one million canadianVancouver: Long waits for surgery and medical treatment cost Canadians $1.9 billion in lost wages last year, finds a new study released by the Fraser Institute, an independent, non-partisan Canadian public policy think-tank.

And for the first time, the estimated number of Canadians who waited for medically necessary treatment exceeded one million in 2017.

“Canadians are waiting longer than ever for health care, and in addition to increased pain and suffering—and potentially worse medical outcomes—these long waits also cost Canadians time at work and with family and friends,” said Bacchus Barua, associate director of health policy studies at the Fraser Institute and co-author of The Private Cost of Public Queues for Medically Necessary Care, 2018.

The study finds that the estimated 1,040,791 patients who waited for medically necessary treatment last year each lost $1,822 (on average) due to work time lost.

When including the value of time outside the traditional work week—evenings and weekends (excluding eight hours of sleep per night)—the estimated cost of waiting jumps from $1.9 billion to $5.8 billion, or $5,559 per patient.

The study draws upon data from the Fraser Institute’s Waiting Your Turn study, an annual survey of Canadian physicians who, in 2017, reported a median wait time from specialist appointment to treatment of 10.9 weeks—three weeks longer than what physicians consider clinically reasonable.

Crucially, the $1.9 billion in lost wages is likely a conservative estimate because it doesn’t account for the additional 10.2-week wait to see a specialist after receiving a referral from a general practitioner. Taken together (10.9 weeks and 10.2 weeks), the median wait time in Canada for medical treatment was 21 weeks in 2017—the longest wait time ever recorded in the Fraser Institute survey’s history.

“As long as lengthy wait times define Canada’s health-care system, patients will continue to pay a price in lost wages and reduced quality of life,” Barua said.

Because wait times and incomes vary by province, so does the cost of waiting for health care. Residents of British Columbia in 2017 faced the highest per-patient cost of waiting ($2,362), followed by Alberta ($2,290) and Manitoba ($2,247).