial systems continue to struggle to provide basic non-emergency care, we’ll continue to see more stories like the Milburn’s. Without reform, many Canadians will continue to be forced to make similarly absurd decisions to get the care they need, rather than focusing on treatment and recovery.

Authors:

Mackenzie Moir and Bacchus Barua

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

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Alberta freest Canadian province, ranks 12th in North American; other provinces rank near bottom

Published on December 5, 2024

Todayville

From the Fraser Institute

By: Dean Stansel, José Torra, Matthew D. Mitchell and Ángel Carrión-Tavárez

Alberta is, once again, the Canadian province with the highest level of economic freedom, while most other provinces rank in the bottom half in the annual Economic Freedom of North America report, published today by the Fraser Institute, an independent, non-partisan, public policy think-tank.

Individuals have more economic freedom when they are allowed to make more of their own economic decisions such as what to buy, where to work and how to start and run a business. And research shows that economic freedom is fundamental to prosperity.

The report ranks the provinces and states individually for each country (Canada, the U.S. and Mexico). In addition, there is a fourth measure comparing and ranking all states and provinces, across all three countries. All of the rankings measure government spending, taxation, regulations and labour market restrictions using data from 2022 (the latest year of available comparable data).

“Higher taxes, higher levels of government spending and overly burdensome regulations continue to depress economic freedom across much of Canada, which makes it harder for individuals and businesses to thrive and create jobs,” said Matthew Mitchell, a senior fellow at the Fraser Institute and co-author of this year’s report.

In the ranking covering all three countries, which includes both federal and provincial government policies, Alberta is once again the highest-ranking Canadian province. It tied four U.S. states at 12th, having improved its ranking from 41st last year.

The next freest province is British Columbia, which ranks 43rd out of 93, followed by Ontario (47th), Saskatchewan (50th), Manitoba (53rd) and Quebec (54th).

The four Atlantic provinces— New Brunswick (57th), Prince Edward Island (58th), Nova Scotia (59th) and Newfoundland and Labrador (60th)—have the lowest levels of economic freedom among all provinces and U.S. states, only outranking the Mexican states and Puerto Rico. New Hampshire, once again, earned the overall top spot amongst all provinces and states in the rankings this year.

“The link between economic freedom and prosperity is clear: people who live in provinces or states that have comparatively lower taxation, lower government, sound regulatory regimes and more flexible labor markets tend, on average, to live happier, healthier and wealthier lives,” Mitchell said.

For instance, according to the latest report, total income in the freest jurisdictions grew 29 per cent after adjusting for inflation over the last decade, while in the least-free jurisdictions, total inflation adjusted income fell 13 per cent.

The Economic Freedom of North America report (co-authored by Dean Stansel, José Torra and Ángel Carrión-Tavárez) is an offshoot of the Fraser Institute’s Economic Freedom of the World index, the result of more than a quarter century of work by more than 60 scholars including three Nobel laureates.

Detailed tables for each country and subnational jurisdiction can be found at www.freetheworld.org.

Economic Freedom of North America 2024

The indices in the Economic Freedom of North America 2024 measure the degree to which governments in North America permit their citizens to make their own economic choices.
They include data from the 10 Canadian provinces, 50 US states, 32 Mexican states, and the US territory of Puerto Rico.
In the all-government index—which takes account of federal as well as state/provincial policies—the most economically-free jurisdiction in North America is New Hampshire, followed by Idaho, Oklahoma and South Carolina tied for third, and Florida and Indiana tied for fifth.
The lowest-ranking jurisdictions are all Mexican states. In last place is Ciudad de México. Above that is Colima, Campeche, Tamaulipas, and Zacatecas.
Alberta is the highest-ranking Canadian province, tied for 12th place with Tennessee, South Dakota, Colorado, and Texas. The next-highest Canadian province is British Columbia, which is tied with Massachusetts, Minnesota, and New Mexico for 43rd.
Average economic freedom across all 93 jurisdictions has fallen every year since 2017 and is now slightly above its all-time low.
Incomes in the freest top 25 percent of North American jurisdictions were 21 times higher than in the least-free.
From 2013 to 2022 the population of the freest US states grew 10 times faster and total employment grew three times faster than in the least-free states.

Energy

Ottawa’s emissions cap—all pain, no gain

Published on December 4, 2024

Todayville

From the Fraser Institute

By: Julio Mejía, Elmira Aliakbari and Tegan Hill

According to a recent analysis by the Conference Board of Canada think-tank, the cap could reduce Canada’s GDP by up to $1 trillion between 2030 and 2040, eliminate up to 151,000 jobs by 2030, reduce federal government revenue by up to $151 billion between 2030 and 2040, and reduce Alberta government revenue by up to $127 billion over the same period.

According to an announcements last week by Premier Danielle Smith, the Alberta government will use the Alberta Sovereignty within a United Canada Act to challenge Ottawa’s proposal to cap greenhouse gas emissions from the oil and gas sector at 35 per cent below 2019 levels by 2030.

Premier Smith, who said the cap will harm the economy and represents an overstep of federal authority, also plans to prevent emissions data from individual oil and gas companies from being shared with Ottawa. While the federal government said the cap is necessary to fight climate change, several studies suggest the cap will impose significant costs on Canadians without yielding detectable environmental benefits.

According to a recent report by Deloitte, a leading audit and consulting firm, the cap will force Canadian firms to curtail oil production by 626,000 barrels per day by 2030 or by approximately 10.0 per cent of the expected production—and curtail gas production by approximately 12.0 per cent.

Deloitte estimates that Alberta will be hit hardest, with 3.6 per cent less investment, almost 70,000 fewer jobs, and a 4.5 per cent decrease in the province’s economic output (i.e. GDP) by 2040. Ontario will lose 15,000 jobs and $2.3 billion from its economy by 2040. And Quebec will lose more than 3,000 jobs and $0.4 billion from its economy during the same period.

Overall, the country will experience an economic loss equivalent to 1.0 per cent of the value of the entire economy (GDP), translating into lower wages, the loss of nearly 113,000 jobs and a 1.3 per cent reduction in government tax revenues. Canada’s inflation-adjusted GDP growth in 2023 was a paltry 1.3 per cent, so a 1 per cent reduction would be a significant economic loss.

Deloitte’s findings echo previous studies. According to a recent analysis by the Conference Board of Canada think-tank, the cap could reduce Canada’s GDP by up to $1 trillion between 2030 and 2040, eliminate up to 151,000 jobs by 2030, reduce federal government revenue by up to $151 billion between 2030 and 2040, and reduce Alberta government revenue by up to $127 billion over the same period.

Similarly, another recent study published by the Fraser Institute found that the cap would reduce production and exports, leading to at least $45 billion in lost economic activity in 2030 alone, accompanied by a substantial drop in government revenue.

Crucially, these huge economic costs to Canadians will come without any discernable environmental benefits. Even if Canada entirely shut down its oil and gas industry by 2030, eliminating all GHG emissions from the sector, the resulting reduction in global GHG emissions would amount to a mere four-tenths of one per cent with virtually no impact on the climate or any detectable environmental, health or safety benefits.

Given the demand for fossil fuels, constraining oil and gas production and exports in Canada would likely merely shift production to other countries with lower environmental and human rights standards such as Iran, Russia and Venezuela. Consequently, global GHG emissions would increase, not decrease. No other major oil and gas-producing country has imposed a similar cap on its leading export sector.

The Trudeau government’s proposed cap, which still must pass the House and Senate, would further strain an already struggling Canadian economy, and to make matters worse, do virtually nothing to improve the environment. The government should cancel the cap plan given the economic costs and nonexistent environmental benefits.