VANCOUVER – Picture paying $19,060 each year to fund public health care, then waiting almost eight months for treatment. That is the reality for a typical family of four in 2025, according to a new Fraser Institute report.
The think tank says Canadians are paying record sums through taxes and payroll deductions, yet access keeps slipping. Doctor shortages, long queues, and middling results raise a blunt question. Are families getting fair value, or are they paying top dollar for slow service?
Founded in 1974, the Fraser Institute studies public policy with a strong focus on costs and outcomes. It has offices in Vancouver, Calgary, Toronto, Montreal, and Halifax, and partners with research groups around the world. Its health-care series is widely read by decision-makers.
The findings often challenge a system many Canadians cherish, but now distrust. As Nadeem Esmail, the Institute’s Director of Health Policy, puts it, health care is a sacred cow in politics, yet families are paying more and waiting longer. That points to a model in need of change.
The 2025 study, The Price of Public Health Care Insurance, sets out the hidden bill for taxpayers. Canada does not charge a single health premium. Instead, costs sit across income taxes, sales taxes, corporate taxes, and employer contributions.
Cost of Health Care
That spread hides the true price for households. For a family of four earning $125,000, the projected cost hits $19,060 in 2025, up from $17,713 in 2024. Lower earners also pay. The bottom 10 percent, with an average income of $28,000, pay about $702. The top 10 percent, at roughly $350,000, face a bill of $58,853.
These are not loose estimates. The figures draw on budgets and fiscal data. Since 1997, health-care costs have risen 2.2 times faster than food, and 1.6 times faster than both housing and average incomes. Total health spending is expected to reach $372 billion in 2024, or $9,054 per person.
That places Canada near the top of the OECD for spending, behind countries like Germany and the Netherlands. With inflation and ageing, the share could rise further in 2025, with health care consuming 12.4 percent of GDP outside the pandemic years.
Yet the Institute argues that bigger budgets have not brought faster access or better results. Patients still pay twice, first in taxes, then in lost pay and productivity while they wait.
The companion report, Waiting Your Turn: Wait Times for Health Care in Canada, 2024 Report, shows the longest queues since tracking began. In 2024, the median time from a GP referral to treatment reached 30 weeks.
Doctor Supply
That is seven and a half months for necessary care across 12 specialties. It breaks the 27.7-week record set in 2023 and towers over the 9.3 weeks recorded in 1993. There are sharp gaps by province. British Columbia sits at 29.5 weeks on average. Nova Scotia faces 56.7 weeks, the longest in the country.
By specialty, the picture is stark. Orthopedic surgery, including hips and knees, averages 57.5 weeks. Pain can turn into disability during that wait. Neurosurgery sits at 46.2 weeks, where delays can change lives. Even scans lag. MRI waits average 16.2 weeks, CT scans 8.1 weeks, well beyond typical clinical advice.
The economic hit is heavy. A separate Fraser estimate puts lost wages at $5.2 billion in 2024, with a 15-week median wait after seeing a specialist. As Senior Policy Analyst Mackenzie Moir warns, these numbers reflect real harm, lost output, and preventable deaths.
Doctor supply is a core problem. The Institute links it to years of tight training budgets and strict licensing rules. Canada ranks 26th of 34 OECD countries for doctors per person, with 2.4 per 1,000 people, far below the OECD average of 3.7.
The family doctor shortfall is 22,823, leaving 6.5 million people without a GP. From 2021 to 2023, the number of family doctors grew by about 1 percent a year, which barely matched population growth. Up to one in five doctors could retire within five years.
Rural and Indigenous communities are hit hardest. In the territories, more than half the population lacks regular access. Quebec and British Columbia both report attachment rates below 80 percent.
Failing Grade
The Institute points to three main barriers. The public monopoly on delivery curbs innovation. Medical school enrolment caps from the 1990s still bite. Licensing makes it hard for internationally trained doctors to practise, so many work outside clinical roles.
As Bacchus Barua, former Director of the Centre for Health Policy Studies, notes, Canada turns away qualified talent while some graduates head to the United States. The country produces about 1,300 new family doctors a year, far short of demand.
Global comparisons are not flattering. The Fraser Institute’s Comparing Performance of Universal Health Care Countries, 2024, ranks Canada near the top for spending, but in the bottom third for speedy access across 31 peers.
A Commonwealth Fund survey found 58 percent of Canadians waited over two months for non-urgent surgery, the highest share among nine universal systems.
In Switzerland, only 15 percent reported waits that long. Patient satisfaction sits at 56 percent in Canada, compared to 94 percent in Switzerland and 83 percent in the Netherlands.
Switzerland spends about the same per person, yet has 64 percent more doctors and uses private providers broadly. About 84 percent of Swiss hospitals are private, both for-profit and not-for-profit. Esmail says that the approach offers universal cover with choice and faster care. He argues Canada could adopt elements of that model while keeping equity.
So, is the $19,060 family bill worth it? The Institute’s answer is no. High spending has brought middling results, average life expectancy, mixed clinical performance, and queues that resemble much poorer systems. Governments have poured in more funds.
British Columbia alone added $1.7 billion in its latest budget. Yet waits grow and access shrinks. Some critics say the Fraser lens overlooks equity issues. Even supporters of the current model now accept that reform is overdue. The Canadian Medical Association backs more training places, faster routes for foreign-trained doctors, and team-based care that makes smart use of nurses and pharmacists.
Flu season will soon push emergency rooms even harder. The Fraser Institute’s reports read like a clear warning. Canadians value universal care, but sentiment will not fix it. Without real changes, with more doctors, shorter waits, and smarter spending, the bill will rise while service falls. As Moir says, policy should put patients first, not ideology. Every extra week in a queue is a week too long.
