By Dr. Lloyd Maybaum

What I am about to present is an idea that I have hesitantly sat upon for the past eight months. Colleagues have noted that the idea has merit, but suggested that I might need a flak jacket if I ever proposed it publicly. Well, the time has come.

We are all aware of the long wait-lists for procedures, investigations and treatment. Much has been debated about the pros and cons of publicly funded private health care and its ability to solve the wait-list dilemma. Perhaps no topic has been more controversial than the notion of queue jumping. Queue jumping or “jumping” is perhaps seen as the most unsavoury if not unwelcome aspect of private care.

Some may bristle with the notion of wealthy people jumping the queue, but we need a reality check. It would seem that the wealthy are essentially already jumping the queue by having their procedures performed in the United States or elsewhere.

Take the case of Newfoundland Premier Danny Williams, who in February chose to undergo heart surgery in Florida. The concern is that sometimes individuals pay huge dollars (i. e. profits) to out-of-province hospitals and organizations to jump the queue. My argument is to keep these profits in Alberta and use them to pay for our public health care services.

If jumping is already occurring in the context of the current health system, then could we somehow learn to embrace the notion of jumping and simultaneously allow all Albertans to benefit?

Perhaps we could let anybody in our current system jump to the front of the line for hip surgery, cataract surgery or whatever else might present with a wait-list. I say this with one major caveat — jumpers would have to pay perhaps five times the actual cost of the intervention. For example, if the total cost to the health-care system (i. e. the taxpayer) for one cataract surgery is $2,000, then jumping to the front of the line would cost that individual perhaps $10,000.

When a jumper pays five times the cost for cataract surgery, all derived profits would be retained within the cataract system to pay for four other people waiting in the queue.

This is a sort of Robin Hood approach except that the jumpers are voluntarily helping to pay for those marooned in the queue. Profits would help underwrite more equipment, nurses, technical staff and physicians.

More operating rooms could be opened, which would also cut faster into the wait-lists.

Performance incentives could be offered to physicians capable of ramping up their practices to meet the increased demand. Eventually, the more queue jumpers we have in this model, the faster the wait-lists would shrink and disappear.

This proposal would seem to benefit most everyone. The jumpers would likely be happy because they not only had their personal medical needs met, but they also voluntarily helped the system and others less fortunate. The taxpayer would benefit and I am certain that we would all be happy to see the end of wait-lists.

Thinking about the model, the only unhappy people might be those profit-minded individuals wishing to embrace the private provision of health care services. Profits from the queue jumpers in my model would benefit the public system and would not benefit private individuals or shareholders. In my model, the ultimate beneficiary from the jumpers is other less fortunate patients and the Alberta taxpayer.

An actuary would have to look at this model, but it seems that the more jumpers we have, the more supercharged the system would become and the faster wait-lists would be eliminated. The rate-limiting steps would be the speed with which procedures and investigations could be performed, staff availability and the number of people interested in paying to queue jump. In order to allow more people to become jumpers, limited tax credits or tax deductions could perhaps be offered. In addition, insurance companies could offer plans to cover jumping expenses. In the end, if the model fails then we are really no farther ahead or behind.

Eventually, as wait-lists subside, the amount paid to jump the queue would likely have to be reduced as wait-lists are eliminated and the system is balanced.

Once balanced, we could invite Canadians from other provinces to have their procedures performed in Alberta where there are no wait times. Such patients would have to pay perhaps two or three times the Alberta cost of the actual procedure so that ongoing profits could continue to supercharge our Alberta health-care system.

If this plan were successful, other provinces may catch on and initiate their own queue jumping program. If Alberta were to strike first, we would have a head start on reducing our wait-lists and therefore be in a position to undercut other provinces. In essence, provinces might compete with each other for jumpers.

This is a seemingly simple solution to the problem of wait-lists and funding in our current health-care system.

Some effort to find acceptance of a queue jumping model such as this may be required, but it seems possible that if we allow paid jumping to occur, everyone would eventually win. Think about it. Let’s try to keep those health-care dollars in Alberta and put them to work for Albertans. I’m prepared to take the flak for making this suggestion. Is anybody willing to consider it? Would the Premier or Health Minister be willing to risk trying something different?

Dr. Lloyd Maybaum is a Calgary psychiatrist and the incoming president of the Calgary and Area Physician’s Association.