This story will sound all too familiar to the many Canadians suffering from what our health-care system labels “non-urgent” maladies. Last year, a family member was diagnosed with spinal ailments that have 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.
His GP did tests and suspected a spinal fusion is needed. After nine frustrating months trying to get an appointment, a spinal neurologist recently confirmed the need for surgery and my relative was placed on a waiting list. Then 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 be treated in 2014.” That would mean at least two years from initial physician referral to treatment. Meanwhile, his pain escalates as his condition worsens, along with his quality of life.
This hope-sapping tale reflects that of thousands of Canadians whose painful story is condensed to a number on a waiting list. Each tears at the heartstrings, made worse by the financial cost to the patient. A Fraser Institute study titled The Private Cost of Public Queues, published last June, estimates the costs of patients waiting for care in 2011 was $1.08-billion. The report 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 person unable to handle previous duties even after treatment. And the individual’s long-term absence from the work force, combined with uncertainty of recovery, forces employers to replace the worker, possibly ending the person’s career and leading to 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 spinal and back problems, are by far the leading cause of lost working days. They often affect skilled workers already in short supply – electricians, carpenters, welders, plumbers, boiler-makers, steel workers, power-line technicians, mechanics and machinists – and waiting lists make their time away from work doubly important. The Fraser study found the median waiting time for orthopedic treatment is more than twice as high as the average in other medical fields.
Last month, the Organization for Economic Development and Co-operation released a report entitled Waiting Time Policies in the Health Sector. The 13-country survey found that Canada has the longest elective surgery waiting times (an average of all elective surgeries), with 25 per cent of patients waiting more than four months compared with 8 per cent in New Zealand; 7 per cent in France, Switzerland, and the United States; and 5 per cent in the Netherlands and Germany.
Despite spending 36-per-cent more per capita on health care than the OECD average, the Canadian system yields the poorest results.
If you keep driving your car long after it develops mechanical problems, the damage will likely worsen. So it goes with the human body. That’s a personal tragedy for Canadians in need of medical treatment, but the prolonged loss of employees with much-needed skills creates a headwind for employers competing in the global productivity race.
Unlike Canada’s monopolistic health-care system – in which hospitals, diagnostic facilities and other health-care infrastructure are controlled and managed by government – all countries ranking ahead of Canada in independent health-care performance surveys deliver publicly funded services through a combination of public and private sources.
Canada is the only country with laws that take away a patient’s right to pay privately for health-care services. The result is the same as it would be for any service for which competition is forbidden: a sclerotic, inflexible system that stifles innovation, takes away freedom of choice, and costs taxpayers and employers dearly.