Health
B.C. government sends patients to U.S. while fighting private options in B.C.
From the Fraser Institute
By Mackenzie Moir and Bacchus Barua
Among universal health-care countries, after adjusting for age, Canada ranked highest for health-care spending as a percentage of the economy in 2021 (the latest year of available comparable data). The problem is how we do universal health care
The recent ordeal of Allison Ducluzeau, a wife and mother from Victoria who spent more than $200,000 out of pocket to seek life-saving cancer treatment in the United States, has been widely shared on social media. Unfortunately, Ducluzeau’s story is not unique.
According to Second Street, a Canadian research organization, Canadians made approximately 217,500 trips abroad to seek health care in 2017, long before the pandemic (and related health-care backlogs and delays). To understand why this happens within our universal system, simply look at the data. In 2023, Canadians could expect a median wait of 27.7 weeks between referral to treatment across 12 medically-necessary specialities. In B.C., patients had to wait four weeks to see an oncologist, and another 5.9 weeks for treatment. In fact, the total wait between referral to treatment for oncology in B.C. (9.9 weeks) is now about twice as long as the Canadian average (4.8 weeks).
Moreover, the Canadian Institute for Health Information reported last year that, among provinces, B.C. was the second-worst performer in the country in meeting the national benchmark for radiation therapy (that is, receiving treatment within four weeks after seeing a specialist).
Why is this happening? Why do B.C. patients face such daunting wait times for potentially life-saving treatment?
For starters, compared to its universal health-care peers, Canada has fewer medical resources available. After adjusting for population age differences among high-income universal health-care countries, Canada ranked 28th (out of 30 countries) for the availability of doctors, 23rd (of 29) for hospital beds, 26th (of 30) for CT scanners and 19th (of 26) for PET scanner availability.
In response to B.C.’s long delays for cancer care, the Eby government recently instituted a cross-border initiative that sends patients to Washington State for treatment. Although this is good news for some patients, it’s not a long-term solution to our health-care woes. And this selective and short-term initiative is cold comfort to patients suffering from other medical conditions and who remain without local options as they endure long delays for medically-necessary care. Indeed, Allison Ducluzeau needed chemotherapy and could not take advantage of this initiative.
To be clear, Canada’s relative dearth of resources and long wait times are not due to inadequate funding. Among universal health-care countries, after adjusting for age, Canada ranked highest for health-care spending as a percentage of the economy in 2021 (the latest year of available comparable data). The problem is how we do universal health care. Unlike Canada, most other universal health-care countries fund their hospitals according to activity levels to incentivize treatment. And they understand that the private sector is a valuable partner in their universal health-care frameworks.
For defenders of the status quo, private involvement in the financing and delivery of health care within our borders remains out of the question. In fact, the same Eby government that sends B.C. patients across the border for care has fought against private options in B.C. And you can be sure that PeaceHealth St. Joseph Cancer Center and the North Cascade Cancer Center in Washington State—where the Eby government is sending cancer patients—will not be subject to the same limitations the Eby government imposes on private clinics in B.C.
If the provincial government is unable to deliver timely access to care through our publicly-funded health-care system, it should allow patients to pay privately for alternatives within our borders. By forcing patients such as Allison Ducluzeau to leave their loved ones and travel abroad to receive life-saving treatment, our policymakers yet again cling to a stubborn and failed approach to universal health care.
Authors:
From the Fraser Institute
Canadians continue to endure long wait times for health care. And while waiting for care can obviously be detrimental to your health and wellbeing, it can also hurt your pocketbook.
In 2024, the latest year of available data, the median wait—from referral by a family doctor to treatment by a specialist—was 30 weeks (including 15 weeks waiting for treatment after seeing a specialist). And last year, an estimated 1.5 million Canadians were waiting for care.
It’s no wonder Canadians are frustrated with the current state of health care.
Again, long waits for care adversely impact patients in many different ways including physical pain, psychological distress and worsened treatment outcomes as lengthy waits can make the treatment of some problems more difficult. There’s also a less-talked about consequence—the impact of health-care waits on the ability of patients to participate in day-to-day life, work and earn a living.
According to a recent study published by the Fraser Institute, wait times for non-emergency surgery cost Canadian patients $5.2 billion in lost wages in 2024. That’s about $3,300 for each of the 1.5 million patients waiting for care. Crucially, this estimate only considers time at work. After also accounting for free time outside of work, the cost increases to $15.9 billion or more than $10,200 per person.
Of course, some advocates of the health-care status quo argue that long waits for care remain a necessary trade-off to ensure all Canadians receive universal health-care coverage. But the experience of many high-income countries with universal health care shows the opposite.
Despite Canada ranking among the highest spenders (4th of 31 countries) on health care (as a percentage of its economy) among other developed countries with universal health care, we consistently rank among the bottom for the number of doctors, hospital beds, MRIs and CT scanners. Canada also has one of the worst records on access to timely health care.
So what do these other countries do differently than Canada? In short, they embrace the private sector as a partner in providing universal care.
Australia, for instance, spends less on health care (again, as a percentage of its economy) than Canada, yet the percentage of patients in Australia (33.1 per cent) who report waiting more than two months for non-emergency surgery was much higher in Canada (58.3 per cent). Unlike in Canada, Australian patients can choose to receive non-emergency surgery in either a private or public hospital. In 2021/22, 58.6 per cent of non-emergency surgeries in Australia were performed in private hospitals.
But we don’t need to look abroad for evidence that the private sector can help reduce wait times by delivering publicly-funded care. From 2010 to 2014, the Saskatchewan government, among other policies, contracted out publicly-funded surgeries to private clinics and lowered the province’s median wait time from one of the longest in the country (26.5 weeks in 2010) to one of the shortest (14.2 weeks in 2014). The initiative also reduced the average cost of procedures by 26 per cent.
Canadians are waiting longer than ever for health care, and the economic costs of these waits have never been higher. Until policymakers have the courage to enact genuine reform, based in part on more successful universal health-care systems, this status quo will continue to cost Canadian patients.
Mackenzie Moir
Senior Policy Analyst, Fraser Institute
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