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Opening independent non-profit hospitals would improve access to care and efficiency in Canada’s healthcare system

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From the Montreal Economic Institute

Autonomous non-profit hospitals tend to perform better than government-run hospitals, shows a study published this morning by the Montreal Economic Institute.

“Interminable waits in Canadian hospitals show that our healthcare systems are struggling to deliver basic services to the population,” says Emmanuelle B. Faubert, economist at MEI and author of the study. “By allowing independent non-profit hospitals to open, our governments would help increase treatment capacity, to the benefit of patients.”

In 2023, the median wait time in Quebec ERs was 5 hours and 13 minutes, up 42 minutes from five years earlier.

It is estimated that as a result of chronic overcrowding in Canadian ERs, there are between 8,000 and 15,000 avoidable deaths each year.

The Canadian health care system ranks 10th out of 11 comparable industrialized countries, just ahead of the United States, in the Commonwealth Fund’s ranking of healthcare systems. The French, German, and Dutch systems are 8th, 5th, and 2nd respectively in the same ranking.

While the Canadian system has no independent non-profit hospitals according to the OECD’s definition, such facilities account for 14 per cent of French hospital beds, 28 per cent of German hospital beds, and 100 per cent of Dutch hospital beds.

The researcher attributes a portion of the success of these facilities to their greater managerial autonomy and to a funding method that encourages the treatment of more patients.

“One of the strengths of these hospitals is how quickly they can adapt, contrary to facilities micromanaged by government ministries, as is the case in Canada,” explains Ms. Faubert. “Since their financing depends on the type and the quantity of ailments treated, administrators see the sustainability of their facilities as being directly linked to their capacity to treat patients.”

Although Canadian hospitals generally have their own boards of directors, the management of their daily activities and their funding are subject to strict government control.

Aside from certain limited experiments, notably in Quebec, Canadian hospitals still depend largely on a global budgeting model, in which funding depends entirely on the level of activity in the previous year.

Since the annual budgetary envelope is fixed, each additional patient is seen as a cost, says the researcher.

In Europe, in contrast, hospitals are largely financed according to an activity-based funding model, whereby a hospital receives a set amount of money for each treatment carried out within its walls. With this system, each additional patient treated represents an immediate source of revenue for the facility, says the researcher.

“It’s clear that our healthcare system can and must do better, and that means changing the incentives of those who manage it,” says Ms. Faubert. “By introducing non-profit hospitals, with a better funding model, and by granting health professionals more flexibility, we will be able to provide better care to more patients, as they do in Europe.”

The MEI study is available here.

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The MEI is an independent public policy think tank with offices in Montreal 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.

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New report warns WHO health rules erode Canada’s democracy and Charter rights

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Justice Centre for Constitutional Freedoms

The Justice Centre for Constitutional Freedoms has released a new report titled Canada’s Surrender of Sovereignty: New WHO health regulations undermine Canadian democracy and Charter freedoms. Authored by Nigel Hannaford, a veteran journalist and researcher, the report warns that Canada’s acceptance of the World Health Organization’s (WHO) revised International Health Regulations (IHR) represents a serious erosion of national independence and democratic accountability.

The IHR amendments, which took effect on September 19, 2025, authorize the WHO Director-General to declare global “health emergencies” that could require Canada to follow directives from bureaucrats in Geneva, bypassing the House of Commons and the will of Canadian voters.

The WHO regards these regulations as “binding,” despite having no ability or legal authority to impose such regulations. Even so, Canada is opting to accept the regulations as binding.

By accepting the WHO’s revised IHR, the report explains, Canada has relinquished its own control over future health crises and instead has agreed to let the WHO determine when a “pandemic emergency” exists and what Canada must do to respond to it, after which Canada must report back to the WHO.

In fact, under these International Health Regulations, the WHO could demand countries like Canada impose stringent freedom-violating health policies, such as lockdowns, vaccine mandates, or travel restrictions without debate, evidence review, or public accountability, the report explains.

Once the WHO declares a “Pandemic Emergency,” member states are obligated to implement such emergency measures “without delay” for a minimum of three months.

Importantly, following these WHO directives would undermine government accountability as politicians may hide behind international “commitments” to justify their actions as “simply following international rules,” the report warns.

Canada should instead withdraw from the revised IHR, following the example of countries like Germany, Austria, Italy, Czech Republic, and the United States. The report recommends continued international cooperation without surrendering control over domestic health policies.

Constitutional lawyer Allison Pejovic said, “[b]y treating WHO edicts as binding, the federal government has effectively placed Canadian sovereignty on loan to an unelected international body.”

“Such directives, if enforced, would likely violate Canadians’ Charter rights and freedoms,” she added.

Mr. Hannaford agreed, saying, “Canada’s health policies must be made in Canada. No free and democratic nation should outsource its emergency powers to unelected bureaucrats in Geneva.”

The Justice Centre urges Canadians to contact their Members of Parliament and demand they support withdrawing from the revised IHR to restore Canadian sovereignty and reject blind compliance with WHO directives.

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Cutting Red Tape Could Help Solve Canada’s Doctor Crisis

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From the Frontier Centre for Public Policy

By Ian Madsen

Doctors waste millions of hours on useless admin. It’s enough to end Canada’s doctor shortage. Ian Madsen says slashing red tape, not just recruiting, is the fastest fix for the clogged system.

Doctors spend more time on paperwork than on patients and that’s fueling Canada’s health care wait lists

Canada doesn’t just lack doctors—it squanders the ones it has. Mountains of paperwork and pointless admin chew up tens of millions of physician hours every year, time that could erase the so-called shortage and slash wait lists if freed for patient care.

Recruiting more doctors helps, but the fastest cure for our sick system is cutting the bureaucracy that strangles the ones already here.

The Canadian Medical Association found that unnecessary non-patient work consumes millions of hours annually. That’s the equivalent of 50.5 million patient visits, enough to give every Canadian at least one appointment and likely erase the physician shortage. Meanwhile, the Canadian Institute for Health Information estimates more than six million Canadians don’t even have a family doctor. That’s roughly one in six of us.

And it’s not just patients who feel the shortage—doctors themselves are paying the price. Endless forms don’t just waste time; they drive doctors out of the profession. Burned out and frustrated, many cut their hours or leave entirely. And the foreign doctors that health authorities are trying to recruit? They might think twice once they discover how much time Canadian physicians spend on paperwork that adds nothing to patient care.

But freeing doctors from forms isn’t as simple as shredding them. Someone has to build systems that reduce, rather than add to, the workload. And that’s where things get tricky. Trimming red tape usually means more Information Technology (IT), and big software projects have a well-earned reputation for spiralling in cost.

Bent Flyvbjerg, the global guru of project disasters, and his colleagues examined more than 5,000 IT projects in a 2022 study. They found outcomes didn’t follow a neat bell curve but a “power-law” distribution, meaning costs don’t just rise steadily, they explode in a fat tail of nasty surprises as variables multiply.

Oxford University and McKinsey offered equally bleak news. Their joint study concluded: “On average, large IT projects run 45 per cent over budget and seven per cent over time while delivering 56 per cent less value than predicted.” If that sounds familiar, it should. Canada’s Phoenix federal payroll fiasco—the payroll software introduced by Ottawa that left tens of thousands of federal workers underpaid or unpaid—is a cautionary tale etched into the national memory.

The lesson isn’t to avoid technology, but to get it right. Canada can’t sidestep the digital route. The question is whether we adapt what others have built or design our own. One option is borrowing from the U.S. or U.K., where electronic health record (EHR) systems (the digital patient files used by doctors and hospitals) are already in place. Both countries have had headaches with their systems, thanks to legal and regulatory differences. But there are signs of progress.

The U.K. is experimenting with artificial intelligence to lighten the administrative load, and a joint U.K.-U.S. study gives a glimpse of what’s possible:

“… AI technologies such as Robotic Process Automation (RPA), predictive analytics, and Natural Language Processing (NLP) are transforming health care administration. RPA and AI-driven software applications are revolutionizing health care administration by automating routine tasks such as appointment scheduling, billing, and documentation. By handling repetitive, rule-based tasks with speed and accuracy, these technologies minimize errors, reduce administrative burden, and enhance overall operational efficiency.”

For patients, that could mean fewer missed referrals, faster follow-up calls and less time waiting for paperwork to clear before treatment. Still, even the best tools come with limits. Systems differ, and customization will drive up costs. But medicine is medicine, and AI tools can bridge more gaps than you might think.

Run the math. If each “freed” patient visit is worth just $20—a conservative figure for the value of a basic appointment—the payoff could hit $1 billion in a single year.

Updating costs would continue, but that’s still cheap compared to the human and financial toll of endless wait lists. Cost-sharing between provinces, Ottawa, municipalities and even doctors themselves could spread the risk. Competitive bidding, with honest budgets and realistic timelines, is non-negotiable if we want to dodge another Phoenix-sized fiasco.

The alternative—clinging to our current dysfunctional patchwork of physician information systems—isn’t really an option. It means more frustrated doctors walking away, fewer new ones coming in, and Canadians left to languish on wait lists that grow ever longer.

And that’s not health care—it’s managed decline.

Ian Madsen is a senior policy analyst at the Frontier Centre for Public Policy.

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