The Fraser Institute

The Fraser Institute

October 08, 2013 06:22 ET

Canada's Long Wait Times for Health Care Leading to Patient Depression and Death; Fundamental Reform of the System Required

CALGARY, ALBERTA--(Marketwired - Oct. 8, 2013) - Long waits for surgeries and specialists - worse in Canada than elsewhere - is a problem that can be fixed without spending more money or eliminating universal coverage, according to a new book released today by the Fraser Institute, an independent, non-partisan Canadian public policy think-tank.

"If Canadians want to enjoy more timely access to health care services, we must adopt more market-oriented policy approaches for funding and providing health care. Failure to do so will continue to condemn those stricken with illness to long wait times for medically necessary care," said Nadeem Esmail, Fraser Institute director of health policy studies and author of two chapters in of Reducing Wait Times for Health Care: What Canada Can Learn From Theory and International Experience.

Wait times for health care in Canada have stalled at historically high levels, in spite of current government strategies aimed at improved timeliness. Canadians wait longer than citizens of many other OECD countries with universal access health care systems, from emergency room visits to physician consultations to elective surgeries, despite Canada's relatively large health expenditures.

"Waiting for health care has important medical, personal, and economic consequences," said Dr. Steven Globerman, director of the Center for International Business at Western Washington University and senior fellow at the Fraser Institute who edited the 168 page book.

Failing to fix wait times has affected the economic well-being of Canadians in a number of important ways. One estimate, from the Centre for Spatial Economics assessing just four procedures - total joint replacement surgery, cataract surgery, coronary artery bypass graft surgery, and MRI scans - found that excessive waits were costing Canadians $14.8 billion, plus another $4.4 billion ($19.2 billion, together) in lost government revenues from reduced economic activity.

Long waits for health care may also be affecting both short-run and long-run economic growth by impacting investments in education and training, parental involvement and support for school-aged children, and both absenteeism and presenteeism in the workforce. While a precise estimate of the economic and non-economic gains associated with any reduction in wait times is not feasible, the evidence suggests that the gains would be substantial.

Besides being expensive, waiting can be cruel. In Chapter 3, The Consequences of Waiting, Dr. Brian Day, an orthopaedic surgeon and former CMA president, argues that waiting can lead to a worsening of conditions; depression; discomfort and indignity; disruption in work; and even death. Among children, he found, the long-term effects of waiting for surgery can worsen health so severely, that the wait may impact young people's education and prospects.

"Waiting for health care is not a benign process or inconvenience for those who need treatment," writes Dr. Day. "Health conditions are often degenerative and can have sudden serious consequences if left untreated."

The book points out how policies that adopt or mimic market mechanisms, including competition and money following patients, can reduce wait times for everyone within a universal construct. At the same time, the authors highlight how manage and spend approaches like Canada's do not lead to more timely care.

"The costs associated with long waits can be reduced and avoided through sensible health care reform. The poor policy decisions of the past and the adherence to the notion that only government can provide health care has prevented Canada from moving forward on policy reform and making the types of beneficial changes seen in other OECD countries that provide universal access health care," Globerman said.

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The Fraser Institute is an independent Canadian public policy research and educational organization with offices in Vancouver, Calgary, Toronto, and Montreal and ties to a global network of 86 think-tanks. Its mission is to measure, study, and communicate the impact of competitive markets and government intervention on the welfare of individuals. To protect the Institute's independence, it does not accept grants from governments or contracts for research. Visit

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