By Bacchus Barua
and Mackenzie Moir
The Fraser Institute
As we continue our battle against COVID-19, another separate health-care crisis rages on. Wait times. Patients in Canada face the longest wait time for elective surgery on record – 22.6 weeks (between referral from a family doctor to receipt of medically necessary treatment).
Of course, the pandemic and the pre-emptive cancellations of procedures have influenced this historic median wait time. However, it’s also the result of decades of policy inertia and disregard for international data.
Despite the name, elective surgery does not usually refer to optional treatment, but rather scheduled or planned treatment (in contrast to emergencies). These include hip and knee surgeries and scheduled neurosurgery and cardiovascular procedures.
Bacchus Barua
To document the extent of delays for patients in need of these treatments, researchers – for almost three decades—consistently surveyed physicians across 12 specialties in Canada. This year’s national wait time (again, 22.6 weeks compared to 20.9 weeks last year) is not just the longest on record, but is more than twice as long as the 9.3 weeks Canadians waited in 1993 when the first national estimates were calculated.
Physicians in Nova Scotia (43.8 weeks), Alberta (29.4 weeks) and Ontario (17.4 weeks) each reported the longest wait times on record in their respective provinces. Meanwhile, patients across the country could expect to wait more than eight months for ophthalmology and otolaryngology (ENT) treatments. It should come as no surprise that physicians routinely report their patients wait longer than clinically reasonable.
It would be easy to blame these current wait times on COVID. And yes, patients are likely waiting longer this year than they would have otherwise. Unfortunately, decades of pre-COVID data tell the same story – wait times in Canada are not just long, but have gotten progressively longer. The survey’s lower response rate this year (11 per cent) invites caution when interpreting its results. But again, it would be a mistake to ignore the 1,258 physicians who did respond this year and clearly indicated their patients wait longer than clinically reasonable.
Mackenzie Moir
Other comprehensive international surveys have also documented Canada’s failure to tackle wait times. According to the Commonwealth Fund, 18 per cent of patients in Canada reported waiting four months or longer for elective surgery compared to Switzerland (six per cent) and Germany (0 per cent). And that’s in 2016, long before the pandemic began.
So what’s to be done?
While today’s priority is to combat COVID and support health-care workers, we should also use this opportunity to study other universal health-care models and plan for the future.
While just about every country around the world has been affected by COVID, many will return to a very different “normal” compared to Canada. Specifically, universal health-care countries such as Switzerland, the Netherlands, Germany and Australia will likely return to much shorter wait times than Canadians routinely face.
Our policymakers should understand how these countries have formed partnerships with the private sector to tackle wait times and better deliver universal health care. Let’s study how Switzerland and the Netherlands use cost-sharing for patients to incentivize more efficient use of medical resources (while simultaneously protecting their vulnerable populations). And let’s consider following their more modern approach to funding hospitals according to actual usage instead of the archaic “global budgeting” formula used in Canada.
Simply put, while COVID has limited our ability to deliver timely care, we have an opportunity to choose what kind of health-care system we return to in the future. Let’s find a way to return to a “better normal” in Canada – one where long wait times are no longer the norm.
Bacchus Barua and Mackenzie Moir are analysts at the Fraser Institute.
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