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Inadequate Progress on Wait-Times Standards

Ever since the Supreme Court of Canada's ruling on the efficient delivery of public health care vs. the right to private insurance, I have felt the necessity for wait-time standards. Our governments have been talking about these standards for a long time, and Greg at the Sinister Thoughts blog has never let us forget that no progress was being made.

Finally, over the weekend, the provincial health ministers have agreed to set some wait-time targets by December 31. Also, today, the Province of Ontario has launched a website that provides wait time results for five major health services: cancer surgery, cardiac procedures, cataract surgery, hip and knee replacements, as well as MRI and CT exams.

All of this represents some sort of progress, but it seems awfully slow.

The Canadian Medical Association has been advocating for wait time benchmarks for a year and a half. In August their Wait Times Alliance released its final report (link PDF). You can find their standards, based on experts' judgments, on page 2 of that report.

So, it seems like it is not too hard to set standards based on medical needs. What's delaying the provinces? I think the provinces don't want to set standards that they can't meet and risk angering their public or losing federal money. They'd rather not set a benchmark that makes it clear that they are failing in some area. Consider this, from the Globe and Mail:

In some areas "we may have a very significant gap between where we're at and where we wish to be," said Ontario Health Minister George Smitherman. For instance, in the area of hip and knee replacement, an aging society and a shortage of medical professionals has made it difficult to keep up with the demand.

"Jurisdictions like Ontario might choose to have an access target, an initial one, that is a half or a third of the way toward the destination point," Mr. Smitherman said, "and once we've hit it we would seek to bring in a more aggressive access target."

But the Supreme Court ruling is telling us that if the public services don't meet reasonable wait times, the government is violating citizens' rights when they block them from having private insurance. So, the provinces need to set wait times that reflect medical needs -- not current capacity -- and then meet them as soon as possible. There's no excuse for moving this slow.

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