Fraser Institute
Endless spending increases will not fix Canada’s health-care system

From the Fraser Institute
By Mackenzie Moir and Jake Fuss
Canada’s health-care system ranked as the most expensive (as a share of the economy) among 30 universal health-care countries. And despite these relatively high levels of spending, Canada continues to lag behind its peers on key indicators of performance.
In February 2023, the federal government announced the money they send to the provinces for health care would increase, yet again. Despite being billed as a fix for health care, these spending increases will not actually provide any relief for Canadian patients.
The Canada Health Transfer (CHT), the main federal financial tool for funding provincial health care, has increased from $34.0 billion in 2015/16 to $52.1 billion this year (2024/25), a 53.1 per cent increase in about a decade. Moreover, the federal government has committed to increases in the transfer at a guaranteed 5 per cent until 2027/28.
This latest increase in the CHT, however, is only one part of the $46.2 billion in new money being doled out over the next 10 years. More than half (roughly $25 billion) is currently being given to provinces who’ve signed up to work towards a number of “shared priorities” with Ottawa, such as mental health and substance abuse.
Clearly, the federal government has decided to substantially increase health-care spending in more than one way. But will it produce results?
These periodic “fixes” occasionally championed by Ottawa every few years are nothing new. And unfortunately, the data show that longstanding problems, including long waits for medical care and doctor shortages, will persist even though Canada is certainly no slouch when compared to its peers on health-care spending.
A recent study found that, when adjusted for differences in age (because older populations tend to spend more on health care), Canada’s health-care system ranked as the most expensive (as a share of the economy) among 30 universal health-care countries. And despite these relatively high levels of spending, Canada continues to lag behind its peers on key indicators of performance.
For example, Canada had some of the fewest physicians (ranked 28th of 30 countries), hospital beds (ranked 23rd of 29) and diagnostic technology such as MRIs (ranking 25th of 29 countries) and CT scanners (ranking 26th out of 30 countries) compared to other high-income countries with universal health care.
It also ranked at or near the bottom on measures such as same-day medical appointments, how easy it is to find afterhours care, and the timeliness of specialist appointments and surgical care.
And wait times have been getting worse. Just last year Canada recorded the longest ever delay for non-emergency care at 27.7 weeks, a 198 per cent increase from the 9.3 week wait experienced in 1993 (the first year national estimates were published).
But it’s not just the health-care system that’s in shambles, despite our high spending. Our federal finances are, too. Years of substantial increases in federal spending have strained the country’s finances. The Trudeau government’s latest budget projects a deficit of $39.8 billion this year, with more spent on debt interest ($54.1 billion) than on what the federal government gives to the provinces for health care.
Again, these periodic injections of federal funds to the provinces to supposedly fix health care are nothing new. Ottawa has relied on this strategy in the past and wait times have grown longer over the last three decades. Endless increases in spending will not fix our health-care system.
Authors:
Automotive
Electric cars just another poor climate policy

From the Fraser Institute
The electric car is widely seen as a symbol of a simple, clean solution to climate change. In reality, it’s inefficient, reliant on massive subsidies, and leaves behind a trail of pollution and death that is seldom acknowledged.
We are constantly reminded by climate activists and politicians that electric cars are cleaner, cheaper, and better. Canada and many other countries have promised to prohibit the sale of new gas and diesel cars within a decade. But if electric cars are really so good, why would we need to ban the alternatives?
And why has Canada needed to subsidize each electric car with a minimum $5,000 from the federal government and more from provincial governments to get them bought? Many people are not sold on the idea of an electric car because they worry about having to plan out where and when to recharge. They don’t want to wait for an uncomfortable amount of time while recharging; they don’t want to pay significantly more for the electric car and then see its used-car value decline much faster. For people not privileged to own their own house, recharging is a real challenge. Surveys show that only 15 per cent of Canadians and 11 per cent of Americans want to buy an electric car.
The main environmental selling point of an electric car is that it doesn’t pollute. It is true that its engine doesn’t produce any CO₂ while driving, but it still emits carbon in other ways. Manufacturing the car generates emissions—especially producing the battery which requires a large amount of energy, mostly achieved with coal in China. So even when an electric car is being recharged with clean power in BC, over its lifetime it will emit about one-third of an equivalent gasoline car. When recharged in Alberta, it will emit almost three-quarters.
In some parts of the world, like India, so much of the power comes from coal that electric cars end up emitting more CO₂ than gasoline cars. Across the world, on average, the International Energy Agency estimates that an electric car using the global average mix of power sources over its lifetime will emit nearly half as much CO₂ as a gasoline-driven car, saving about 22 tonnes of CO₂.
But using an electric car to cut emissions is incredibly ineffective. On America’s longest-established carbon trading system, you could buy 22 tonnes of carbon emission cuts for about $660 (US$460). Yet, Ottawa is subsidizing every electric car to the tune of $5,000 or nearly ten times as much, which increases even more if provincial subsidies are included. And since about half of those electrical vehicles would have been bought anyway, it is likely that Canada has spent nearly twenty-times too much cutting CO₂ with electric cars than it could have. To put it differently, Canada could have cut twenty-times more CO₂ for the same amount of money.
Moreover, all these estimates assume that electric cars are driven as far as gasoline cars. They are not. In the US, nine-in-ten households with an electric car actually have one, two or more non-electric cars, with most including an SUV, truck or minivan. Moreover, the electric car is usually driven less than half as much as the other vehicles, which means the CO₂ emission reduction is much smaller. Subsidized electric cars are typically a ‘second’ car for rich people to show off their environmental credentials.
Electric cars are also 320–440 kilograms heavier than equivalent gasoline cars because of their enormous batteries. This means they will wear down roads faster, and cost societies more. They will also cause more air pollution by shredding more particulates from tire and road wear along with their brakes. Now, gasoline cars also pollute through combustion, but electric cars in total pollute more, both from tire and road wear and from forcing more power stations online, often the most polluting ones. The latest meta-study shows that overall electric cars are worse on particulate air pollution. Another study found that in two-thirds of US states, electric cars cause more of the most dangerous particulate air pollution than gasoline-powered cars.
These heavy electric cars are also more dangerous when involved in accidents, because heavy cars more often kill the other party. A study in Nature shows that in total, heavier electric cars will cause so many more deaths that the toll could outweigh the total climate benefits from reduced CO₂ emissions.
Many pundits suggest electric car sales will dominate gasoline cars within a few decades, but the reality is starkly different. A 2023-estimate from the Biden Administration shows that even in 2050, more than two-thirds of all cars globally will still be powered by gas or diesel.
Source: US Energy Information Administration, reference scenario, October 2023
Fossil fuel cars, vast majority is gasoline, also some diesel, all light duty vehicles, the remaining % is mostly LPG.
Electric vehicles will only take over when innovation has made them better and cheaper for real. For now, electric cars run not mostly on electricity but on bad policy and subsidies, costing hundreds of billions of dollars, blocking consumers from choosing the cars they want, and achieving virtually nothing for climate change.
2025 Federal Election
Fixing Canada’s immigration system should be next government’s top priority

From the Fraser Institute
Whichever party forms government after the April 28 election must put Canada’s broken immigration system at the top of the to-do list.
This country has one of the world’s lowest fertility rates. Were it not for immigration, our population would soon start to decline, just as it’s declining in dozens of other low-fertility countries around the world.
To avoid the social and economic tensions of an aging and declining population, the federal government should re-establish an immigration system that combines a high intake with strictly enforced regulations. Once Canadians see that program in place and working, public support for immigration should return.
Canada’s total fertility rate (the number of children, on average, a woman will have in her lifetime) has been declining, with the odd blip here and there, since the 1960s. In 1972, it fell below the replacement rate of 2.1.
According to Statistics Canada, the country’s fertility rate fell to a record low of 1.26 in 2023. That puts us in the company of other lowest-low fertility countries such as Italy (1.21), Japan (1.26) and South Korea (0.82).
Those three countries are all losing population. But Canada’s population continues to grow, with immigrants replacing the babies who aren’t born. The problem is that, in the years that followed the COVID-19 lockdowns, the population grew too much.
The Liberal government was unhappy that the pandemic had forced Canada to restrict immigration and concerned about post-pandemic labour shortages. To compensate, Ottawa set a target of 500,000 new permanent residents for 2025, double the already-high intake of about 250,000 a year that had served as a benchmark for the Conservative government of Stephen Harper and the Liberal governments of Paul Martin and Jean Chrétien.
Ottawa also loosened restrictions on temporary foreign worker permits and the admission of foreign students to colleges and universities. Both populations quickly exploded.
Employers preferred hiring workers from overseas rather than paying higher wages for native-born workers. Community colleges swelled their ranks with international students who were also issued work permits. Private colleges—Immigration Minister Marc Miller called them “puppy mills”—sprang up that offered no real education at all.
At the same time, the number of asylum claimants in Canada skyrocketed due to troubles overseas and relaxed entry procedures, reaching a total of 457,285 in 2024.
On January 1 of this year, Statistics Canada estimated that there were more than three million temporary residents in the country, pushing Canada’s population up above 41.5 million.
Their presence worsened housing shortages, suppressed wages and increased unemployment among younger workers. The public became alarmed at the huge influx of foreign residents.
For the first time in a quarter century, according to an Environics poll, a majority of Canadians believed there were too many immigrants coming into Canada.
Some may argue that the solution to Canada’s demographic challenges lie in adopting family-friendly policies that encourage couples to have children. But while governments improve parental supports and filter policies through a family-friendly lens—for example, houses with backyards are more family-friendly than high-rise towers—no government has been able to reverse declining fertility back up to the replacement rate of 2.1.
The steps to repairing Canada’s immigration mess lie in returning to first principles.
According to Statistics Canada, there were about 300,000 international students at postsecondary institutions when the Liberals came to power in 2015. Let’s return to those levels.
The temporary foreign worker program should be toughened up. The government recently implemented stricter Labour Market Impact Assessments, but even stricter rules may be needed to ensure that foreign workers are only brought in when local labour markets cannot meet employer needs, while paying workers a living wage.
New legislation should ensure that only asylum claimants who can demonstrate they are at risk of persecution or other harm in their home country are given refuge in Canada, and that the process for assessing claims is fair, swift and final. If necessary, the government should consider employing the Constitution’s notwithstanding clause to protect such legislation from court challenges.
Finally, the government should admit fewer permanent residents under the family reunification stream and more from the economic stream. And the total admitted should be kept to around 1 per cent of the total population. That would still permit an extremely robust intake of about 450,000 new Canadians each year.
Restoring public confidence in Canada’s immigration system will take much longer than it took to undermine that confidence. But there can be no higher priority for the federal government. The country’s demographic future is at stake.
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