STAR PHOENIX COLUMN: Saskatchewan Fails to Track Suffering from Surgery Waitlists

The odds are you know someone who’s currently on a health-care wait-list.

Right now, there are more than 34,000 Saskatchewan residents waiting for surgery alone. Wait times have only been getting worse over the years: the Fraser Institute reports that the median wait time for surgery in Saskatchewan in 2022 was more than 30 weeks; up from 14 weeks in 2014.

That’s just the median wait; there are plenty of examples of people waiting well over a year for procedures like hip surgery.

But what isn’t talked about often enough is how much suffering is caused by these long wait times. Sure, waiting a year or two for hip surgery is painful and makes it hard to move around, but the long-term health consequences can be a lot worse than that.

For one, patients are often prescribed painkillers while waiting for the care they need. Consider Sharon Kilkenny from Emerald Park. She faced a 93-week long wait for hip surgery.

Her doctors started her on a painkiller, but she quit shortly after for fear of getting addicted and potentially dealing with liver damage down the line.

Mental health is another major concern. Think about the truly blood-curdling story of Jolene Van Alstine. As the Regina Leader-Post reported in late 2022, she’s been suffering on a waitlist for more than six years with a painful thyroid condition.

She copes with splitting abdominal pain and bone fractures, which have led her to develop depression. It’s got so bad that she’s actively considering assisted suicide.

With stories like this, one would think the government would be concerned with tracking or analyzing patient suffering during wait times and identifying problem areas.

You’d be wrong to assume that.

SecondStreet.org’s latest policy brief explores this issue in further detail. We filed freedom of information requests with every provincial government, asking them to provide any memos, analysis or reports on patient suffering while waiting long periods for surgery and other health services.

Not a single province provided any documents, including Saskatchewan. This province said those documents do not exist. How is it possible to address the problem if you’re not even talking about it?

One option would be for governments to survey patients from time to time to ask what they’re experiencing. If, for example, they’ve been suffering from depression, the government could, perhaps, offer counselling and other mental health services.

But that doesn’t address the fundamental problem of waitlists. The Moe government has made some positive steps on health reform. For instance, last summer, Premier Scott Moe committed to contracting out more taxpayer-funded surgeries to private providers, to help reduce the surgical backlog.

This is good, but more can be done.

One option that could help patients immediately would be to copy the European Union’s Cross-Border Directive, a policy SecondStreet.org has written about extensively in the past.

In short, it would allow patients to pay for surgery in another province or country, then be reimbursed by the Saskatchewan government — up to what the province would have paid for the procedure locally.

This would not only allow more patients to avoid long waiting lists, those who choose to remain in Saskatchewan for surgery would get to move up a spot in line each time someone ahead of them in line decides to try this new policy.

The Saskatchewan government has shown in the past that it’s willing to lead and try new initiatives in health care. Copying Europe’s Cross-Border Directive is an outside-the-box option that could help patients immediately without breaking the government’s budget.

One thing is clear, many patients are suffering. More action is needed to help them.

Dom Lucyk is the communications director with SecondStreet.org, a Canadian think tank.

This column was originally published in the Saskatoon Star Phoenix on April 14, 2023.

Share on Facebook
Share on Twitter

You can help us continue to research and tell stories about this issue by making a donation or sharing this content with your friends. Be sure to sign up for our updates too!

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.