Saturday, December 27, 2025

Canada’s median health-care wait time hits 28.6 weeks—second longest ever recorded

By Mackenzie Moir and Nadeem Esmail of The Fraser Institute.

Waiting Your Turn: Wait Times for Health Care in Canada, 2025 Report

  • In 2025, physicians across Canada reported a median wait time of 28.6 weeks between a referral from a GP and receipt of treatment; down from 30.0 weeks in 2024.
  • This is 208% longer than the 9.3 week wait Canadian patients could expect in 1993.
  • Wait times have decreased in Alberta, Saskatchewan, Ontario, New Brunswick and Prince Edward Island, while increasing in the other five provinces.
  • Ontario reported the shortest total wait (19.2 weeks), followed by British Columbia (32.2 weeks) and Quebec (32.5 weeks).
  • Patients waited longest in New Brunswick (60.9 weeks), Prince Edward Island (49.7 weeks) and Nova Scotia (49.0 weeks).
  • The national 28.6 week total wait comprises two segments: 1) Referral by a GP to consultation with a specialist: 15.3 weeks, an increase over the 15.0 weeks recorded in 2024. 2) Consultation with a specialist to receipt of treatment: 13.3 weeks, a decrease from the 15.0 weeks recorded in 2024.
  • Among the various specialties, patients waited the longest for Neurosurgery (49.9 weeks) and Orthopaedic Surgery (48.6 weeks)
  • By contrast, patients faced shorter waits for Radiation Oncology (4.2 weeks) and Medical Oncology (4.7 weeks).
  • After seeing a specialist, Canadian patients waited 4.5 weeks longer than what physicians consider to be clinically reasonable (8.8 weeks).
  • Patients also suffered considerable delays for diagnostic technology: 8.8 weeks for CT scans, 18.1 weeks for MRI scans, and 5.4 weeks for Ultrasound.
  • Across 10 provinces, the study estimated that patients in Canada were waiting for 1.4 million procedures in 2025.

 

Friday, December 26, 2025

Nothing Fails Like Prohibition

By David R Henderson. Excerpts:

"First, is killing people carrying the drugs, rather than arresting them, justified? Second, should those drugs be illegal or should we instead allow a free market in drugs with restrictions on purchases by minors?"

"My answer is that the drugs should be legal for adults. If my answer is correct, then I have also answered the first question. If drugs should be legal, then there is no justification for killing people who transport them."

"The main principle is freedom. Because we own our bodies, we should be free to ingest whatever we wish, even if it can be harmful. But the drug war doesn’t destroy just our freedom to consume what we want. Fighting the drug war has led the government to restrict many of our other freedoms.

The pragmatic reason for legalizing drugs is that criminalizing the industry has caused many harms. Our experience with prohibition of alcohol for thirteen years has a lot to teach us, if only we’re willing to learn. Prohibition worked in the narrow sense of reducing consumption of alcohol but caused horrible side effects. It shifted alcohol production and distribution away from law-abiding citizens to hardened criminals; it reduced respect for the law; and it caused many deaths. Drug prohibition does the same. If drugs were legalized, they would be sold by law-abiding people who have an incentive to care about quality. Organized crime would exit the industry. And the deaths from gang wars, which often include deaths of completely innocent people, would end. Would legalization be problem-free? No. But the problems would tend to be for those who use drugs, not for those who are innocent victims."

"before the Harrison Narcotic Tax Act of 1914, marijuana, cocaine, and heroin were all legal. Some of these drugs were widely used. Yet there was no drug epidemic with these drugs. Second, most people favor allowing activities that are much riskier than the consumption of drugs. Google “the fatality rate in climbing K2” and you’ll learn that historically, fatalities have been about 23 to 25 percent of successful climbs of that peak. Yet the vast majority of people seem to accept that climbers have a right to take this risk." 

SNAP Has an Eligibility Loophole. Congress Needs to Close It.

By Romina Boccia and Tyler Turman of Cato.

"The Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, served 41.7 million Americans and cost taxpayers $100 billion in fiscal year 2024.

Congress established firm income and asset limits to target households with the greatest financial need. Yet, states have found a way around these rules.

Through a policy called broad-based categorical eligibility (BBCE), states can bypass federal eligibility standards and draw down more federal dollars. The result: Millions of people are receiving SNAP benefits that Congress never intended.

Congress has so far failed to close this loophole, so United States Department of Agriculture (USDA) Secretary Brooke Rollins is considering taking action. But only legislation can fully restore SNAP’s eligibility standards. Representative Ben Cline’s (R‑VA) No Welfare for the Wealthy Act (H.R. 416) would require all households on SNAP to meet the program’s federal income and asset requirements.

How States Exploit Categorical Eligibility

Federal law provides two pathways to qualify for SNAP:

  • Statutory eligibility: gross income at or below 130 percent of the federal poverty level (FPL)—$2,292 for the average two-person household—net income (gross income minus deductions for certain expenses) at or below 100 percent of FPL, and countable assets under $3,000 ($4,500 for elderly or disabled households).
  • Categorical eligibility: automatic qualification for households receiving or authorized to receive benefits from other welfare programs, such as Temporary Assistance for Needy Families (TANF).

Congress made categorical eligibility a permanent feature of SNAP to reduce paperwork. But over time, the USDA stretched this authority to broaden SNAP far beyond Congress’s intent. The USDA currently recognizes three types of categorical eligibility:

  • Traditional categorical eligibility: Households receiving specifically cash benefits from programs such as TANF are SNAP-eligible. Federal law requires states to implement this form of categorical eligibility. Eligibility requirements for TANF cash assistance are more restrictive than SNAP in many states.
  • Narrow categorical eligibility: States can confer categorical eligibility through noncash TANF benefits, but these are primarily limited to services such as childcare or counseling.
  • Broad-based categorical eligibility: States can make most, if not all, low-income households categorically eligible for SNAP if they receive or are authorized to receive minimal noncash TANF benefits or services. The USDA’s 2000 regulation allowed states to raise gross income limits up to 200 percent of FPL when determining eligibility for noncash TANF benefits aimed at reducing out-of-wedlock pregnancies or promoting two-parent families. In 2009, the USDA added that even pamphlets and hotline referrals could qualify as noncash TANF benefits. Another memo clarified that states could, in addition to raising gross income limits, also increase or eliminate asset limits for these noncash benefits through BBCE. By 2011, even notices of eligibility could count as a benefit. States that use BBCE are not required to impose net income tests, but households would still be subject to the gross income limit.

As of 2025, 43 states and the District of Columbia have seized the opportunity to grow their SNAP rolls at federal taxpayers’ expense by adopting BBCE. The Foundation for Government Accountability recently estimated that 5.9 million people are on SNAP through BBCE despite not meeting federal eligibility criteria. This costs taxpayers almost $11 billion in annual benefits.

Setting the Rules Straight

Congress nearly took a step toward eliminating BBCE during debate on the One Big Beautiful Bill Act (OBBBA), but Representative Michael Cloud’s (R‑TX) amendment to close the loophole was excluded from the final legislation.

The USDA now appears ready to act through regulation. A preliminary notice indicates that the department would limit categorical eligibility to “ongoing and substantial” benefits from TANF-funded programs “designed to assist households and move them towards self-sufficiency.” This would eliminate states’ ability to use BBCE to trigger SNAP eligibility for those beyond SNAP’s gross income and asset limits with “token TANF” benefits.

This would be an improvement, but it is not enough. Any changes that the USDA makes through regulation can be undone through regulation. Case in point: Trump’s USDA proposed reining in BBCE in 2019, but Biden’s USDA withdrew it in 2021. The No Welfare for the Wealthy Act would align SNAP eligibility with federal law without loopholes and, more importantly, establish durable boundaries that can be reversed only by another act of Congress, unlike agency regulations that can flip-flop with every administration.

Aligning Authority with Accountability

States’ abuse of BBCE has allowed people with six-figure assets, millionaires, and lottery winners to receive SNAP benefits. It should be abolished.

Defenders of BBCE argue that it gives states the necessary flexibility to adjust income and asset limits to reflect their local economic conditions. But SNAP is a program funded almost entirely by the federal government. Asking Uncle Sam for more “flexibility” in spending taxpayers’ money is akin to a teenager asking Dad for the “flexibility” to use his credit card.

The states are free to experiment with eligibility rules for welfare programs as they please—if they’re willing to pay for them. Congress can further empower states by devolving welfare programs and having them take more fiscal responsibility for how they are run. This would align authority with accountability and give states the flexibility to tailor their programs to local needs but with the fiscal incentive to manage them judiciously. Additionally, devolution would eliminate the perverse incentive states have to maximize enrollment through loopholes such as BBCE because the federal government would no longer be footing the bill.

However, some states may be ill-equipped to pay for their share of more than 40 million people’s SNAP benefits. Additionally, starting in FY 2028, many states may be on the hook to pay for part of their SNAP benefits if they have payment error rates above 6 percent due to OBBBA’s matching fund requirements. Since SNAP participants eligible through BBCE have been tied to disproportionately high payment error rates compared to other households, eliminating this policy could help states lower their improper payments and meet OBBBA’s requirements. More importantly, SNAP’s devolution to the states should begin with rightsizing the program by removing those who do not meet its statutory eligibility requirements. Congress should establish firm eligibility standards for SNAP, as Representative Cline’s No Welfare for the Wealthy Act would do."

Tuesday, December 23, 2025

About That ACA ‘Innovation’

It’s time to nix the CMMI

Letter to The WSJ.

"In your editorial “The Republican Clock Is Ticking” (Dec. 4), you note that a second reconciliation bill is a crucial opportunity to improve our fiscal health.

A great place to start is a program few Americans have heard of: the Center for Medicare and Medicaid Innovation. Launched in 2010 as part of the Affordable Care Act, CMMI was intended to test different payment models that would reduce healthcare costs and improve quality. Instead of saving $2.8 billion between 2011 and 2020, as the Congressional Budget Office projected, it cost $5.4 billion. One analysis from 2021 found that only four of 172 Medicare-related CMMI models met the criteria for expansion and 15% decreased costs. All this despite the program receiving $10 billion a decade.

Fifteen years is a long enough test. Americans are fed up with the waste and lack of accountability that emanates from Washington. Republicans can score an easy win by nixing the CMMI for good.

Tom Schatz

Col. for Citizens Against Gov’t. Waste"

 

How Lina Khan Killed iRobot

She blocked Amazon’s takeover, and now the Chinese will own it

WSJ editorial. Exceerpts:

"We explained at the time how Ms. Warren and progressives in the Biden Administration thwarted Amazon’s attempt to buy iRobot in 2022. They claimed the $1.7 billion acquisition would unfairly augment Amazon’s lead in robotics and home devices. They also said the Roomba would enable Amazon to hoover up data and spy on Americans. 

Amazon is “‘almost universally recognized’ as the leader in warehouse and fulfillment robotics space,” Ms. Warren and other progressives wrote to Biden Federal Trade Commission Chair Lina Khan in September 2022. The deal “would open up a new market to Amazon’s abuses.” Heaven forefend Amazon would use robots to make chores less laborious, as it has for warehouse work."

"iRobot’s main competitors were Chinese companies, which were fast stealing market share. Beijing wants to dominate robotics."

"After the deal collapsed, iRobot said it would cut 31% of its workforce and send overseas “non-core engineering functions to lower-cost regions.” Even then, the Bedford, Mass.-based company continued to struggle against Chinese competitors. Amazon’s backing might have helped it innovate into new robotics fields that Chinese firms hadn’t penetrated." 

Can Congress Finally Reform NEPA?

A bipartisan bill would fix the main obstacle to faster U.S. projects.

WSJ editorial. Excerpts:

"Federal agencies take an average of 4.5 years to approve environmental impact statements"

"Environmental Quality, and an environmental review can add more than $4 million to project costs. Lawsuits challenging the reviews force companies to revise projects multiple times, tying up capital companies are ready to deploy."

"“The unrealized returns on projects in the permitting pipeline amount to $100 billion to $140 billion each year,” McKinsey found in a July study."

"Lawsuits filed under NEPA and a review process lifted the pipeline’s [the Atlantic Coast Pipeline] cost to $8 billion from $4.5 billion." 

Why Treat Weed Differently?

Public policy shouldn’t infantilize people simply because minors might misuse a product, writes Dr. Jeffrey Singer.

Letter to The WSJ.

"It’s no surprise that adolescents can have serious psychiatric reactions to high-dose THC or otherwise suffer from severe nausea and vomiting (“Potheads Head for the ER,” Review & Outlook, Dec. 10). Clinicians have been aware of these risks associated with cannabis use for years.

They’ve also long known that alcohol can trigger acute hallucinations and psychotic reactions. Anyone who’s been to a college party also knows how easily excessive drinking leads to uncontrollable vomiting. Studies consistently show that college-age drinkers face sharply higher risks of alcohol-related injuries, car crashes and sexual or physical assault than older users.

Yet no serious person suggests revisiting prohibition. We trust adults to weigh the risks and benefits of drinking, and we rely on age restrictions and enforcement, not broad bans, to keep alcohol out of minors’ hands.

Why should we treat cannabis differently? All drugs carry some risk, but the harms of adolescent use don’t justify laws that strip adults of their right to consumption. Public policy shouldn’t infantilize people simply because minors might misuse a product. We don’t ban alcohol, driving or ordinary household chemicals on that basis, and we shouldn’t apply a more paternalistic standard to cannabis.

Jeffrey A. Singer, M.D.

Cato Institute"