Canadian patients want other options outside crumbling health-care system

The vast majority of Canadians want the option to receive treatment elsewhere in a more timely fashion—and they want their provincial government to help pay for it. According to a recent poll, 74 per cent of respondents would support replicating the European Union’s Cross-Border Directive, which does just that. And who can blame them? With a crumbling health-care system, and the longest wait times on record, patients are clearly desperate for solutions.

But long-term solutions to Canada’s health-care crisis require a fundamental rethink of how we do health care. And that requires understanding the true nature of the problem.

In 2022, Canadians could expect a median wait time of 27.4 weeks for medical treatment. On average, after getting a referral from their family doctor, patients faced a 12.6 week wait to see a specialist, followed by a further 14.8-week wait for the treatment. Together, this wait time is the longest on record in three decades of measurement, and 195 per cent longer than in 1993 when the first national estimates were calculated. Moreover, the median wait between specialist and treatment (14.8 weeks) is 6.7 weeks longer than what physicians consider clinically reasonable.

To be clear, this record-high wait for treatment is only partially the result of the pandemic and resulting surgical backlogs. Prior to the pandemic, Canadians still faced a median wait time of 20.9 weeks in 2019.

This lack of timely access to care is not the result of underfunding. Among 30 high-income countries with universal health care in 2021 (the latest year of available data), Canada was the highest spender on health care as a share of the economy (12.6 per cent) and ninth-highest per person (after adjusting for population age). Unfortunately, this high spending didn’t translate into impressive performance.

For example, Canada ranked 28th out of 30 countries on the availability of doctors and 23rd out of 29 countries for hospital beds while having fewer diagnostic technologies such as MRIs and CT scanners than its international peers. Among countries with comparable data, Canada also had the longest waits for both specialist care and elective surgery (10th out of 10 countries).

What do other universal health-care countries do differently than Canada?

One notable difference is that countries such as Switzerland, Germany and Australia either partner with their private sector or use it as a pressure-valve to alleviate the burden on the public system.

Although some provinces such as Saskatchewan have explored limited partnerships where the private sector delivers publicly-funded surgeries, the backlash from opponents of reform is routine and intense. (See the response to Ontario’s recent efforts to reduce wait times through contracts with private surgical clinics.)

And the Trudeau government has repeatedly chastised provinces that might allow patients to use their own money to purchase health care from private providers in Canada, following a tradition of federal and provincial ministers routinely threatening to “crack down” on private clinics and doctors for accepting private payment for treatments.

Yet provincial governments themselves seem to have no issues with using taxpayer dollars to purchase certain types of care from private clinics south of the border. For example, the Eby government in British Columbia recently decided to pay clinics in Washington to provide 24,000 sessions of radiation treatment (plus travel and accommodation) for an estimated 4,800 British Columbians. Meanwhile, the same government spent years in court fighting Dr. Brian Day, former head of the Canadian Medical Association, who wanted to provide privately-funded care for B.C. patients failed by the public system.

While it’s important to explore options such as the Cross-Border Directive, which the majority of Canadians clearly support, Canadians must not lose sight of the fundamental issues that plague our health-care system. Ultimately, patients deserve to receive timely access to care close to their homes, their caregivers and loved ones. Allowing patients to receive care from local private clinics, and to have the option to pay for it themselves if they choose, should be considered before shipping them off to companies in Washington State.