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Waiting in pain for ‘free’ health care

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VICTORIA — This story will sound all too familiar to many Canadians suffering from what our health-care system labels "non-urgent" maladies.

In March of last year, a family member was diagnosed with spinal ailments that have continuously worsened to the point where his mobility is severely impaired and he is in constant pain. The agricultural job he has held for almost 30 years has become impossible.

After reviewing an X-ray, his GP suspected that he’d need a spinal fusion. After nine frustrating months trying to get an appointment, a spinal neurologist recently confirmed the need for surgery and he was placed on a wait list. Then just last week came devastating news from the scheduling nurse: "I don’t see any chance that you’ll get surgery in 2013 and I can’t guarantee you’ll get treated in 2014." That would mean at least two years from GP referral to treatment.

Meanwhile, his pain escalates as his condition continues to worsen, along with his quality of life.

This hope-sapping story is mirrored by thousands of other Canadians whose painful story is condensed to a number on a waiting list. Each story tears at the heartstrings, but what about the financial cost to the patients?

A Fraser Institute study entitled The Private Cost of Public Queues estimates earnings loss to patients waiting for care in 2011 was more than $1 billion. The author acknowledged this was a conservative estimate and that is most certainly true. One reason is that almost all health conditions deteriorate with time, sometimes rendering the patient unable to handle previous duties even after treatment. And then there’s the reality that their long-term absence combined with uncertainty of recovery forces employers to replace the worker, possibly ending their career and creating long term dependency on social support.

Those are the downsides for the patient, but what about the impact on Canadian business productivity? Orthopedic ailments, such as our family member’s back problem, are by far the leading cause of lost working days. And these orthopedic ailments often afflict workers already in short supply. Skilled trades including electricians, carpenters, welders, plumbers, boiler-makers, steel workers, power line technicians, mechanics and machinists are frequently impacted and waiting lists make their time away from work unnecessarily long. The Fraser study shows the median wait time for orthopedic treatment is more than twice as high as the average in other medical fields.

Earlier this month, The Organization for Economic Development and Co-operation released a report entitled Waiting Time Policies in the Health Sector. The 11 country survey found that Canada has the longest elective surgery waiting times with 25 per cent of patients waiting more than four months compared with eight per cent in New Zealand, seven per cent in France, Switzerland, and the United States, and just five per cent in the Netherlands and Germany. This data is the average of all elective surgeries and, as the Fraser study found, orthopedic wait times are more than twice the Canadian average.

Continuing to drive your car long after mechanical problems are evident is likely to worsen the damage. So it goes with the human body. No wonder that, despite spending 36 per cent more per capita on health care than the OECD average, our system yields the poorest results. That’s a personally tragedy for patients, but the lengthy loss of employees with needed skills creates a headwind for employers competing in the global productivity race.

It’s not just wait times where Canada’s health care system is underperforming. Canada also ranks poorly on multi-factorial studies. The 2010 edition of the Euro-Canada Health Consumer Index found that, despite the fourth-highest per-capita spending, Canadian health care ranks 25th when compared with 33 European countries.

What can be done? Here are two instructive facts. First: unlike Canada’s monopoly system wherein hospitals, diagnostic facilities and other infrastructure are controlled and managed by government bureaucracies, all countries ranking ahead of Canada in independent international health care performance surveys deliver publicly funded services through a competitive combination of public and private sources. Second: Canada is the only country with laws that take away a patient’s right to pay personally for health care services.

The result is the same as it would be for any service where competition was forbidden; a sclerotic, inflexible system that stifles innovation, takes away patient freedom of choice and costs taxpayers and employers dearly.


Gwyn Morgan is a Canadian business leader and director of two global corporations.


—Troy Media

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