Fraser Institute findings and methodology on wait times criticized by CDM

July 14, 2015

The Medical Post

A new study released by the Fraser Institute suggests that wait times in 2014 cost Canadians $1.2 billion in lost income and productivity, but the methods used by the research group to arrive at those figures has come under fire.

According to the study, the 937,345 patients—who spent an average of 9.8 weeks waiting for medical treatment—lost an average of $1,289 each.

The figure was calculated using a methodology developed by Fraser analysts Steven Globerman and Lorna Hoye in the early 90s.

The researchers multiplied the total number of weeks a patient spends waiting for care (provided by specialists during their annual survey) by the proportion of that time that’s rendered unproductive by the physical and emotional impact of their untreated medical condition.

The authors then factor in the average weekly wages of Canadians in each province to determine the total lost income.

“Whether it’s actually lost income from not working, lower productivity, or reduced engagement with friends and family, waiting is costing Canadians dearly,” said Bacchus Barua, a senior economist at the Fraser Institute and co-author of the study.

However, Dr. Ryan Meili, a family physician in Saskatchewan and Vice Chair of Canadian Doctors for Medicare, voiced some particularly severe criticisms of the study. He said it is “worse than noise—it’s noise with an agenda.”

“Their purpose is to say ‘the sky is falling, we must privatize.’One, their conclusion is wrong, they don’t know whether the sky is falling or not. (He took aim at their methodology to determine wait times, pointing to previous work by health policy consultant Steven Lewis). Two, their solution to that diagnosis is wrong. If we increase more private care we won’t shorten wait times, we’ll actually lengthen them.”

He argued that when you have a parallel system, you draw specialists and other doctors out of the public system, resulting a reduced capacity to handle complex cases. He went on to say that this is particularly problematic because the doctors charging for services have the option to “cherry pick” the easier cases.

Yet, Dr. Meili allowed for the fact that these sorts of studies could prompt more nuanced discussion about the problem of wait times.

“It’s still a worthwhile conversation to be having.”