Time to tackle health-care wait times in Canada

With the pandemic now behind us, it’s time to turn our attention back to the other perennial pandemic that plagues Canadian health care—long wait times. A new report estimates these wait times cost Canadians almost $4.1 billion in lost wages and productivity last year. While some of this is undoubtedly related to COVID, a brief history of wait times suggests a problem more chronic in nature.

First, some background. Last year, the Fraser Institute’s annual survey of physicians measured a median wait of 14.5 weeks for medically necessary care (after consultation with a specialist), the longest wait time recorded in the 30-plus year history of the report, with an estimated 1.4 million Canadians waiting for treatment in 2021.

Of course, some of this backlog is due to “surgical ramp-downs” as provinces postpone elective treatment to ensure adequate resources for new COVID-19 cases. However, almost as many patients (an estimated 1.1 million) were waiting for medically necessary care in 2019, before the first documented case of COVID-19 in Canada. In other words, COVID has exacerbated, but is not the primary cause, of long waiting lists for treatment in Canada.

It’s important to understand that these waits are not simply benign inconveniences. Elective procedures include treatments ranging from cataract removals to life-saving cardiac care so protracted waits impose very real costs on Canadian patients such as pain, emotional distress, permanent disability and death.

But there’s also an economic cost in the form of lost wages and productivity while waiting for care. Again, according to the new data, last year wait times cost Canadians an estimated $4.1 billion in lost wages and productivity—or $2,848 per queued patient.

Moreover, if we include the time patients spend in a diminished state outside of work (while still allowing for eight hours of sleep), the total cost increases to $12.4 billion or $8,706 per patient. And remember, these figures, based on the wait time after consultation with a specialist, exclude the first wait (11.1 weeks) between seeing a family physician and a specialist.

Finally, while some argue that rationing is a necessary tradeoff for universal coverage, international experience suggests otherwise.

For example, in 2020 (the first full year of the pandemic), the Commonwealth Fund reported that only 62 per cent of Canadians waited less than four months for elective surgery, ranking last of the 10 other universal health-care systems compared (i.e. excluding the United States), compared to around 90 per cent in the Netherlands and Switzerland and 99 per cent in Germany. While COVID undoubtedly impacted these figures, data from 2016 (the last time this international survey was conducted) show that Canada ranked last on similar measures of timely access to care.

Canada’s inability to provide timely access to care precedes the COVID pandemic, which has only made a bad situation worse. Now that we’ve dealt with the most serious and immediate consequences of the COVID, it’s time to devote the same passion and seriousness to this other critical issue that impacts millions of Canadians every year.