Canadians are dishing out billions in hidden costs due to growing wait times to access medical care.
A study by the Fraser Institute, an independent, nonpartisan Canadian public policy think tank, found that long wait times for surgery and medical treatment cost the 1.2 million Canadians who were waiting for medically necessary treatment an average of $2,871 worth of time they could have spent working.
According to the study, “The Private Cost of Public Queues for Medically Necessary Care, 2024,” Canadians lost a combined total of almost $3.5 billion in wages and lower productivity while waiting to access essential healthcare.
In 2023 Canadians waited 13.1 weeks on average while trying to access medically necessary treatment.
The study calculated the cost of waiting by estimating the amount of time patients could not use productively while waiting.
“That is a substantial cost to be imposed on Canadians by a failing health care system,” economist Nadeem Esmail told True North in an interview. Waiting for medically necessary treatment is a hallmark of the Canadian health care experience, and it’s not a benign process.”
Esmail is a senior fellow in health policy at Fraser Institute. He told True North the $3.5 billion estimate does not consider other cost factors associated with medical wait times.
“This is an underestimate or at least a conservative estimate of the actual privately borne cost of lost wages, productivity, and quality of life for Canadians,” Esmail said. “Due to the reality of data, (the study) counts only the time from the specialists’ decision to treat to treatment.”
He said the study doesn’t count the 14.6-week wait to see the specialist, other delays during the care process, including MRIs or CT scans, or the impact on friends and family who may be in mental anguish or concerned for the patient.
“It doesn’t count the non-medical costs of waiting, including increased risk of mortality or risk of poor outcomes, including permanent disability,” he said. “Even an underestimate shows $3.5 billion in lost wages to lengthy wait times that have come to define the Canadian health care system.”
In another report from the Fraser Institute, Canada ranked last, or close to last, on all four indicators of timeliness of care, despite having one of the most expensive universal healthcare systems in the OECD.
“We ranked dead last in international comparisons of wait times for specialist and non-emergency surgical care,” Esmail said.
He thinks Canada should follow the lead of the Scandinavian, Australian, Swiss, and German approaches to the universal healthcare system.
“The solution to this problem is reforming the healthcare system along pathways that we know work. We have proven track records in (those) other developed nations that maintain universal approaches to healthcare,” he said.
He said those nations have the same core policies the Canadian system should adopt.
“They have private competition in the delivery of universally accessible services, not just clinics at the fringe, but actual private competition and delivery, and a significant role for the private sector in the delivery of universally accessible care,” Esmail said.
The health care system he advocates for would still deliver care based on need, regardless of a patient’s ability to pay. However, he said the difference is “how the money flows through the health care system.”
Rather than paying hospitals a lump sum budget as Canada does, those nations pay hospitals based on the needs of individual patients. They also have cost-sharing, where the price is split with the patient or user fees for universal healthcare system access.
“(Budgets) result in real consequences regarding reduced efficiency and viewing each patient as a cost to the hospital,” he said. “In these other nations, hospitals are funded on the basis of the number of patients treated or money following patients to the hospital based on their individual needs and conditions.”
He said changing how hospitals are paid through universal healthcare “meaningfully” incentivizes hospitals to deliver more care, more efficiently, and with higher quality.
Last year, while fighting private options for healthcare, the BC NDP government sent patients in need of life-saving cancer treatment to the U.S., due to a lack of resources.
“This common set of policies of high-performing universal access health care systems could be implemented in Canada to the benefit of Canadian patients to help solve this $3.5 billion problem,” he said. “And yet, Canadian governments are stuck in the model that we have today with a real reluctance to move away from it.”
