When a system is performing poorly, it is natural to look around and take note of what’s working better elsewhere. So it is no surprise that Americans who are frustrated with their healthcare system would look to Canada, as the United States’s neighbor, for ideas on how to solve their healthcare woes. Documentarian Michael Moore famously did just that in his 2007 film Sicko, but an update would be more than justified. Canadians are trapped waiting hours in emergency rooms and scrambling for years to get access to a family doctor. We’re no model for excellence.
On its face, the Canadian healthcare system seems great. It’s free! You just walk into a doctor’s office and walk out without having to pay. Of course, it is not actually free, and it is not easy to see a doctor. The ratio of 40 million Canadians to roughly 96,000 doctors is a practical problem still in search of a solution.
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When it comes to costs, the Vancouver-based think tank Fraser Institute has shown the actual toll of “free” healthcare for Canadians. If you are a single Canadian making around $55,000, you are paying around $5,600 a year for healthcare through taxes, whether you access it or not. For a family of four, two parents with two children pulling an average income, your healthcare tax payment is around $17,700 a year.
That’s a massive hit for any family for a barely accessible service. And it’s only getting worse, with Fraser showing that between 1997 and 2024, the cost of healthcare increased by up to 125.5% for that same single Canadian and up to 85.1% for the family of four.
A recent study by the Montreal Economic Institute found that patients left around 1 in every 13 visits to the emergency room in Canada without having been treated because of the long wait time. We’re not talking patients in need of a Band-Aid; many of these people leaving were classified as urgent. Every Canadian knows about this problem.
A large number of people who opt to leave the emergency room eventually seek care again. Returning to the ER backs up an already overburdened healthcare system, and it also means more intervention is required, since whatever ailment a patient had in the first place has progressively gotten worse since they left. In 2024, Canadians were 35.5% more likely to leave the emergency room because of wait times than five years ago. This represents over 1 million Canadians being denied access to healthcare in all of 2024.
America’s healthcare debates tend to center on coverage and ignore the next question, which is that of accessibility. You can be covered and not have access to care.
If you are on a waitlist to be seen for a serious problem, you are most certainly out of luck. Canadian think tank Second Street obtained data showing that at least 3.7 million Canadians are waiting for surgery, a diagnostic scan, or to see a specialist. This might be a conservative figure, as researchers believe the actual number is around 5.8 million, or 1 in 8 Canadians.
Seventy-five thousand people have died on waiting lists in Canada since 2018.
The Canadian government charges its citizens an exorbitant amount of money for their “free” healthcare, but simply cannot deliver. Canada’s capital city, Ottawa, has formed a committee to attract more doctors so locals can actually receive healthcare. Ottawa faces a shortage of around 270 practicing family doctors, which usually pushes people to go to the ER.
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The issue is at the doorstep of those in power, and still, all they do is charge Canadians more for a service they can hardly access. It is an unending cycle of inefficiency stemming from poor funding models from the provincial governments, unending waits to see specialists, and even restrictions on licensed doctors from abroad who face barriers when they immigrate to try to help alleviate Canada’s crisis.
There is something fundamentally wrong in a country that claims the fourth-highest healthcare spending in terms of GDP in the world while still ranking second to last on the Consumer Choice Center’s Healthcare Time Saved Index. The Canadian healthcare system isn’t what outsiders think it is, and Americans looking for reform should run in the other direction.
Sabine Benoit is the Canadian policy associate at the Consumer Choice Center.
