There isn’t a week that goes by without another story about a Canadian patient waiting far too long for basic medical care. For example, Manitoban Cheryl Grewar who’s reached the two-year mark in her wait for spinal surgery.

Unfortunately, the data suggest we should expect these sorts of stories by now.

A recent report found that patients in Manitoba waited a median of 15 weeks to see a specialist and then, after consultation, could expect to wait an additional 14.1 weeks for treatment. In total, across 12 specialities measured, Manitobans seeking non-emergency care could expect to wait of 29.1 weeks.

For Manitobans seeking surgeries on the spine, the wait can be quite a bit longer. For orthopedic surgeries, which include hip and knee replacements and other surgeries on the spine, the wait in Manitoba was 53.4 weeks. For neurosurgical treatments, which can include disc surgeries, patients could expect to wait 43.5 weeks between a GP referral and getting treatment.

And some patients, like Cheryl Grewar, face considerably longer waits.

To be clear, long waits are not unique to Manitoba. The same report found that Canadians could expect to wait 27.7 weeks between a GP referral to a specialist and getting treated—the longest wait for care since 1993 (the first year national estimates were published).

But these long waits are not inevitable in a universal system. In fact, patients in other countries with universal health care are more likely to report timely non-emergency care when compared to Canada. These countries include Germany (where 99 per cent reported timely care), Switzerland (94 per cent) and Australia (72 per cent) compared to 62 per cent of patients in Canada. All these countries also outperform Canada on timely specialist appointments as well.

These long waits are also not the result of inadequate spending. Canada in 2021 was the highest spender on health care, as a share of the economy, compared to its peers (after adjusting for differences in population age in the countries).

So what explained this difference in performance?

All these countries approach universal coverage differently than Canada.

One key difference is their attitude to the private sector. In Switzerland, patients are mandated to purchase insurance from private competing insurance firms, while the country’s most vulnerable receive subsidies so they’re able to obtain a plan that best fits their needs. In 2021, 45 per cent of all German hospitals were classified as for profit. And in Australia, 41 per cent of hospital services occurred in a private facility in 2021/22 (the latest year of data available).

Crucially, to incentivize the responsible use of resources, all these countries expect patients to share in the cost of treatment (with exemptions and support for vulnerable populations). They also fund their hospitals on the volume of services they actually provide, which incentivizes them to provide more care. This contrasts with Canada where hospitals mostly operate on a “global budget,” which means the amount of money a hospital receives is disconnected from the level of service it provides. The result is that new patients are treated as costs to be minimized.

If you’re a patient in Canada, no matter where you live, you’ve likely experienced a delay for care. Policymakers looking to shorten wait times should look abroad for solutions.