A Fraser Institute study reveals Canadian families pay up to $19,060 yearly for public health care, costs rising faster than income. Despite high spending, Canada ranks poorly in access and outcomes. Reforms like modest user fees and private sector roles could improve value without losing universal access.
A new study by the Fraser Institute reveals that Canadian families are paying substantially more for public health care than commonly perceived, with costs rising much faster than income or basic living expenses over the last three decades. The report, titled “The Price of Public Health Care Insurance, 2025,” estimates that Canadian families pay between $5,213 and $19,060 annually for public health-care insurance through their taxes, depending on family size. This financial burden is largely hidden because health care is provided at no direct charge at the point of use, creating a widespread misunderstanding about the true cost of the system.
Health-care costs have dramatically outpaced income growth in Canada. Between 1997 and 2025, the inflation-adjusted cost of public health-care insurance grew 1.6 times faster than average income and 2.2 times faster than food costs. For an average family of four, the report estimates annual costs above $19,000. This escalating expense is consuming a rising share of family budgets, although the public often remains unaware due to the system’s tax-based financing.
Despite Canada being one of the most expensive universal health-care systems globally, it performs poorly in international comparisons. Canada ranks fourth in health-care spending among developed countries but ranks near the bottom in several critical areas: 28th in doctors per capita, last in wait times, and low in availability of care beds and advanced medical equipment like CT scanners. Such inefficiencies raise questions about whether Canadians are receiving adequate value for their high investment in public health care.
The study suggests that policy reforms could enhance value without sacrificing universal access. Countries such as Switzerland, Germany, and Australia provide models where universal health care is delivered with better outcomes at similar or lower costs. These systems often incorporate modest user fees, encourage private sector participation, and employ more efficient hospital funding mechanisms.
The current Canadian policies contribute to inefficiencies and excess demand. The zero-dollar cost at the point of access encourages overuse of services, a phenomenon known as moral hazard. Esmail, the report’s co-author, explains that small user fees, common internationally, encourage more informed use of health services while protecting vulnerable populations. Restrictive hospital funding models and barriers to private sector innovation further worsen the system’s performance.
Esmail concludes that Canada’s health-care system is in crisis, burdened by high costs and poor outcomes. He highlights that, tragically, some deaths could be avoidable with better policy choices. Despite this, there appears to be resistance to adopting reforms that have proven successful elsewhere, leaving Canadians with a costly system that struggles to deliver timely, effective care .
