Health-ca­re wait ti­mes cost pa­tients mi­llions in ti­me, wa­ges

The con­sis­tent lengt­he­ning of wait ti­mes for treat­ment ma­kes us so­me­ti­mes for­get our sys­tem for­ces peo­ple to suf­fer whi­le wai­ting for ti­mely ac­cess to ca­re

La Jornada (Canada) - - ENGLISH SECTION -

For mo­re than two de­ca­des, the Fra­ser Ins­ti­tu­te has an­nually sur­ve­yed spe­cia­list phy­si­cians across Ca­na­da to es­ti­ma­te how long pa­tients wait for treat­ment. The la­test re­sults are dis­tres­sing.

Our sur­vey found that in 2016, ove­rall, pa­tients wai­ted 20 weeks from re­fe­rral from a fa­mily doc­tor to treat­ment - the lon­gest wait in our sur­vey’s his­tory and 115 per cent lon­ger than in 1993.

Whi­le the in­ter­ve­ning years ha­ve seen in­crea­sed mea­su­re­ment and ack­now­ledg­ment of wait ti­mes in Ca­na­da, they al­so pro­du­ced an un­healthy ac­cep­tan­ce of the pro­blem - as though wait ti­mes are the ne­ces­sary pri­ce for uni­ver­sal health ca­re. Li­ke the frog in the pot of cold wa­ter, slowly brought to a boil wit­hout the frog’s know­led­ge or im­me­dia­te dis­com­fort, the slow but fairly con­sis­tent lengt­he­ning of wait ti­mes for treat­ment has ma­de us so­me­ti­mes for­get that our sys­tem fails to de­li­ver ti­mely ac­cess to ca­re and peo­ple suf­fer as a re­sult.

This is not okay. Whi­le so­me pa­tients may be able to wait for treat­ment, ot­hers ex­pe­rien­ce con­si­de­ra­ble pain and dis­com­fort, fa­ce wor­se me­di­cal out­co­mes, or are una­ble to use their ti­me pro­duc­ti­vely. Our re­cent study spotlights the eco­no­mic cost of ti­me lost whi­le wai­ting for treat­ment. By com­bi­ning es­ti­ma­tes of the wait bet­ween spe­cia­list and treat­ment, the num­ber of pa­tients wai­ting, ave­ra­ge wa­ges, and the pro­por­tion of pa­tients re­por­ting that waits af­fec­ted their li­ves, the es­ti­ma­ted cost of wai­ting for ca­re was $1.7 bi­llion in 2016.

And this a con­ser­va­ti­ve es­ti­ma­te, ba­sed only on hours lost du­ring the ave­ra­ge work week. By ex­pan­ding the analy­sis to in­clu­de the value of ti­me lost du­ring eve­nings and wee­kends (but still ex­clu­ding eight hours of sleep at night), the es­ti­ma­ted cost of wai­ting in 2016 ri­ses to $5.2 bi­llion. And this still ex­clu­des the costs of ca­re pro­vi­ded by fa­mily mem­bers, in­crea­sed risk of mor­ta­lity and the wait to see a spe­cia­list in the first pla­ce. In fact, a 2008 study peg­ged the cost en­du­red by pa­tients wai­ting for just four me­di­cal pro­ce­du­res at $14.8 bi­llion.

The­se num­bers re­mind us that wait ti­mes are not be­nign in­con­ve­nien­ces. For­tu­na­tely, they’re not a ne­ces­sary pri­ce to pay for uni­ver­sal health ca­re. In fact, the Com­mon­wealth Fund’s most re­cent sur­vey clearly shows that ot­her uni­ver­sal health-ca­re sys­tems (such as the Net­her­lands, Swit­zer­land, Ger­many, Aus­tra­lia, and Fran­ce) ha­ve much shor­ter wait ti­mes for ca­re than Ca­na­da. They al­so do uni­ver­sal health ca­re dif­fe­rently.

For exam­ple, they tend to em­bra­ce the pri­va­te sec­tor as a part­ner wit­hin their uni­ver­sal health-ca­re sys­tems, or allow it to ope­ra­te as an al­ter­na­ti­ve (li­ke a pres­su­re val­ve). They al­so ge­ne­rally re­qui­re pa­tients to share in the cost of treat­ment (to var­ying ex­tents). This helps tem­per de­mand by re­min­ding in­di­vi­duals that health-ca­re re­sour­ces are scar­ce and must be used res­pon­sibly. Of cour­se, most coun­tries that re­qui­re such pay­ments al­so in­cor­po­ra­te va­rious po­li­cies to en­su­re that vul­ne­ra­ble po­pu­la­tions ne­ver fa­ce fi­nan­cial bur­den when see­king health ca­re.

Anot­her ma­jor dif­fe­ren­ce in­vol­ves the way hos­pi­tals are paid, with most ot­her suc­cess­ful uni­ver­sal health-ca­re sys­tems using so­me form of fun­ding that en­cou­ra­ges pro­duc­ti­vity. This is in con­trast to the pros­pec­ti­ve glo­bal bud­ge­ting sys­tem com­mon in Ca­na­da, which helps con­trol costs to an ex­tent but ac­tually dis-in­cen­ti­vi­zes hos­pi­tals to treat pa­tients, who are seen as costs.

Ul­ti­ma­tely, it’s up to Ca­na­dians and po­licy-ma­kers to de­ci­de which of the­se po­li­cies will work best he­re. Ho­we­ver, the clock is tic­king and thou­sands of pa­tients con­ti­nue to wait to re­cei­ve treat­ment. Many are in pain and many ha­ve me­di­cal con­di­tions that are wor­se­ning.

Many are lo­sing wa­ges and ti­me that could be used pro­duc­ti­vely - or, at the very least, in lei­su­re with their fa­mi­lies. We must not for­get the­se Ca­na­dians and how they suf­fer due to our stub­born ad­he­ren­ce to the sta­tus quo. -TROYMEDIA

Bac­chus Ba­rua is a se­nior eco­no­mist at the Fra­ser Ins­ti­tu­te.

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