NCPA - National Center for Policy Analysis

Lining Up for Canadian Health Care

April 23, 2004

Proponents of the Canadian model health care system praise its universal coverage and its apparent low cost. Unfortunately, the system is much more costly than advertised because it is highly efficient in hiding costs, says economist Pierre Lemieux (Independent Institute).

The hidden costs include the poor quality of services, and the costs imposed on customers (aptly called "patients" in this case) who have to wait in queues. Long waiting lists for treatment are a fixture of the system. According to the Fraser Institute, a Vancouver think tank:

  • In 2003, the average waiting time from referral by a general practitioner to actual treatment was more than four months.
  • Waiting times vary among specialties (and, less wildly, among provinces), but remain high even for critical diseases: The shortest median wait is 6.1 weeks for oncology treatment; excluding radiation, which is longer.
  • Extreme cases include more than a year's median wait for neurosurgery in New Brunswick and the median wait for an MRI is three months; since 1993, waiting times have increased by 90 percent.

Waiting lines impose a real cost, which is approximated by what individuals would be willing to pay to avoid them. Waiting costs include health risk, lost time (especially for individuals whose time is most valuable), pain and anguish. Socialist systems are notoriously oblivious to anguish, discomfort, humiliation and other subjective factors which bureaucrats cannot measure or don't value the same way as the patient does, says Lemieux.

As noted by Harvard University professor Patricia Dantzon, another hidden cost of the Canadian system comes "from forcing everyone to have the same level and type of insurance," regardless of their individual preferences.

Source: Pierre Lemieux, "Canada's 'Free' Health Care Has Hidden Costs," Wall Street Journal, April 23, 2004 and Nadeem Esmail and Michael Walker, "Waiting Your Turn: Hospital Waiting Lists in Canada (13th Edition)," Fraser Institute, October 2003.

For WSJ text (subscription required),,SB108267290367391256,00.html


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