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WAIT TIMES—THE OTHER HEALTH CARE CRISIS MACKENZIE MOIR AND BACCHUS BARUA
It has been more than a year since the first case of COVID-19 was confirmed in Canada. Since then, more than one million Canadians have tested positive for the virus, which has claimed the lives of more than 23,000. The pandemic, and the consequent lockdowns, have also ravaged our economy and forced the government to spend more per person than we did during the Second World War. Less discussed, however, are the effects of another perennial health care crisis that’s only gotten worse over the last year—long wait times for health care. In 2020, the average total wait time between referral from a GP and receiving care was measured at 22.6 weeks—the longest wait recorded in the 30-year history of the Fraser Institute’s annual survey and 143 per cent larger than the 9.3-week wait recorded in 1993. It may be tempting to blame our current predicament on COVID, and certainly several provinces across Canada have made difficult decision to postpone elective treatments in anticipation of surging COVID cases. However, while these cancellations may well have exacerbated wait times, they are not the cause. For example, in 2019 Canadian patients experienced a total 20.9 week wait for medically necessary care, well before the pandemic started. These wait times are not benign inconveniences. They can result in physical pain and suffering, poorer medical outcomes and in some cases cause permanent disability or even death. Reduced productivity and income are a consequence of these wait times,
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resulting in an economic cost for patients and the economy more generally. A recent study attempted to attach a dollar value to the time Canadians lost between seeing a specialist and receiving treatment (a 12.1-week wait). In 2020, the elective surgery queue cost 1.2 million Canadians a total of $2.8 billion (or $2,254 per person) in lost wages and productivity. This estimate only includes hours Canadians spend working during the average workweek. When we expand our analysis to include the value of time spent in a diminished capacity outside of work (but excluding eight hours for sleep), this figure increases to $8.4 billion (or $6,838 per person). Importantly, these cost estimates do not account for time it takes to see a specialist in the first place (10.5 weeks), which also carries its own risk for increased morbidity. These waits are not an unavoidable cost of universal care. For example, in 2016, the Commonwealth Fund found that a significant number of Canadians (18 per cent), the highest proportion recorded that year, reported waiting four months or longer for elective surgery. This figure was striking when compared with other universal countries such as Australia (8 per cent), Switzerland (6 per cent) and Germany (0 per cent). Of course, like Canada, many of these countries will likely experience increased wait times for treatment, given COVID-related delays in elective surgeries just about everywhere. However, a more recent version of this international survey, taken between March 2020 and July 2020, similarly found that Canadians were the least likely to report waiting under four months
