OPINION: Healthcare wait times cost Canadians billions of dollars

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Although the pandemic is now fully behind us, Canadian governments remain unable to provide timely access to medically necessary elective (including scheduled) surgical care. And a new study reveals the economic cost of that wait time to patients and the economy.

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Last year, Canadians could expect to wait an average of 14.8 weeks for treatment (egorthopaedic surgery) after seeing a specialist. This wait was 164% longer than the 5.6-week wait in 1993 and the longest in the more than 30-year history of the survey. As a result, patients were waiting for an estimated 1.2 million procedures in 2022.

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Regrettably, the system has had backlogs for decades, reaching 1.1 million procedures in 2019 before governments scaled back scheduled surgeries during the pandemic. While some provincial governments have successfully addressed their COVID-related backlogs, surgical backlogs remain a persistent feature of Canadian healthcare.

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The waiting time of 14.8 weeks between a specialist and treatment is also significantly longer than what the doctors surveyed consider clinically justifiable (8.1 weeks). Of course, unreasonably long waits for elective surgery have physical and emotional consequences. Without timely treatment, physical illnesses can progress and worsen the patient’s health condition up to disability and even death. Patients, their families, and caregivers may also feel anxiety and stress while waiting for treatment.

In addition, waiting for care in an impaired physical condition can affect patients’ ability to work and result in economic costs. Waiting times for elective care will cost an estimated $3.6 billion ($2,925 per patient wait) in lost wages and productivity in 2022, according to a new study published by the Fraser Institute. If we expand the analysis to include the time patients spend in a disabled state in their free time (still excluding eight hours of sleep per night), this estimate rises to $10.9 billion (or $8,897 per waiting patient).

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And crucially, none of these estimates take into account the average 12.6 weeks patients waited to see a specialist last year (after being referred by a GP) – the cost estimates only reflect the wait between specialist appointment and treatment.

While advocates of the status quo often claim that care rationing is an unfortunate but necessary price to pay for universal coverage, experience of universal schemes abroad shows the opposite.

In 2020, the Commonwealth Fund found that Canadians were the least likely (at 38%) to report waiting less than four weeks for a specialist appointment compared to nine other general health care systems. And only 62% of patients in Canada reported waiting less than four months for non-emergency surgery, a much lower percentage than in France (90%), Switzerland (94%) and Germany (99%).

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Why? They operate universal health care differently than Canada, and they enlist the private sector as a partner or let it act as a pressure valve to relieve the public system. They also expect patients to share in the cost of care (while protecting vulnerable populations) and that hospitals are generally funded by activity (unlike in Canada).

Unfortunately, not a single provincial government is seriously pursuing these reforms. So while politicians continue the failed approach of higher spending without meaningful reforms, the burden of these waits rests squarely on the shoulders of patients.

Mackenzie Moir and Bacchus Barua are analysts at the Fraser Institute