Canada’s health care system is the third-most expensive but ranks 27th for doctor availability compared to other developed countries: study

Canada spends the third-most on health care compared to other high-income countries with universal health care, yet ranks near the bottom across a number of key metrics, according to a new research study from the Fraser Institute. These include the availability of doctors, care beds, Magnetic Resonance Imaging (MRI) units, and CT scanners. “Clearly, there is an imbalance between what Canadians receive in return for the relatively high amount of money they spend on their health-care system,” Mackenzie Moir, author of the study and Fraser Institute senior policy analyst, concluded in reviewing his research. The study found Canada was below average compared to the universal health-care systems of 30 other OECD (Organization for Economic Co-operation and Development) countries, and across 13 indicators reviewed for “medical resources and timely access to medical services.” Canada’s poor performance is all the more noteworthy because the Canadian governments spent the third-most of any country as an overall percentage of GDP (when adjusted for the age profile of the country) in 2023. That year, Canada spent approximately $344 billion on healthcare, or $8,740 per Canadian. Canada, per the study’s findings, allocated 11.6 percent of its overall GDP in 2023 to health care, which was only surpassed by Switzerland (11.9) and New Zealand (12.2). Meanwhile, countries such as South Korea (8.9), Portugal (8.9), Greece (7.6), and Japan (8.1) all ranked below the OECD average of 9.2 percent. The newly released 2025 installment of the Fraser Institute’s annual study—“Comparing Performance of Universal Health Care Countries”—also showed Canada ranked 27th and 25th for the availability of doctors and hospital beds in 2023. “The report gives us an opportunity to understand what countries are doing a better job than we are. Let’s look at Switzerland, where we have a very similar level of expenditure. This is another of the developed world’s most expensive universal access health-care systems, and yet it’s one of the most accessible in the developed world,” Fraser Institute director of health policy Nadeem Esmail told The Hub in an interview. “They have some of the shortest wait times for access to health care. They have far better access to physicians, hospital beds, and medical technologies than Canadians do…[and] they have private hospitals delivering universally accessible care. They have a private alternative to the universal scheme.” The percentage of Canada’s GDP spent on health care has risen in the subsequent two years, as the country’s aging Boomer generation begins to strain the system, with costs on average growing exponentially for those over the age of 65 and into retirement. Exacerbating the situation, Canada’s GDP growth has been anemic over the last decade. The Parliamentary Budget Officer (PBO) projects growth to remain sluggish for the remainder of the decade. The Fraser Institute paper shows that the Canadian taxpayers aren’t getting a good return on their investment. Besides a shortage of doctors and hospital beds, Canada ranks terribly for medical, technological, and diagnostic imaging equipment: 27th for MRI units, 28th for CT scanners, 22nd for PET scanners, and 13th for mammographs. Canada also ranked low for per capita availability of nurses (13th) and psychiatric-care beds (27th). Canada also fared poorly in a ranking of nine OECD health-care wait times within the report: 8th for both a next-day appointment when sick and one month for seeing a specialist, and 9th for waiting more than two months for elective surgery. Inordinately long wait times for Canadians at the emergency room, obtaining family doctors, and hospital beds have made headlines in recent years. Health-care demands have increased with the country’s population growing by 3.6 million people in the last five years. The health-care system in Canada is still a largely publicly funded, universal model governed by the Canada Health Act, providing free access to medically necessary hospital and physician services. Amid the recent strain on provincial health-care systems, Alberta and Ontario have expanded private care options—such as for-profit clinics for diagnostics and surgeries—to alleviate public system pressures. Esmail explained that Canada is a “unique” outlier in the developed world for not offering a private parallel option to citizens. “The value of the private option is clearly demonstrated in the developed world’s highest-performing universal access health-care systems. No nation with very short wait times has managed that performance without the involvement of the private sector. No nation that does a better job at health care than we do in terms of timeliness and access with lower spending has managed that performance without a larger role for the private sector,” Esmail said. Esmail believes some provinces in Canada have started to address the rigidity of a strictly universal access system, with Alberta and Quebec leading the way. “Alberta and Quebec are standouts in terms of their focus on shifting to patient-focused funding for hospital care or surgical care, having money follow patients through that system, which has been done in other developed nations…Canada is a laggard when it comes to introducing the policy,” Esmail explained. Canadian public sentiment has shifted to a majority of Canadians (56 percent) now being open to more alternative non-governmental health-care provider options, according to an Ipsos poll. For the last decade, the Trudeau government was adamant about preventing the expansion of private care. “We’re not going to allow that to happen. Let me be very clear, Canada and Canadians are deeply proud of having a public health-care system,” Health Minister Mark Holland told Global News last year. However, more recently, Prime Minister Mark Carney appears to be leaving the door open. While initially stressing that “In America, health care is a big business. In Canada, it’s a right,” when asked directly on the campaign trail how he would enforce the Canada Health Act to prevent private options, he was ambivalent. “I’m a believer in results and getting results for Canadians,” he said.