We often hear about how much money we have to spend just to maintain the status quo in health care, and the billions of dollars in new funding coming from Ottawa to keep the same system going.
The irony, of course, is that maintaining the status quo will impose the heaviest costs on Canadians. Last year, Canadians waited an average of 13.1 weeks to receive treatment after seeing a specialist. Not only is this wait time more than double since 1993, but it also adds an estimated 1.2 million procedures to the wait across the country.
This delay, a month longer than what doctors consider a reasonable waiting period, is far from harmless – in fact, it could have devastating physical and psychological consequences.
While it may be tempting to blame the pandemic for our current predicament, in reality, long wait times were the norm long before COVID-19 hit: In fact, in 2019, the wait time between seeing a specialist and starting treatment was nearly two and a half weeks shorter than it is today, and the number of waiting procedures (1.1 million) was also slightly lower than it is today (1.2 million).
In addition to the physical and psychological costs of waiting, there are also serious economic costs. A new study finds that waiting time for non-urgent care will cost Canadians $3.5 billion in lost wages and productivity in 2023, or $2,871 for each person waiting for a procedure — more than double the cost in 2004 (adjusted for inflation). When taking into account patients' non-work leisure time, the 2023 estimate increases to $10.6 billion, or $8,730 for each person waiting.
While some advocates of the status quo argue that these costs are necessary to maintain universal health care, international evidence shows the opposite: indeed, Canada not only has the highest health care expenditures (as a percentage of the economy) of high-income countries with universal health care (after adjusting for differences in the age structure of the population), it also has the fewest health care resources and one of the worst access to timely care.
What would be different in a better universal health care system?
To varying degrees, they have embraced the private sector as a partner: Australia, for example, now has a higher performance than Canada in performing the majority of non-urgent surgeries and treatments in private hospitals, yet spends less (as a percentage of the economy) than Australia.
Nationally, we have seen what real reform involving the private sector can produce. In Saskatchewan, the government outsourced publicly funded surgeries to private clinics between 2010 and 2014, reducing wait times there from among the country’s highest (26.5 weeks in 2010) to among the lowest (14.2 weeks in 2014). Quebec, which has consistently “low” wait times, has outsourced one in six day surgery procedures to private clinics in recent years.
Despite the protests of those who defend today’s unworkable status quo, there are indeed ways to improve Canada’s health care system while preserving its universality. But unless we are willing to pursue that path, wait times and the associated costs will continue to burden Canadian patients and their families.
