Medicare not sustainable, & less universal than we think

“Medicare can be properly characterized as a mile deep and inch wide,” according to a new report published by the Macdonald-Laurier Institute [“Toward a more fair medicare: Why Canadian health care isn’t equitable or sustainable and how it can be” July 2016 Sean Speer & Ian Lee]

“Fiscal capacity” determined “hospitals and doctors” are essential services and excluded “drugs, dental and continuing care services.”

As a result: “… the present mix of public and private financing is inegalitarian to the extent that it publicly subsidizes the cost of hospital and physician services for all Canadians irrespective of income or wealth, and then offers minimal support for low-income Canadians to pay for services not covered by public insurance.”

Not Sustainable

  • “The Parliamentary Budget Office [2016] has recently reported that overall provincial is unsustainable mostly due to health care spending. The point is: rising health care costs are an inescapable reality for Canadian politicians, public servants, patients, and taxpayers.”
  • Furthermore, the budget office “estimates that health care spending will climb from 7.3 per cent in 2015 to 12.5 per cent of GDP by the end of the century.”
  • “Most industrialized countries are facing a similar challenge with respect to health care spending. And it is far from a new trend. The average growth rate of public health spending has exceeded GDP growth in all OECD countries for the past 20 years.”

The report references “Baumol’s cost-disease” whereby “the lack of competition in health care contributes to … inflationary pressures [that] exceed general inflation in the broader economy.”

It points out “universality and public financing are not synonymous — private financing can contribute to the public goal of universal and affordable access to health care.”


Canada’s government-run health care system – Medicare -- is a monopoly that prohibits private hospital and private physician care. Medicare is a subpar performer, ranking 10th among 11 advanced countries. Canadians deserve much better! Patients deserve timely access to quality care and choice of hospitals and physicians. Taxpayers deserve much more value for their tax dollars.

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