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Saskatchewan delivers better care for the buck

Author: Todd MacKay 2015/05/06

This OpEd was originally printed in the Regina Leader-Post and Saskatoon StarPhoenix on May 6, 2015

Healthcare is vitally important, but it is not a mystical rite shrouded in sacred policy. It is an important job to be done well. And the quest for excellence must follow the most effective path.

The Canadian Institute for Health Information (CIHI) recently released a wait-time report that indicates Saskatchewan is on that right path.

The CIHI tracks each province’s wait-times for five procedures. Saskatchewan ranked: second for hip replacements; second for knee replacements; sixth for hip fracture repairs; third for cataract surgery; and, for radiation therapy it was a virtual tie with all provinces meeting standard wait-times 90 per cent of the time or better.

Saskatchewan ranked second overall for wait times.

In another report, the CIHI also tracked healthcare spending in each province. Saskatchewan spends $4,461 per capita on healthcare, according to the CIHI. That’s about 4.6 per cent higher than the national average.

Newfoundland and Labrador is the only province that ranks better than Saskatchewan for wait-times, but Newfoundland is also the biggest spender with $5,087 spent on healthcare per capita. That’s 19 per cent higher than the national average.

Manitoba spends virtually the same as Saskatchewan ($31 less per capita) on healthcare, but its wait-time performance is poor. More than a quarter of Manitobans waiting for hip replacements wait more than six months. The same is true for knee surgeries. Virtually all hip fractures were treated within two days. But more than a third of Manitobans waiting for cataract surgery wait more than 112 days.

Saskatchewan is doing something right and the answer is not simply about money.

One key difference is Saskatchewan’s decision to allow private businesses to deliver routine surgeries. Saskatchewan contracts private for-profit clinics that specialize in specific procedures such as knee surgeries. Those businesses get good at those procedures and get them done quickly and efficiently.

Now, it’s critical to understand how those private clinics are paid. No Saskatchewanian pulls out a credit card to pay for that care (although they should be able to if they wanted). These private clinics are contracted by the province and paid by the province. The bill doesn’t go to the patient. So universal medicare is every bit as universal in Saskatchewan – it’s just faster and more efficient.

Saskatchewan started using private clinics to perform routine surgeries in 2010. The CIHI report card is clear evidence that this innovation is paying off. And the commitment to innovation must continue.

There’s skepticism about Saskatchewan’s Lean initiatives to drive efficiencies in healthcare. It seems strange to use Japanese terminology and count the number of footsteps health workers take on a ward, but the government says these efficiencies are already saving millions. Over the coming years, experience and third-party validation will provide more concrete assessments. There will be both successes and failures and there will be praise and criticism accordingly. What is absolutely certain is that innovation is indispensable and we have to explore every opportunity to improve the quality of care delivered by every tax dollar.

Sometimes the destination is more important than the journey. For someone in pain, the question of public versus private delivery of care is not particularly important. What is important is relief and wellness. The CIHI says Saskatchewan is a leader in reducing wait-times. A commitment to systematic innovation is a key factor. And that innovation must continue.


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