Rationing By Waiting Under Canadian National Health Insurance
June 1, 1995
Half of all Canadian patients needing surgery spend at least a month waiting for an appointment with a specialist, and many spend two months or more. After they see a specialist, patients wait another month or more for the surgery to be performed.
Average (median) waiting times for surgery increased in 1994 in all Canadian provinces except Alberta, New Brunswick and Newfoundland. The number of people waiting increased only slightly from 183,528 in 1993 to 183,569 in 1994.
- In 81 percent of the cases, actual waiting times are greater than specialists say is reasonable for those surgeries.
- Data published by Statistics Canada indicate that 45 percent of all patients waiting for health care say they are in pain.
Time spent waiting for surgery may be affected by several factors, but 53.5 percent of specialists surveyed attributed the changes to the availability of hospital beds or operating room time.
All Canadians are covered by a mandatory government health program that provides no incentives to patients, doctors or hospitals to reduce costs. Requiring patients to queue up for service is a form of non-price rationing of medical services.
The average (median) time between diagnosis by a specialist and treatment varies widely by the type of surgery or procedure:
- longest waits are 21.3 weeks for orthopedic surgery and 29 weeks for elective cardiovascular surgery.
- The shortest wait is 2.5 weeks for cancer patients receiving chemotherapy.
Waiting times also vary widely by province. Generally, provinces spending the most per capita (adjusted for age differences in the population) have the shortest waiting times. Quebec and Newfoundland are exceptions, both with below-average costs and waiting times.
Source: Cynthia Ramsey and Michael Walker, "Waiting Your Turn: Hospital Waiting Lists in Canada (5th Edition)," Fraser Forum, Critical Issues Bulletin supplement, 1995, Fraser Institute, 626 Bute Street, Vancouver, BC V6E 3M1, (604) 688-0221.
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