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Fraser Institute

Ottawa’s health-care deal cements failed status quo in Canada

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From the Fraser Institute

By Mackenzie Moir and Jake Fuss

Canada will reach a projected $244.1 billion in 2023, which translates to $6,205 per person—nearly double the level of per-person spending (inflation-adjusted) three decades ago. And yet, last year Canadians endured the longest median wait time (27.7 weeks) ever recorded for non-emergency surgery.

Last week, as part of Ottawa’s promised $46 billion in additional health-care spending, the Trudeau government agreed to increase Quebec’s share of federal health-care dollars by $900 million annually. Quebec was the last province to reach an agreement with Ottawa before the March 31 deadline. With the closure of this agreement, Canadian taxpayers are on the hook for more health-care spending than ever before. For the same old broken health-care system.

Of course, it ultimately doesn’t matter whether the $46 billion originates from Ottawa or the provinces. In the end, Canadian taxpayers foot the bill. And what do we get in return for our health-care dollars?

In 2021, the latest year of comparable data, Canada’s total health-care spending (as a percentage of the economy) was the highest among 29 other comparable countries with universal health care (after adjusting for differences in population age). This isn’t a new development. Canada has a long history of having one of most expensive systems among high-income universal health-care countries.

Despite this, according to the latest comparable data, Canada ranks among the poorest performing universal health-care countries in key areas such as the number of physicians, hospital beds and diagnostic technology (e.g. MRI machines). Further, according to the Commonwealth Fund, in 2020 Canada ranked dead last on timely access to specialist consultations and non-emergency surgery.

Meanwhile, public health-care spending in Canada will reach a projected $244.1 billion in 2023, which translates to $6,205 per person—nearly double the level of per-person spending (inflation-adjusted) three decades ago. And yet, last year Canadians endured the longest median wait time (27.7 weeks) ever recorded for non-emergency surgery.

In short, Canada’s health-care system is in shambles, but the answer does not lie in simply throwing more money in its general direction. Federal politicians should instead look to the example of welfare reform during the Chrétien era in the 1990s. Those reforms, which reduced federal transfers to provinces and eliminated most of the “strings” attached to federal funding, resulted in increased provincial autonomy, greater policy experimentation, fewer Canadians needing welfare and savings for the federal government (i.e. taxpayers).

This is the opposite of today’s approach to health care, where the existing vehicle for federal funding (the Canada Health Transfer) is connected to the Canada Health Act (CHA), which prevents provincial governments from innovating and experimenting in health care by threatening financial penalties for non-compliance with often vaguely defined federal preferences. The result is a stalemate that satisfies no one and ensures that Canada’s policies remain at odds with the policies of our better-performing universal health-care peers.

While new federal dollars for health care are undoubtedly appealing to premiers, they will not improve the state of health care for Canadians. Until our federal politicians have the courage to reform the CHA and follow the example of 1990s welfare reform to improve outcomes, our health-care system’s unacceptable status quo will continue.

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Fraser Institute

Latest federal budget will continue trend of negative outcomes for Canadians

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From the Fraser Institute

By Matthew Lau

From the third quarter of 2015 to the fourth quarter of 2023, growth in real GDP per-person (a common indicator of living standards) was less than 1 per cent cumulatively versus more than 15 per cent in the United States. This despite—or more accurately, because of—massive government spending including on corporate subsidies

Reading the federal budget, which the Trudeau government tabled last week, is not an activity likely to improve the equanimity of Canadians suffering from over-taxation and anxious about stagnating living standards. The fact is, the budget sets Canadians even further behind with increased costs and higher taxes, which are sure to reduce productivity and investment further.

In terms of taxes, the main headline is the increase to the capital gains tax to a two-thirds inclusion rate for amounts over $250,000 per year. With Canada’s business investment numbers already dismal, the capital gains tax hike makes things worse by discouraging entrepreneurship and distorting economic decisions to favour present day consumption instead of saving and investment. Indeed, because people know the money they earned today will be taxed more heavily when they invest it tomorrow, the capital gains tax hike reduces incentives to work and earn today.

When it comes to costs, the “total expenses” line in the fiscal tables is most instructive. In last year’s budget, the Trudeau government said it would spend $496.9 billion in 2023-24 and $513.5 billion in 2024-25, rising to $556.9 billion by 2027-28 for a total of $2.6 trillion over five years. But according to this year’s budget, its $505.1 billion for 2023-24, $537.6 billion in 2024-25 and $588.2 billion by 2027-28, for a total of $2.8 trillion over the same five-year period, with both higher program spending and greater borrowing costs contributing to the increase.

In other words, the Trudeau government overspent its budget last year by an estimated $8.2 billion, has increased its spending for this year by $24.1 billion, and will now overspend last year’s fiscal plan by a total of $120.8 billion over five years. And that’s assuming the Liberals stick to the spending plan they just tabled. The Trudeau government has a track record of blowing past its original spending targets, often by astonishing margins, a trend continued in its latest budget. So taxpayers might reasonably expect even the significantly increased costs presented in this latest budget are an understatement.

Canadians might find the exorbitant costs of federal spending easier to accept if they saw some benefits commensurate to the spending, but they have not. From the third quarter of 2015 to the fourth quarter of 2023, growth in real GDP per-person (a common indicator of living standards) was less than 1 per cent cumulatively versus more than 15 per cent in the United States. This despite—or more accurately, because of—massive government spending including on corporate subsidies and other initiatives the government claimed would boost economic growth. Clearly, such growth has not materialized.

The latest budget increased spending for the national child-care program, but the thing has been a disaster  from coast to coast, with families unable to find spots, daycare operators in dire straits, and costs to taxpayers ballooning. Similarly, while health-care spending has risen over the years, access to medical care has gone down. Spending and regulation related to climate change have exploded under the Trudeau government, but the environmental benefits of initiatives such as electric vehicle consumer subsidies and plastic bans, if there are any environmental benefits at all, are nowhere near high enough to offset the burden to taxpayers and consumers.

Clearly, the Trudeau government’s ramp-up in spending and increased taxation, as the GDP and investment figures show, have produced severely negative outcomes for eight years. By ramping spending and taxation up yet higher, it will help continue these negative outcomes.

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Fraser Institute

Federal government’s fiscal record—one for the history books

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From the Fraser Institute

By Jake Fuss and Grady Munro

Per-person federal spending is expected to equal $11,901 this year. To put this into perspective, this is significantly more than Ottawa spent during the global financial crisis in 2008 or either world war.

The Trudeau government tabled its 2024 budget earlier this month and the contents of the fiscal plan laid bare the alarming state of federal finances. Both spending and debt per person are at or near record highs and prospects for the future don’t appear any brighter.

In the budget, the Trudeau government outlined plans for federal finances over the next five years. Annual program spending (total spending minus debt interest costs) will reach a projected $483. billion in 2024/25, $498.7 billion in 2025/26, and continue growing in the years following. By 2028/29 the government plans to spend $542.0 billion on programs—an 18.4 per cent increase from current levels.

This is not a new or surprising development for federal finances. Since taking office in 2015, the Trudeau government has shown a proclivity to spend at nearly every turn. Prime Minister Trudeau has already recorded the five highest levels of federal program spending per person (adjusted for inflation) in Canadian history from 2018 to 2022. Projections for spending in the 2024 budget assert the prime minister is now on track to have the eight highest years of per-person spending on record by the end of the 2025/26 fiscal year.

Per-person federal spending is expected to equal $11,901 this year. To put this into perspective, this is significantly more than Ottawa spent during the global financial crisis in 2008 or either world war. It’s also about 28.0 per cent higher than the full final year of Stephen Harper’s time as prime minister, meaning the size of the federal government has expanded by more than one quarter in a decade.

The government has chosen to borrow substantial sums of money to fund a lot of this marked growth in spending. Federal debt under the Trudeau government has risen before, during and after COVID regardless of whether the economy is performing relatively well or comparatively poor. Between 2015 and 2024, Ottawa is expected to run 10 consecutive deficits, with total gross debt set to reach $2.1 trillion within the next 12 months.

The scale of recent debt accumulation is eye-popping even after accounting for a growing population and the relatively high inflation of the past two years. By the end of the current fiscal year, each Canadian will be burdened with $12,769 more in total federal debt (adjusted for inflation) than they were in 2014/15.

You can attribute some of this increase in borrowing to the effects of COVID, but debt had already grown by $2,954 per person from 2014 to 2019—before the pandemic. Moreover, budget estimates show gross debt per person (adjusted for inflation) is expected to rise by more than $2,500 by 2028/29.

As with spending, the Trudeau government is on track to record the six highest years of federal debt per-person (adjusted for inflation) in Canadian history between 2020/21 and the end of its term next autumn. Why should Canadians care about this record debt?

Simply put, rising debt leads to higher interest payments that current and future generations of taxpayers must pay—leaving less money for important priorities such as health care and social services. Moreover, all this spending and debt hasn’t helped improve living standards for Canadians. Canada’s GDP per person—a broad measure of incomes—was lower at the end of 2023 than it was nearly a decade ago in 2014.

The Trudeau government’s track record with federal finances is one for the history books. Ottawa’s spending continues to be at near-record levels and Canadians have never been burdened with more debt. Those aren’t the type of records we should strive to achieve.

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