The test results are in and the patient is sick. Unfortunately for Saskatchewan taxpayers, the patient is Saskatchewan’s medical system. In the words of Tony Dagnone, the man who headed the province’s Patient First Review, the system is good but not good enough.

Even from a distance, the view is grim. The health bill has grown by 7 per cent each year since 1996 and now consumes more than 40 per cent of the provincial budget. The per person cost is $5,393—more than the national average and only one more reminder that Medicare is not, and never was, free. “Despite this increasing investment,” Dagnone writes, “unacceptable gaps in the quality and safety of health care persist.”

Throw a rock in any direction and you’ll hit a problem. The quality of care varies too greatly depending on where a patient lives. People don’t get the care they need, and the resulting medical complications mean worse health and higher health costs. Too many patients receive care they don’t need that adds to costs and sometimes even worsens their health. And, at least one person dies prematurely in a Saskatchewan hospital every day because of unnecessary injuries caused in their “care.”

At least 27,000 people are waiting for surgery in the province right now. More than 4,000 of those have waited at least a year.

In the end, Dagnone says, it’s not about these numbers, it’s about people. He heard both positive and negative accounts from 4,000 patients. The negative ones are nothing short of harrowing.

One woman undergoing a pelvic exam watched in disbelief as her doctor took a personal call. Meanwhile she sat with her feet in stirrups in a compromising position as her doctor took chatted away.

Another patient couldn’t get surgery when she hoped because no beds were available. This reason alone caused an additional six month wait, during which she lost 70 pounds and was in constant pain. After all this, she twice had the experience of fasting all day before surgery, only to be told at day’s end that her surgery was cancelled because the bed was unavailable.

Dagnone heard many say they felt they didn’t matter. They weren’t warned about the recovery time for their surgery. Nor did they feel they had a voice.

Armed with Dagnone’s 16 recommendations, Premier Wall has set the goal of reducing surgical wait times to three months over the next four years.  Wall has also said publicly funded, but privately delivered services would also be an option. But this should be regarded as just the beginning.

According to the Fraser Institute, Austria, Belgium, France, Germany, Japan, Luxembourg, and Switzerland have universal health care but without any wait times at all. Each of these countries guarantees citizens access to medical treatment regardless of their ability to pay. Under the public insurance contract, patients may choose public or private facilities. Yet, they must pay for a portion of the expenses out of their own pockets.  This ensures a wiser use of resources and also lightens the burden for taxpayers. In addition, patients may purchase medical care privately apart from the public system altogether.   A health system reform that lacks patient co-payment and private sector options is no reform at all. Mere tinkering with efficiencies and co-operation in a public system has been tried to death—for some patients literally. The status quo fails miserably at Medicare’s original goal: timely, quality, affordable health care for all. And it will take political courage and substantial change to get us there.