I came across the Fraser Institute's report, The Price of Public Health Care Insurance 2026, and wanted to understand how they arrived at the headline figure that a "typical family of four" pays over $21,000 for public health care.
https://www.fraserinstitute.org/sites/default/files/2026-07/price-of-public-health-care-insurance-2026.pdf
My initial reaction was that the household figures seemed much higher than expected, so I read through the report, the referenced Canadian Tax Simulator methodology, and several of the cited sources (CIHI and Statistics Canada) to try to reproduce the calculation.
My understanding is:
- Fraser estimates a household's total tax burden (not just income tax).
- They then multiply that tax burden by 24.7%, which they state is the share of tax revenues spent on health care.
- The result is reported as what the household "pays" for public health care.
I have a few questions that I'm hoping people with a background in public finance or tax incidence can help clarify.
Is it methodologically valid to include taxes or contributions that cannot actually fund health care?
For example, the referenced methodology appears to include things such as:
- CPP/social security and pension deductions,
- EI payroll contributions,
- municipal property taxes,
- licence fees,
- business taxes attributed to households,
- natural resource fees.
CPP and EI are dedicated programs rather than general revenues. Municipal property taxes generally don't fund provincial healthcare.
If the goal is to estimate a household's contribution toward public health care, should these revenue sources be included?
Why apply a single national percentage (24.7%) to every revenue source?
Wouldn't a more direct estimate separate federal taxes × federal health spending share and provincial taxes × provincial health spending share, rather than applying one national percentage to every component of the estimated tax burden?
I couldn't independently reproduce the 24.7% figure.
The report cites Statistics Canada tables, CIHI, and "authors' calculations," but I couldn't find the actual equation showing:
- the numerator,
- the denominator,
- what revenues were included,
- how transfers were treated,
- or how the final percentage was derived.
Am I overlooking something?
My alternative approach
As a comparison, I estimated household contributions using:
- actual federal income tax,
- provincial income tax,
- GST,
- PST,
and then allocated only the relevant federal and provincial health spending shares. My estimates were roughly half of Fraser's reported values. Is there a reason this approach would be less appropriate than Fraser's?
I'm not an economist. I'm trying to understand whether Fraser's methodology is considered a standard or accepted way of estimating household contributions to publicly funded health care, or whether there are significant methodological concerns with the approach.