Saskatchewan and MRIs: An example of patients first, ideology second

The Government of Saskatchewan recently passed legislation that will allow patients to pay for Magnetic Resonance Imaging (MRI) scans using their own money. This move has, of course, caused many of those who are ideologically opposed to any involvement of the private sector in health care—even if it’s to the advantage of all parties involved—to get up in arms. 

However, the motivation behind such a move and the potential benefits should be given due consideration.

Diagnostic imaging scans like MRI’s are incredibly important tools when it comes to triaging—the system whereby patients are prioritized for surgery according to the severity of their illness. Unfortunately, Canadians (across all provinces) face a median wait of 8.7 weeks just to find out whether or not they need urgent medical attention. The very fact that the Saskatchewan government has recognized this failure of the public system should be applauded.

More importantly, their specific reaction to this failure will benefit all patients waiting for treatment—not just those who can afford to pay for a private scan.

Here’s why.

First, one of the reasons for long wait times is simply that the available resources are insufficient to ensure timely health care. Wait times are a means of rationing care when demand for services exceeds supply. If permitted, private companies have an incentive to provide additional capacity to the health-care sector given the existence of waiting lists. The Saskatchewan government’s decision therefore means more machines available overall for the entire population. Moreover, the increased capacity is achievable at no extra cost to government (which already spends almost 40 per cent of its budget on health care).

Second, by allowing patients to leave the public queue, there will be less demand for publically-financed MRI machines, thereby shortening the public queue. There will, presumably, still be as many people waiting for surgery—but shorter wait times (in both the private and public systems) for diagnoses should improve the overall efficiency of the health-care system. For one thing, shorter wait times for MRIs may help identify problems that can be treated more efficiently (and cheaply) before they progress and require more complex (and more costly) treatment. As well, quicker diagnoses may also help shorten queues by identifying the lack of a serious medical problem, thereby allowing the system to identify and treat patients with more severe conditions.

Third, Saskatchewan has chosen to implement this policy under an interesting “two-for-one” approach. This requires that an additional patient from the public queue receives a free MRI scan at no charge for every privately purchased scan. Such policy should result in even fewer patients waiting for publically-funded MRI scans, although precisely how and how well the subsidy scheme will work in practice remains unclear. 

Those who are still concerned about the possibility of queue-jumping should consider two facts. The first is the reality that queue-jumping already occurs. Never mind the hidden world of political and family connections; workers compensation boards in certain provinces (including Saskatchewan and B.C.) and professional athletes already have access to private medical services. Second, those who can afford to do so simply leave the country (for scans, or complete treatment).

What Saskatchewan’s policy does is make private scans more readily available to those who aren’t professional athletes and can’t afford to leave the country, but are willing to pay the price to get an MRI because the public system has failed them. 

Further, it also subsidizes those patients who may not be able to afford private-sector scans, and acts as a pressure valve—alleviating the strain from the public system, which should be able to provide more timely care as a result of reduced demand on its scarce capacity.

All this said, the policy is not a panacea for the province’s (and Canada’s) wait time woes. However, in this instance, Saskatchewan is clearly putting patients before ideology, and should be applauded for doing so.