Appeared in the Chronicle Herald, December 24, 2019
By Bacchus Barua and Alex Whalen
Nova Scotians are worried about health care—and rightly so, as the province’s wait times are among the longest in the country.
According to a new study from the Fraser Institute, patients in Nova Scotia in 2019 waited 33.3 weeks, from referral by a family doctor to treatment (broken down, this median wait time includes 16.2 weeks of waiting from referral to specialist and 17.1 weeks from specialist to treatment).
Long wait times for medically necessary treatments can increase suffering for patients, decrease quality of life, and in the worst cases, lead to disability or death. So it’s critical to put these data in context, both regionally and historically.
Nova Scotia’s 2019 median wait time (again, from referral to treatment) dwarfs the national median of 20.6 weeks—itself a staggering number, just shy of the record-setting 21.2 weeks Canadians faced in 2017.
Moreover, the Maritime provinces have the three highest wait times in the country, with Prince Edward Island (49.3 weeks) followed by New Brunswick (39.7 weeks) and Nova Scotia (33.3 weeks). There’s also a great deal of variation among medical specialties. Nova Scotians can routinely expect to wait more than one year for orthopedic surgery compared to the 39.1-week national average.
And things have gotten worse over time. In 1993, the first year the Fraser Institute calculated a national estimate of wait times, Nova Scotia’s median wait time was 11.5 weeks. At that time, the province was much closer to the national average of 9.3 weeks.
Given today’s long wait times, it’s not surprising that physicians routinely report that their patients wait longer than they consider clinically reasonable. What remains surprising, however, is that we continue to ignore policy options that could substantially improve our health-care system and the lives of the patients it serves.
In reality, long wait times are not the necessary price we must pay for our universal health-care system. Countries such as Switzerland, the Netherlands, Germany and Australia—which all deliver universal health care—have much shorter wait times than us.
The catch? Their policies stand in stark contrast to ours. All four countries embrace the private sector as either a partner or alternative to the public system. Switzerland and the Netherlands also expect patients to share the cost of treatment through deductibles and co-payments. And all four fund hospitals based on activity, to create sensible performance incentives for delivering treatment. This is a distinctly different approach than the “global budgeting” of hospitals in Canada.
In a health-care system with increasing pressures, due in part to our aging population in Nova Scotia and across Canada, it’s time to look at options to create positive change. Clearly, other countries—with shorter wait times—do universal health care very differently than Canada. Unless we learn from their experiences, patients will likely continue to suffer while they wait for treatment. What’s the argument against reform? Nova Scotians and all Canadians deserve much better.