Health
Canadians face longest waits for health care on record
From the Fraser Institute
By Bacchus Barua and Mackenzie Moir
Just when you thought Canadian health care had hit rock bottom, wait times in 2024 have hit an all-time high.
According to the latest version of our annual report published by the Fraser Institute, the median wait from referral by a family doctor to treatment (averaged across 10 provinces and 12 medical specialties including surgeries) is now 30 weeks—the longest wait in the report’s history and more than three times longer than the 9.3-week median wait in 1993.
Of course, wait times vary by province, and some provinces are worse than others. In New Brunswick and Prince Edward Island, the median wait is more than one year. And even in Ontario, which reported the shortest wait times in Canada this year, patients faced a 23.6-week wait, the longest in the province’s history.
In fact, compared to last year, wait times grew in every province (except Nova Scotia where patients still faced a median wait just shy of 40 weeks this year).
There’s also considerable variation in wait times depending on the type of care. For example, patients faced the longest waits for orthopedic surgeries (57.5 weeks) and neurosurgery (46.2 weeks) and shorter waits for chemotherapy (4.7 weeks), and radiological cancer treatments (4.5 weeks). In total, the study estimated that Canadian patients were waiting for more than 1.5 million procedures in 2024.
These waits for care are not benign inconveniences. Patients may experience physical pain, psychological distress and worsening physical condition while awaiting care. This year, the 15-week median wait for treatment after seeing a specialist was more than a month and a half longer than what physicians consider a reasonable wait (8.6 weeks). And this doesn’t even include the median 15-week wait to see a specialist in the first place.
Moreover, according to the Commonwealth Fund, a U.S.-based health-care research organization, among nine universal health-care systems worldwide, last year patients in Canada were the second-most likely to report waiting longer than one month for a specialist consultation, and the most likely to report waiting more than two months for surgery. In other words, although long wait times remain a staple of Canadian health care, they are not a necessary trade-off for having universal coverage.
And to be clear, wait times are only one manifestation of the strain on Canada’s health-care system. It’s now also normal to see emergency room closures, health-care worker burnout, and data suggesting millions of Canadians are without access to a regular health-care provider.
What’s the solution to Canada’s crippling health-care wait times?
There are many options for reform. But put simply, if policymakers in Canada want to reduce wait times for patients across the country, they should learn from better-performing universal health-care countries where patients receive more timely care. With wait times this year reaching an all-time high, relief can’t come soon enough.
Bacchus Barua
Director, Health Policy Studies, Fraser Institute
Mackenzie Moir
Senior Policy Analyst, Fraser Institute
From the Fraser Institute
By Nadeem Esmail and Tegan Hill
The Smith government may soon allow Albertans to privately purchase diagnostic screening and testing services, prompting familiar cries from defenders of the status quo. But in reality, this change, which the government plans to propose in the legislature in the coming months, would simply give Albertans an option already available to patients in every other developed country with universal health care.
It’s important for Albertans and indeed all Canadians to understand the unique nature of our health-care system. In every one of the 30 other developed countries with universal health care, patients are free to seek care on their own terms with their own resources when the universal system is unwilling or unable to satisfy their needs. Whether to access care with shorter wait times and a more rapid return to full health, to access more personalized services or meet a personal health need, or to access new advances in medical technology. But not in Canada.
That prohibition has not served Albertans well. Despite being one of the highest-spending provinces in one of the most expensive universal health-care systems in the developed world, Albertans endure some of the longest wait times for health care and some of the worst availability of advanced diagnostic and medical technologies including MRI machines and CT scanners.
Introducing new medical technologies is a costly endeavour, which requires money and the actual equipment, but also the proficiency, knowledge and expertise to use it properly. By allowing Albertans to privately purchase diagnostic screening and testing services, the Smith government would encourage private providers to make these technologies available and develop the requisite knowledge.
Obviously, these new providers would improve access to these services for all Alberta patients—first for those willing to pay for them, and then for patients in the public system. In other words, adding providers to the health-care system expands the supply of these services, which will reduce wait times for everyone, not just those using private clinics. And relief can’t come soon enough. In Alberta, in 2024 the median wait time for a CT scan was 12 weeks and 24 weeks for an MRI.
Greater access and shorter wait times will also benefit Albertans concerned about their future health or preventative care. When these Albertans can quickly access a private provider, their appointments may lead to the early discovery of medical problems. Early detection can improve health outcomes and reduce the amount of public health-care resources these Albertans may ultimately use in the future. And that means more resources available for all other patients, to the benefit of all Albertans including those unable to access the private option.
Opponents of this approach argue that it’s a move towards two-tier health care, which will drain resources from the public system, or that this is “American-style” health care. But these arguments ignore that private alternatives benefit all patients in universal health-care systems in the rest of the developed world. For example, Switzerland, Germany, the Netherlands and Australia all have higher-performing universal systems that provide more timely care because of—not despite—the private options available to patients.
In reality, the Smith government’s plan to allow Albertans to privately purchase diagnostic screening and testing services is a small step in the right direction to reduce wait times and improve health-care access in the province. In fact, the proposal doesn’t go far enough—the government should allow Albertans to purchase physician appointments and surgeries privately, too. Hopefully the Smith government continues to reform the province’s health-care system, despite ill-informed objections, with all patients in mind.
Nadeem Esmail
Tegan Hill
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