Nova Scotians pay dearly for health-care wait times

The COVID pandemic has placed health care at the forefront of the national conversation, as Canadians work collectively to reduce transmission rates while debating next steps. Health-care professionals have worked tirelessly during these trying times, but our health-care system still faces major challenges.

For example, due to COVID, some provincial governments have cancelled many elective surgeries, exacerbating the long-standing problem of health-care wait times. Pre-COVID, Atlantic provinces were already making difficult and unpopular decisions to manage the tide.

For nearly three decades, the Fraser Institute has surveyed physicians across Canada to document wait times for medically-necessary elective procedures. For example, the most recent report found that Nova Scotians endure some of the longest wait times in the country, with a total median wait time of 33.3 weeks between referral (from a GP) to treatment. This wait is a 190 per cent longer than the 11.5 week wait Nova Scotians faced in 1993, when the Fraser Institute first calculated nationwide estimates.

While some patients may be able to wait without relatively little disruption to their lives, others may experience increased suffering, decreased quality of life, worsening disability and even death. Consequences also include the economic cost privately borne by patients.

To estimate the cost, the study used data on median wait times, weekly wages, estimated number of patients waiting for elective procedures and the proportion of patients who reported difficulty in their lives while waiting for care. On this front, Nova Scotians are paying dearly. In fact, a new study by the Fraser Institute estimated a total economic cost of $134 million dollars in 2019 for Nova Scotia’s median 17.1 week wait to receive treatment after seeing a specialist.

Nova Scotia bears a much larger economic cost for wait times than the other three Atlantic provinces (almost double the total cost borne by patients in Newfoundland and Labrador) and more than $20 million more than the estimated cost in Saskatchewan, which has a larger population than Nova Scotia but a shorter wait (13.7 weeks) for treatment after seeing a specialist. Further, with 5.8 per cent of the province’s population waiting for treatment, Nova Scotia has the highest proportion people on waiting lists in Canada.

Across Canada, the study estimated that wait times cost Canadians up to $2.1 billion or $1,963 for each person waiting for treatment.

But perhaps surprisingly to some, this heavy price is not the inevitable cost of universal access. International data reveal that several other universal heal-care systems have shorter wait times compared to Canada. For example, significantly more Canadians (18 per cent) reported waiting four months or longer for elective surgery in 2016 compared to Switzerland (6 per cent), Germany (0 per cent) and Australia (8 per cent).

How do these countries ensure timelier access? Simply put, they do universal health care differently than we do.

To start, each country embraces the private sector as either a partner or alternative to the public insurance system while expecting patients to share the cost of care. With protections in place for the vulnerable, this cost-sharing is typically done via deductibles, premiums and co-payments, among other things.

The result? Universal access to care with shorter wait times for treatment—for about the same (and sometimes even lower) cost.

A large number of Nova Scotians are forced to wait long periods for medically-necessary treatment due to the inherent rationing of our health-care system. Health-care workers should be commended for helping us through this pandemic, and provincial health ministers have made difficult decisions. But we must also consider policy reform that can potentially benefit patients once we are through the COVID crisis. The current system produces long wait times that impose many costs, including a significant financial cost in the form of lost wages and productivity. It’s time to look to for better options in Nova Scotia, Atlantic Canada and across the country.