When you’ve grappled with a problem for decades and you just can’t seem to figure it out, what should you do? Double down on an approach that hasn’t produced results? Or try something new?The Canadian health care system has been getting steadily worse for decades. While spending has increased well above inflation over the past 30 years, wait times have tripled. Spending way up, wait times way up... that isn’t a good news story.If Alberta and other provinces copied an innovative and proven policy from the European Union, we could however see some positive results for patients. The policy is called the Cross-Border Directive and it’s a simple, yet effective idea. In short, if someone living in one EU country is facing a long waitlist for, say, a hip replacement, they have the right to travel to another EU country, pay for the surgery, then be reimbursed for up to what it would have cost their home government to provide the procedure locally. Instead of a European patient only having health options locally, they literally have thousands of additional options to consider.As things stand right now, Albertans, with few exceptions, have two options when they need surgery: wait for the public system to eventually provide treatment or travel outside the province and pay for treatment. While the Alberta government has made some positive steps, too many patients are falling through the cracks. Travelling outside the province and paying for private surgery is something that generally only the wealthy and middle-income Canadians (who can borrow the funds) can access. On the other hand, the EU’s policy helps all patients, including those with lower incomes, with the cost of surgery abroad.For governments, the best aspect of this policy is they can help patients access treatment sooner without breaking their budget. After all, the Cross-Border Directive is basically cost-neutral in the medium term: instead of the government paying for someone’s surgery next year, the government would pay for it this year. One option for Premier Danielle Smith and Health Minister Adriana LaGrange to consider is a pilot program. Identify which procedures have the longest waitlists and use this approach for a period of six months to a year. For instance, the average wait time for a hip or knee replacement in Edmonton is more than 40 weeks just for a consultation, with another 33 weeks on top until the actual surgery, according to the Alberta Bone and Joint Health Institute. That’s well over a year-and-a-half, which is far from acceptable. The Alberta government could allow patients waiting for those procedures to travel to a short list of other jurisdictions with high-quality health care — for example, the US, European nations and other Canadian provinces that have private surgical options. After the pilot project is over, if patients find this option to be helpful, the program could be expanded to other services. Readers should note that Premier Danielle Smith once mused about the idea last summer on her radio show, noting that “If we are not treating people here within a medically reasonable period of time, then we have to be able to support them getting their care elsewhere.” In fact, she also campaigned on this idea back in 2012 when she was leader of the Wildrose Party.An October 2023 poll commissioned by SecondStreet.org found that 74% of Canadians like this idea, so it’s an example where the political side and the public are both on board. To be sure, the policy will not cure all that ails the health care system. But it could help countless patients who are languishing on waiting lists right now. Isn’t that the point of the system in the first place?Dom Lucyk is the Communications Director for SecondStreet.org, a Canadian think tank.
When you’ve grappled with a problem for decades and you just can’t seem to figure it out, what should you do? Double down on an approach that hasn’t produced results? Or try something new?The Canadian health care system has been getting steadily worse for decades. While spending has increased well above inflation over the past 30 years, wait times have tripled. Spending way up, wait times way up... that isn’t a good news story.If Alberta and other provinces copied an innovative and proven policy from the European Union, we could however see some positive results for patients. The policy is called the Cross-Border Directive and it’s a simple, yet effective idea. In short, if someone living in one EU country is facing a long waitlist for, say, a hip replacement, they have the right to travel to another EU country, pay for the surgery, then be reimbursed for up to what it would have cost their home government to provide the procedure locally. Instead of a European patient only having health options locally, they literally have thousands of additional options to consider.As things stand right now, Albertans, with few exceptions, have two options when they need surgery: wait for the public system to eventually provide treatment or travel outside the province and pay for treatment. While the Alberta government has made some positive steps, too many patients are falling through the cracks. Travelling outside the province and paying for private surgery is something that generally only the wealthy and middle-income Canadians (who can borrow the funds) can access. On the other hand, the EU’s policy helps all patients, including those with lower incomes, with the cost of surgery abroad.For governments, the best aspect of this policy is they can help patients access treatment sooner without breaking their budget. After all, the Cross-Border Directive is basically cost-neutral in the medium term: instead of the government paying for someone’s surgery next year, the government would pay for it this year. One option for Premier Danielle Smith and Health Minister Adriana LaGrange to consider is a pilot program. Identify which procedures have the longest waitlists and use this approach for a period of six months to a year. For instance, the average wait time for a hip or knee replacement in Edmonton is more than 40 weeks just for a consultation, with another 33 weeks on top until the actual surgery, according to the Alberta Bone and Joint Health Institute. That’s well over a year-and-a-half, which is far from acceptable. The Alberta government could allow patients waiting for those procedures to travel to a short list of other jurisdictions with high-quality health care — for example, the US, European nations and other Canadian provinces that have private surgical options. After the pilot project is over, if patients find this option to be helpful, the program could be expanded to other services. Readers should note that Premier Danielle Smith once mused about the idea last summer on her radio show, noting that “If we are not treating people here within a medically reasonable period of time, then we have to be able to support them getting their care elsewhere.” In fact, she also campaigned on this idea back in 2012 when she was leader of the Wildrose Party.An October 2023 poll commissioned by SecondStreet.org found that 74% of Canadians like this idea, so it’s an example where the political side and the public are both on board. To be sure, the policy will not cure all that ails the health care system. But it could help countless patients who are languishing on waiting lists right now. Isn’t that the point of the system in the first place?Dom Lucyk is the Communications Director for SecondStreet.org, a Canadian think tank.
