JUNO NEWS COLUMN: Waitlist deaths grow again but it doesn’t have to be this way

More Canadians are dying at the hands of a broken health care system. It’s hardly a unique problem to any given region, or even the province… but it’s been going on for far too long, and it needs to be fixed.

Early signs from one region in the west show the trend doesn’t seem to be shifting. New data obtained by SecondStreet.org shows that nearly 1,600 patients died on a waitlist in B.C.’s Interior Health region in 2024-25. That’s a six-year high, up from 767 in 2019-20. Shockingly, this data is not disclosed publicly by Interior Health (or any of BC’s five health regions).

SecondStreet.org files Freedom of Information (FOI) requests yearly with health regions and provincial governments to uncover this crucial data, which governments may or may not respond to.

Through this method, we’ve been able to uncover over 76,000 patient deaths on a waitlist across Canada since we started counting in 2019. Considering many health regions in Canada don’t track the problem, the true number is likely double.

This is clearly a catastrophic failure on the part of the health region. Crucially, patients are paying for this system that keeps failing them.

Critics may leap to the government’s defense with a cry: “So what if someone dies waiting for a knee replacement, or cataract surgery?” This isn’t uncommon. Interior Health defended the results by saying patients may have been waiting for elective surgeries. So what? Would you want to spend the final years of your life unable to walk or see because the government has left you on a waiting list? Quality of life matters, too.

In the midst of this tragedy, there is hope. It is possible to run a universal health care system where patients aren’t forced to wait months or years for life-changing or life-saving surgery and diagnostics.

In fact, it’s been done dozens of times and continues to work well in many other parts of the world with better universal health care systems.

Europe is always a great place to look. The Commonwealth Fund’s yearly report comparing health care systems across the world usually places Canada among the bottom of the pack in many areas, including having a regular family doctor (9th of 10), seeing a doctor the same or next day when patients needed care (10th of 10), and patients who reported waiting a week or less to see a specialist (7th of 10).

So why are these systems outperforming Canada?

One reason is that they don’t lock patients into the public system. For example, both Sweden and France have universal public systems that allow patients a choice to pay for private care if they so desire. This helps take pressure off of the public system, and helps everyone get care more quickly. In Canada, governments have a series of barriers that prevent patients from paying surgery and other services in their own province. No other developed country does this.

But not only do these countries allow alternatives, they also have a more collaborative way of looking at health care delivery. Simply put, countries like France will gladly partner with a non-profit or for-profit clinic if they can deliver quality care in a cost-effective manner to patients in the public system. In many cases, these partnerships are more efficient, such as St. Gorans – a Swedish hospital where they’re able to deliver care 30 per cent cheaper per procedure than government-run hospitals.

These are a couple examples of health reform ideas that could make the system more efficient in B.C. and the rest of Canada.

And yet, sadly, the B.C. government seems to be more focused on injecting more money into the system rather than implementing real health reform.

Well, the system has already received ‘more money.’ Spending across Canada has gone up past the rate of inflation for more than 30 years, and yet outcomes have only gotten worse.

It’s time that B.C. and the rest of the country take a long, hard look at what’s done in countries that have better universal health care systems. If something isn’t done, and quickly, the deaths will likely continue to pile up.

Dom Lucyk is the Communications Director with SecondStreet.org, a Canadian think tank.

This column was originally published on September 4, 2025.

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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.