NCPA - National Center for Policy Analysis

Waiting for Free Care

November 12, 2003

In Canada's public-health system, which promises free, equal-access care to all citizens, medical resources are explicitly rationed, reports the Wall Street Journal, and patients sometimes face long waits to see doctors or get treatment.

  • There are fewer specialists for patients to see -- and once patients see a family doctor and get a referral for specialist care, they may have to wait weeks or even months to get an appointment.
  • In some parts of the country, patients waiting for admission to a hospital sometimes wait for hours and even days on gurneys in corridors and receive treatment there.
  • Waits for certain nonemergency surgeries in Canada can be up to two years.
  • In parts of the country, there are long lines for such things as magnetic resonance imaging or children's mental-health services.

Waiting is common in many national health-care plans. A study this year by the Organization for Economic Cooperation and Development found waiting times for elective surgery are a "significant health-policy concern" in about half of the group's 30 members, including the United Kingdom, Australia, Sweden, Canada, Italy, Denmark and Spain. Waiting times weren't a problem in the United States, the group said.

The reason for the long waits is rationing. In Canada, one way hospitals restrain costs is by trying to always run at capacity, but that means lines always form. And when there are surges in demand, such as outbreaks of infectious diseases, the system can be overwhelmed.

Some U.S. experts who have studied the Canadian system say that waiting lists are a sign that the health-care system isn't wasting money on unnecessary procedures, equipment or personnel. Health-care spending accounts for 10 percent of Canada's gross domestic product, while it consumes about 14 percent of U.S. GDP. The government health care system is not as comprehensive as some Americans might think: In Canada, 30 percent of health care is paid for privately.

Source: Elena Cherney, "Universal Care Has a Big Price: Patients Wait," Wall Street Journal, November 12, 2003.

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