Wait lists and innovation

It’s amazing how much can be explained by supply and demand. The big crisis in waiting lists in recent years has been concentrated in a few procedures, mostly knee and hip replacements and cataracts. These surgeries have been made much more widely available in recent years due to the advent of relatively non-invasive day surgeries in place of long hospital stays associated with major surgeries. This has led to a huge increase in demand, as many more people, whose previous option would have been suffering, can avail themselves of such surgeries.

On the supply side, there has been a lag but the number of surgeries has increased far in excess of what would be required given population growth and population aging. Here is a clip from the Globe about the latest CIHI report on the topic:

Canada has seen an 87 per cent increase in the number of hip and knee replacement surgeries being performed over the past decade, according to a new … Canadian Institute for Health Information report issued Wednesday. … “The number of hip and knee replacement surgeries is increasing at a faster rate than the population is aging,” said Margaret Keresteci, CIHI’s manager of Clinical Registries, in a statement Wednesday.

Governments are addressing the waiting list issue, but the underlying reason for the waiting list increases is rooted in new surgical techniques that have expanded the size of the market. This has created opportunities for private day surgery clinics to get into the game and make all sorts of bad noises about the public system. But the same efficiencies can be had in the public system. Alberta instituted day surgeries in public clinics and they were just as effective.