REGINA, Sask. — A new Fraser Institute study released Tuesday shows that despite being among the highest spenders, Canada has significantly fewer doctors, hospital beds and medical technologies than other high-income countries with universal health care.
According to the study titled Comparing Performance of Universal Health-Care Countries, 2026, Canada was the second-highest spender as a share of the economy, after adjusting for population age, out of 32 high-income countries with universal health care in 2024.
Despite that, Canada still ranked 30th out of 32 for the availability of doctors, 26th out of 31 for hospital beds and 28th out of 31 countries for the availability of MRI machines and CT scanners.
“We find that the Canadian health-care system ranks right at the top in terms of health-care expenditures and yet delivers some of the worst access to health care in the developed world,” said Nadeem Esmail, director of health policy studies at the Fraser Institute and co-author of the study.
Among the nine countries for which comparable wait-time measures are available, Canada ranked last for the percentage of patients reporting they were able to make a same-day or next-day appointment.
“Absolutely. We rank behind Germany, Switzerland and the Netherlands,” Esmail said. “These are leading nations that deliver very timely access to primary care, to specialist consultations and to elective surgery, where Canada, despite spending the same, or in fact much more than these other countries in many cases, is getting much worse waiting times. Yeah, so certainly there are troubling results coming out of this report here.”
In terms of countries that are doing well, Esmail pointed to Australia, Sweden, Switzerland, Germany and the Netherlands as standouts.
“All are doing a much better job than Canada at delivering high-quality, universally accessible services at reasonable costs for their taxpayers.”
The Netherlands, in particular, ranked well ahead of Canada in terms of being able to make an in-person, telephone or video appointment on the same or next day.
“It does, and of course these countries are not spending small amounts of money.
“I'm looking at the spending numbers. The new spending numbers for Australia have jumped up a little bit since last year or the year before. But they're getting far better access to services for a similar level of health-care spending … faster access to primary care, faster access to specialists, far more medical technologies, far more doctors, far more hospital beds. They're doing a far better job at turning health-care dollars into actual health care for their citizens in their universal health-care system.”
The report also points to Canada having fewer medical technologies, such as MRI machines and CT scanners, than the average OECD country with universal health care.
“We have about half as many medical technologies as the average OECD country in spite of the fact that we're one of the highest spenders,” said Esmail.
“We have 10.7 MRI machines for every million Canadians. The average country is 20.6. And if we look at the leaders, say Japan has 45 machines, four times as many as Canada. Germany, 36 machines. Australia, twice as many machines or about 80 per cent more machines than we have. And the same for CT scanners. We're at 15.
“The average country is just under 31. And again, Australia, similar spending, very similar demographics, similar geography in terms of population distribution. They have 80 CT scanners per million population to our 15 for a similar level of spending.
“It helps Canadians understand, I think, why we wait so long for a CT scan or an MRI scan and why it's so hard to get one for anything that isn't really important or critical.”
As for what policy leaders and people in government should take away from this report and what they are seeing here, Esmail had this to say:
“I think it's important for Canadians to understand there are other ways to provide universal access to health care out there that are delivering better access without the same health expenditures, for similar or lower spending. Better access to health-care services. And it's important for policymakers to look around the developed world and ask the question, how are these other countries doing that? How is Australia spending eight or 10 per cent less than we are and yet getting much shorter wait times and far better access to physicians and technologies? The same for Switzerland, for Germany, for the Netherlands, for Sweden.
“And it turns out when we look around the developed world, the policies of the top performers are all the same and they're all different from Canada. They all have private competition in the delivery of health-care services. They all have parallel private health-care sectors. They all have cost-sharing or user fees for services. A different policy approach in universal health-care systems that is delivering better universal access to health care.”
“When we spend more, we get less. And the reality is that's driven by the health policy choices that governments have made. We need to look abroad to understand how other countries just do a better job of delivering health care for the dollar.”
