FLEMING: Canadians staying home over waitlist fears

Harrison Fleming is the Legislative and Policy Director for SecondStreet.org, a Canadian Think TankMillions of Canadians are currently waiting for surgery, a diagnostic scan or an appointment with a specialist; the number is currently estimated to be about one in eight Canadians. While the personal story of the patient suffering behind these numbers is often heartbreaking — chronic pain, lost time with loved ones and even death — the good news is the public is ready for reform, and there are options that could help patients immediately.And just as well... it's no surprise that Canadian patients are facing the longest recorded wait times since the Fraser Institute began tracking that data 30 years ago. On average, Canadians are waiting for more than half a year before they can get the care they need. These waits have very real consequences for patients. A growing number of Canadians are turning away from the health care system altogether. According to new polling data released by SecondStreet.org, 47 per cent — nearly half — of Canadians are choosing to stay home rather than access Canadian health care services. While that number on its own should bring a pause to governments across Canada, it’s even more heartbreaking when we apply the data SecondStreet.org collects. If we know more than 60,000 patients died in Canada while waiting for care, what does that mean for patients who never sought treatment at all? It’s impossible to know, but it is damning that it's happening at all. It’s no wonder then, why nearly three in four Canadians support following the example of the European Union, and giving more choice to patients through a policy called the Cross Border Directive. In Europe, patients have the right to travel to another EU country, pay for surgery and then be reimbursed by their home government. Reimbursements cover up to the same amount their home government would have paid to provide care locally. This policy brings together the health resources of the continent, and opens new pathways for patients to get the care they need if local wait times happen to be long. This means that if patients can find a provider that can perform the treatment for the same or a lower cost, it would be entirely covered by their own government. If they went to a jurisdiction where it may cost more, they would not have to bear the full cost of that treatment out of pocket. Even better news for provincial policy makers: this policy would already comply with the Canada Health Act, and has been utilized by some governments on occasion, often for one-off procedures they cannot perform. Shockingly, an Ontario court ruled earlier this year that taxpayers were on the hook to send an individual to a private clinic in Texas to have an artificial vagina installed behind a functioning penis. Why they won’t do the same for patients waiting months for knee or hip replacements is quite frankly bizarre. In practice, the Cross Border Directive means lower wait times and better access to care, which is true of nearly every universal health care system across Europe. However, many Canadians would suggest they are uneasy about the idea of paying out of pocket for health services, but when faced with a lack of access to the care they need, they are already making that choice. Eleven per cent of Canadians are already choosing to pay out of pocket for private health services. Even more interesting is that number remained similar across all incomes — with 9 percent of the lowest earners still finding a way to put their own health first. If patients had access to rebates from their governments for those services, imagine how many more people could access care when Canada’s government-run system couldn’t provide it. At the very least, it might be worth exploring a pilot where a few procedures could qualify for such a program, like the hip and knee replacements which face a significant backlog across Canada. It’s certainly better than allowing even more Canadians to lose faith in our own health care system. Harrison Fleming is the Legislative and Policy Director for SecondStreet.org, a Canadian Think Tank.