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TORONTO SUN COLUMN: Canadians Are Dying While They Wait For Surgery

If you’re concerned about the state of health care in Canada, try asking your local provincial politician a simple question ­– how many patients died last year in your province while waiting for surgery?

Waiting List Second Street
Canadians are waiting too long to receive life-improving and life-saving treatment (photo: Robert Daly/Getty Images)

Many elected officials won’t be able to provide an answer as their government simply doesn’t track this important information.

The Vancouver Coastal Health region informed SecondStreet.org they don’t track the data, and information from Quebec was scarce at best. Many other health bodies don’t have the info or it was incomplete.

In Ontario, the government indicated that 1,096 patients died last year while waiting for surgery and 6,491 patients died while waiting for MRI and CT scans. The government wouldn’t break out their data to show the types of surgery patients were waiting for when they died or how their wait times compared with maximum recommended wait times. The province claims it’s confidential.

Oddly enough, the Nova Scotia Health Authority had no problem providing the data SecondStreet.org requested.

The Atlantic province shared extensive data and noted 51 patients died last year while waiting for surgeries which could have potentially saved their lives. In “just over three quarters” of those cases, patients waited longer than the recommended wait times.

Behind these numbers are, of course, real people with real consequences. Shannon Anderson, a mother of four from Ontario, developed a treatable heart problem last year. The government told her it would take at least a month before they could treat her condition. Sadly, she passed away after waiting several weeks for care, leaving behind four children.

We can’t forget that governments essentially have a monopoly on health care in Canada. Shannon didn’t have the option of going to a private clinic and paying for the procedure she required. The government doesn’t allow that choice. The same is generally true for private hip and knee operations and other procedures which can improve a patient’s quality of life.

With that in mind, it’s especially galling that governments aren’t more accountable for tracking and disclosing information on the suffering they cause patients.

Some think that Canada’s health care woes right now are due to the pandemic.

The pandemic is part of the problem. But data shows our system was struggling well before COVID-19 landed in Canada.

Ontario Health provided data to SecondStreet.org that shows in fiscal year 2015-16, there were 944 patients that died while waiting for CT scans. The annual total rose to 3,924 the year before the pandemic. Data for the most recent year, 2020-21, shows 4,624 patient deaths. If one looks at statistics for MRI scans, we find a similar pattern – a nearly 400% increase since 2015-16.

To be clear, many of these patients would have been waiting for treatment that would not have saved their life, but improved their quality of life – a hip operation, knee operation, etc. But isn’t that equally important to track? Would you want to spend your final years living with chronic pain in your apartment?

Recent polling by SecondStreet.org shows 79% of Canadians agree that governments should track and disclose data on patients dying and suffering while waiting for surgery and other procedures.

Try asking your local politician what they think. If they agree, what are they going to do about it?

Colin Craig is the President of SecondStreet.org, a new Canadian think tank. You can reach him at colin@secondstreet.org or follow him on Twitter (@colincraig1).

Article originally published by the Toronto Sun.

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Prevention – reduce demand in the first place

If Canadians lived healthier lives, we could reduce demand for emergency services, orthopaedic surgeries, primary care and more. 

For instance, if you visit the Canadian Cancer Society’s website, you’ll read that “about four in ten” cancer cases are preventable. The Heart and Stroke Foundation notes that “almost 80 percent of premature heart disease and stroke can be prevented through healthy behaviours.” A similar number of Diabetes cases are also preventable. 

Many joint replacements and visits to ERs and walk-in clinics could also be avoided through healthy living. 

To be sure, not all health problems can be avoided through healthy living – everyday the system treats Canadians with genetic conditions, helps those injured in unavoidable accidents and more.  

But there is an opportunity to reduce pressure on the health care system through Canadians shifting to healthier lifestyles – better diets, more exercise, etc. 

To learn more, watch our Health Reform Now documentary (scroll up) or see this column. 

Partner with non-profits and for-profit clinics

European countries will partner with anyone who can help patients. 

It doesn’t matter if it’s a non-profit, a government entity or a private clinic. What matters is that patients receive quality treatment, in a timely manner and for a competitive price.  

In Canada, governments often delivery services using government-run hospitals instead of seeing if non-profit or private clinics could deliver the services more effectively. 

When governments have partnered with non-profit and private clinics, the results have often been quite good – Saskatchewan, Ontario and British Columbia are just a few examples of where partnerships have worked well. 

Canada should pursue more of these partnerships to reduce wait times and increase the volume of services provided to patients.  

To learn more, watch our Health Reform Now documentary (scroll up) or see the links above. 

Make cross border care more accessible

In Canada, citizens pay high taxes each year and we’re promised universal health care services in return. The problem is, wait times are often extremely long in our health system – sometimes patients have to wait years to see a specialist or receive surgery. 

If patients don’t want to wait long periods, they often have to reach into their own pocket and pay for treatment outside the province or country. 

Throughout the European Union, we also find universal health care systems. But a key difference is that EU patients have the right to go to other EU countries, pay for surgery and then be reimbursed by their home government. Reimbursements cover up to what the patient’s home government would have spent to provide the treatment locally. 

If Canada copied this approach, a patient waiting a year to get their hip operation could instead receive treatment next week in one of thousands of surgical clinics throughout the developed world. 

Governments benefit too as the patient is now back on their feet and avoiding complications that sometimes come with long wait times – meaning the government doesn’t have to treat those complications on top of the initial health problem. 

To learn more, watch our Health Reform Now documentary (scroll up) or this shorter video. 

Legalize access to non-government providers

Canada is the only country in the world that puts up barriers, or outright bans patients from paying for health services locally. 

For instance, a patient in Toronto cannot pay for a hip operation at a private clinic in Toronto. Their only option is to wait for the government to eventually provide treatment or leave the province and pay elsewhere. 

Countries with better-performing universal health care systems do not have such bans. They allow patients a choice – use the public system or pay privately for treatment. Sweden, France, Australia and more – they all allow choice. 

Why? One reason is that allowing choice means some patients will decide to pay privately. This takes pressure off the public system. For instance, in Sweden, 87% of patients use the public system, but 13% purchase private health insurance. 

Ultimately, more choice improves access for patients. 

To learn more, watch our Health Reform Now documentary (scroll up) or watch this short clip on this topic. 

Shift to funding services for patients, not bureaucracies

In Canada, most hospitals receive a cheque from the government each year and are then asked to do their best to help patients. This approach is known as “block funding”. 

Under this model, a patient walking in the door represents a drain on the hospital’s budget. Over the course of a year, hospital administrators have to make sure the budget stretches out so services are rationed. This is why you might have to wait until next year or the year after for a hip operation, knee operation, etc. 

In better-performing universal health systems, they take the opposite approach – hospitals receive money from the government each time they help a patient. If a hospital completes a knee operation, it might receive, say, $10,000. If it completes a knee operation on another patient, it receives another $10,000. 

This model incentivizes hospitals to help more patients – to help more patients with knee operations, cataract surgery, etc. This approach also incentivizes hospitals to spend money on expenses that help patients (e.g. more doctors, nurses, equipment, etc.) rather than using the money on expenses that don’t help patients (e.g. more admin staff). 

To learn more about this policy option, please watch our Health Reform Now documentary (scroll up) or see this post by MEI.