Medical waits cost Canadian economy $14.8B

Recently, an elderly Ottawa man visited his optometrist to find out about having cataract surgery before renewing his driver's licence, which Ontarians must do when they turn 80.

But Dr. William Clarke couldn't guarantee an ophthalmologist would remove the cataracts before the man's scheduled driver's test.

"He thought it was absurd that I couldn't get him in to see the specialist within that time period," Clarke recounted.

Clarke sympathizes with his patient. It's frustrating having to tell people worried about their sight that they may face a long wait to have their cataracts removed.

"What's going to happen is that the patient is going to vent their frustration on us."

At least if the man couldn't drive for a short period, Ottawa has public transit, Clarke noted.

"What if you're in Northern Ontario and you don't even have access to that?"

The costs of waiting too long for cataract surgery aren't just borne by the patient, however. According to a study for the Canadian Medical Association, excessive waits for medical procedures cost the economy at least $14.8 billion in 2007.

The study, which focused on just four specialties, also concludes that the federal and provincial governments lost $4.4 billion in revenues last year because of prolonged wait times.

The "conservative" figures are based on loss of productivity for those awaiting hip and knee replacements, MRI scans, coronary bypass grafts, and cataract surgery. These areas were singled out for number-crunching because the provincial premiers agreed to make them priorities back in 2004.

"To put this in perspective, the economic value lost to excess wait times for these four procedures is equivalent to 40 per cent of Ontario's total health-care budget," said the study, carried out by the Centre for Spatial Economics. It does not estimate what the cost to the economy would be to reduce wait times to meet physicians' recommendations.

Lost productivity was calculated based on the inability of the patient to work or spend due to poor health while awaiting the medical procedure past the recommended wait time.

Also factored in was the cost of having a friend or family member give up some of their own work and leisure activities to help the person on the waiting list. Extra health costs were added, too, such as additional checkups and drugs that would not have been needed if the patient had not been kept waiting so long.

"As an orthopedic surgeon, I have seen patients develop chronic and severe irreversible damage, addiction to painkillers and depression" from waiting too long for surgery, said Dr. Brian Day, head of the Canadian Medical Association. "Auditor generals should insist that finance ministers write this debt into their annual budgets."

In a speech to The Economic Club of Toronto Tuesday, Day blamed governments for creating the excessive wait times, decrying their "monopoly on the funding and delivery of hospital and physician services.

"Forcing patients to endure pain and suffering in order to sustain a social program is wrong," Day said.

The study acknowledges wait-time improvements in some areas since provincial governments identified priorities for action. In many regions of Ontario, for instance, the wait for routine cataract surgery is well within acceptable limits, said Dr. Sherif El-Defrawy, head of ophthalmology at Hotel Dieu Hospital in Kingston, Ont. El-Defrawy performs 10 cataract operations a day. The hospital handles about 3,200 a year.

El-Defrawy said the mean wait time for the procedure at Hotel Dieu is currently two to three months.

For routine surgeries, "we know that a wait time of 60 days is very reasonable," he told Sun Media.

When he arrived at the hospital three-and-half years ago, waits were much longer, but resources and staffing have been expanded.

He added that while cataract wait times have been reduced, other areas of ophthalmology, such as glaucoma and corneal surgery "don't have that kind of success."Wait Times

Maximum recommended wait times for key medical procedures:

Total joint replacement surgery (knee and hip) - 182 days.

Cataract surgery - 112 days.

Coronary artery bypass graft - 42 days.

Current median wait times in Ontario:

Total joint replacement surgery - 81days.

Cataract surgery - 49 days.

Coronary artery bypass graft - 18 days.