Long medical wait times costing Canadians billions: Fraser Institute

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Long wait times for medical treatment cost 1.2 million Canadian patients an estimated $3.5 billion in out-of-pocket expenses last year, according to a new study by the Fraser Institute.

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The fiscally conservative think-tank said the estimate — averaging $2,871 per patient — is conservative because it only includes costs borne directly by patients waiting for treatment in terms of lost productivity during an average work week.

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“Valuing all hours of the week, including evenings and weekends but excluding eight hours of sleep per night, would increase the estimated cost of waiting to $10.6 billion or about $8,730 per person,” study authors Mackenzie Moir and Bacchus Barua said in their report, The Private Cost of Public Queues for Medically Necessary Care, 2024.

“The rationing of health care in Canada through queues for medically necessary health services imposes direct costs on those waiting for care.

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“The ability of individuals who are waiting to enjoy leisure time and earn an income to support their families is diminished by physical and psychological pain and suffering. In addition, friends and family may be asked to help those waiting for treatment or may suffer similar reductions in their productive lives because of their own psychological pain.”

The authors noted their estimates excluded such non-monetary costs as the increased risk of adverse medical events or death to patients while waiting for treatment, as well as the added financial, physical and mental burdens placed on loved ones helping to care for them while awaiting treatment.

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The report said the root problem is that Canadians continue to face some of the longest medical wait times for treatment in the developed world, a chronic feature of Canada’s health-care system.

Previous Fraser Institute studies estimated this delay at 27.7 weeks on average in 2023, from the time of a referral by a general practitioner to the start of treatment by a specialist, which includes an average 13.1-week delay for patients waiting to see the specialist after the GP recommends them for treatment.

The total medical waiting time of 27.7 weeks in 2023 was up from 27.4 weeks in 2022, although the average wait time from obtaining an appointment to see a specialist to the start of treatment was 1.7 weeks shorter than in 2022.

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The study surveyed wait times for 13 medical specialities including orthopaedic surgery, internal medicine, general surgery, neurosurgery, cardiovascular surgery, gynecology, ophthalmology, urology, otolaryngology and radiation and medical oncology.

From a historical perspective, the average out-of-pocket costs to patients across Canada awaiting treatment in 2023 of $2,871, which was 56% higher than the $1,840 average cost in 2004 in inflation-adjusted dollars, although it was 1.8% lower compared to 2022 when the average cost was $2,925.

The average out-of-pocket costs to patients in 2023 varied substantially from province to province.

It was highest in Prince Edward Island at $4,805 followed in descending order by New Brunswick ($4,800); Nova Scotia ($4,683); Saskatchewan ($4,033); Alberta ($3,470); British Columbia ($2,963); Quebec ($2,828); Manitoba ($2,277); Newfoundland and Labrador ($1,915); and Ontario ($1,660).

The study noted that the data in the report needs to be interpreted with caution because of the lingering impact of the COVID-19 pandemic on medical response rates, wait times and the number of procedures being performed in hospitals.

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