Canada spent second most out of 32 countries on health care with little to show for it': Fraser report

A new report from the Fraser Institute notes that, of the 32 high-income countries offering universal health care, Canada ranks among the highest for spending but falls consistently at the bottom when it comes to results.

The report , “Comparing Performance of Universal Health Care Countries,” by Mackenzie Moir and Nadeem Esmail, is the latest annual look at the topic by the Fraser Institute.

It examined countries that were members of the Organisation for Economic Co-operation and Development (OECD), offered universal or near-universal and had a gross national income per capita of more than US$13,935. Of the 38 OECD countries, four — Mexico, Costa Rica, Estonia and the United States — do not have universal health care and two others — Türkiye and Colombia — did not meet the income cutoff.

Of the remaining 32 countries, Canada ranked second highest for spending as a percentage of GDP in 2024, the most recent year of comparable data. Only Chile spent more.

However, across 13 indictors of the availability of medical resources and timely access to medical services, Canada was generally below average among OECD countries.

Notably, it ranked 30th out of 32 countries for the availability of doctors, 26th out of 31 for hospital beds dedicated to physical care, 28th out of 31 for the availability of MRI machines, and 28th out of 31 for CT scanners.

More specifically, Canada was found to have 2.8 doctors per thousand people. The average was 4.1, and the top countries in the category — Greece, Austria, Iceland and Norway — had more than five per thousand people.

Canada fared better on availability of nurses, with 10.5 per thousand people where the average was 10.1. However, this put our country in 14th place for this measurement, with top countries Switzerland, Iceland, Luxembourg and Ireland all recording more than 16 nurses per thousand people.

Canada’s MRI machine tally was 10.7 per million residents, barely more than half the OECD average of 20.6 per million. CT and PET scanners were similarly near or below half the average in other countries. Canada had a better ranking for a type of scanner known as a gamma camera, placing third with 14.3 per million people. It also had 17.2 mammographs per million people, putting it in 13th place, though still below the average of 23.4.

Meanwhile, among the nine countries for which comparable wait times measures are available, Canada ranked dead last for the percentage of patients reporting they were able to make a same- or next-day appointment when sick, at 22 per cent.

When it came to timely access, our country also placed eighth out of nine for patients who waited more than one month to see a specialist (65 per cent) and had the highest percentage of patients (58 per cent) who waited two months or more for non-emergency surgery.

“There’s a clear imbalance between the high cost of Canada’s health-care system and the actual care Canadians receive,” said Nadeem Esmail, director of health policy studies at the Fraser Institute and co-author of the report.

The report did not make specific recommendations, but noted: “To improve health care for Canadians, our policymakers should learn from other countries around the world that also provide universal health care, often at lower costs to taxpayers and with significantly better access and shorter wait times.”

The methodology used in the report is based on that used in previous reports published between 2016 and 2025, the Institute said. It looked at 13 indicators, representing two broad categories: availability of resources, and access to resources.

It also noted that the population age profiles in the 32 countries vary significantly, and that older populations require higher levels of health-care spending. “For this reason, this study presents indicators measuring health-care expenditures and the availability of resources adjusted according to the age-profile of the country,” it added.

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