In April, the Consumer Choice Center released its “Healthcare Time Saved Index 2025,” ranking Canada as the second most inefficient health-care system in terms of time wasted by patients. The organization followed up with an article in the Financial Post, arguing that privatization is the solution to Canada’s health-care challenges. While it’s true that our system is overwhelmed and needs reform, their argument was narrow, ideologically driven and ignored more balanced alternatives.
The centre’s report lacks the rigor necessary to support such sweeping policy recommendations. As a public health professional, I believe Canadians deserve a more thoughtful, nuanced conversation about health-care reform – one that acknowledges complexity instead of relying on market-based ideology as a cure-all.
The index compared 20 countries – 15 from Europe, along with the U.S., Canada, Australia and two from Asia – on several criteria: telemedicine access, hospital travel time, wait times for care/surgery, blister pack usage and contraceptive availability. The centre didn’t collect new data but instead aggregated various existing sources to generate a composite score. Countries were then ranked, with Denmark and the Netherlands tied for first place. The U.S. ranked fourth. Canada landed in 19th, ahead of only Ireland.
For each category, the author assigned a score. For example, if a medical appointment lost an average of 20 minutes due to inefficiency, a country received 15 points. If the duration lasted more than 40 minutes, it got zero. Non-time-based measures – like whether contraception is available – were simply scored as five or zero points. These scores were then totalled to determine rankings.
However, the methodology is deeply flawed.
First, data were drawn from studies with varying designs, inclusion criteria and confounding variables. While conducting a large-scale, multinational study is undoubtedly difficult, simply compiling conclusions from disparate sources without adjusting for methodological differences is irresponsible. It undermines the validity of any comparative analysis.
Second, the data were taken from studies conducted across vastly different time periods. For example, the hospital travel time data came from studies that drew data from 2008 (Switzerland), 2014 (Japan), 2016 (United Kingdom) and 2018 (U.S.). These temporal inconsistencies make meaningful cross-country comparisons impossible. Presenting outdated data as reflective of the 2025 health-care landscape is not only misleading, it borders on deceptive.
Third, the authors manipulated numbers in questionable ways. It cites a 13-minute average hospital travel time in the U.S., derived by averaging urban (10.4 min), suburban (11.9 min) and rural (17 min) times from Pew Research. However, Pew never presented this as a national average, nor did it recommend averaging these values without accounting for population distribution. This oversimplification distorts the data. In Canada, the report claims a 32-minute travel time for a 15.1 km distance, based on a figure from a 2020 Canada Health Infoway presentation. However, that travel time was neither calculated nor presented in the original source. At an urban speed limit of 50 km/h, the trip would realistically take around 18 minutes by car.
There are several other limitations that further undermine the report’s credibility. The point system, for instance, is entirely subjective. The scoring system can award two countries the same score whether they exceed a threshold by 10 or 100 minutes, making the scoring not only imprecise but misleading. The selection of the 20 countries analyzed is also unexplained; the authors vaguely refer to a “top 20” without defining the criteria used for inclusion. Some source links are outdated or broken, despite the report being released this year. Other questionable choices include using blister pack usage and contraceptive availability as measures of health-care efficiency and assigning zero points in cases where no data source could be found – effectively penalizing countries because authors could not find the data.
Despite these serious issues, the centre uses the report to justify privatization as a silver-bullet solution. This framing oversimplifies a complex issue. Yes, privatization may play a role in reform, but it is not the only – or even necessarily the best – approach. The piece failed to discuss critical alternatives: increasing funding for hospital infrastructure, expanding the workforce by investing in training and retention and improving the number of diagnostic equipment like MRI machines. Public health strategies aimed at disease prevention and chronic disease management also deserve more attention.
What’s missing from the analysis is any recognition of the trade-offs involved in privatization. It’s not enough to identify inefficiencies; we must also examine equity access, and long-term outcomes. Unfortunately, the centre’s report, and the opinion piece that followed, offered little more than cherry-picked data to support a predetermined conclusion.
It’s worth noting the Consumer Choice Center’s broader agenda. Though it presents itself as a nonpartisan voice for consumers, the organization has ties to right-wing lobbying groups that oppose regulations on fossil fuel emissions, pesticide use and tobacco – all issues with direct public health implications. Canadians should approach analyses from such organizations with caution and consider the underlying agendas that may shape how data is presented.
Ultimately, we need a serious, honest conversation about health-care reform – one rooted in evidence, transparency and a commitment to equity. Reports like the Healthcare Time Saved Index may generate headlines, but without methodological integrity, they do more harm than good. Canadians deserve better than biased reports and simplistic solutions.
