Canada's surgical backlog could make US think twice about single-payer healthcare

Payer Issues

Americans dissatisfied with U.S. healthcare are looking abroad to understand how other systems could be replicated at home, but they need only look north of the border to see the challenges Canada is facing addressing its increasing backlog.

For decades, public dissatisfaction with the healthcare system has been significantly lower in the U.S. than other high-income countries. Expensive out-of-pocket costs and health equity are two of the major concerns among U.S. citizens, compounded by the record profits that many commercial insurers reported during the COVID-19 pandemic.

North of the border, 66 percent of Canadians are satisfied with the country's single-payer model — a universal healthcare system funded through taxes — but crave increased access to care, according to a December survey from market research company Ipsos Healthcare.

Though hospitals and health systems across the globe are playing catch-up with surgical backlogs stemming from delayed care during the pandemic, Canada's healthcare system — where each of the 13 provinces and territories are responsible for their own system — may not be as well-equipped as the U.S. to address those backlogs, which continue to grow.

In the Canadian province of Manitoba, for example, almost 168,000 people are waiting to have procedures, an increase of about 6,300 since February, according to CBC News. Doctors Manitoba, a nonprofit representing almost 4,000 members, reported that 54,820 of those procedures are surgical cases.

"Pre-pandemic volumes alone won't help to clear the massive backlog," said Kristjan Thompson, PhD, president of Doctors Manitoba. "New capacity must be added to help those Manitobans who are still left waiting in pain and uncertainty."

One strategy Manitoba is hoping will reduce the backlog is sending some patients to the U.S. to have surgery. Sanford Medical Center has identified up to 300 patients in Manitoba who are healthy enough to travel to Fargo, N.D., to have spine surgery. The hospital began a pilot program with five spine patients in March and is expected to make a decision on how to proceed shortly.

The Canadian Spine Society has criticized the program, arguing that it would redirect "badly needed money that could be applied to improving access within the province."

Meanwhile, in the U.S., hospitals and systems are implementing their own strategies to work though their backlogs.

Becker's Hospital Review learned that Indianapolis-based IU Health has 5,000 to 6,000 surgical cases in its backlog, Seattle-based UW Medicine is working to accommodate more than 18,000 procedures, and Salt Lake City-based University of Utah Hospital is addressing 500 backlogged cases.

One big knock against a single-payer, government-run healthcare system in the U.S. is that it would severely limit access and quality care that Americans are accustomed to, and at a time when they most need it.

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