As surgical wait lists grow, Canada's private clinics cash in

It's a contentious reality in a country with a universal medicare system: Canadians can pay to sidestep the queue for surgeries with long waiting lists, such as hip and knee replacements.

Private clinics across Canada are advertising to prospective patients that within weeks they can get surgeries that typically take six months or more under provincial health plans. The price for a single hip or knee replacement runs in the range of $20,000 to $28,000, depending on the clinic. 

In the wake of the COVID-19 pandemic driving up surgical wait times, there's some evidence suggesting a growing number of Canadians are pulling out their wallets to pay privately. 

The trend is raising concerns about the potential for private clinics to drain more health professionals away from the already strained public system, and it's provoking fears that two-tier health care is becoming a reality.

The private Duval Clinic in Laval, Que. — where surgeons only do hip and knee replacements for fee-paying patients — has seen a significant increase in demand over the past few years, says its medical director, Dr. Pascal-André Vendittoli. 

"We've quadrupled the number of cases we do at the clinic," said Vendittoli in an interview with CBC News. 

"There are more and more patients willing to pay for their hip or knee replacement because they see that it is almost impossible to get their treatment in the public system."

Mike Johansen, 62, of Edmonton spent $23,500 for a hip replacement at the Duval Clinic. 

"Best investment I ever made," Johansen said in an interview. "I don't look at myself as a person who jumped to the front of the queue, I got out of the queue." 

Before the operation, Johansen's hip problem made just about any movement painful. 

"About 70, 80 per cent of the time I was laying in bed. That was the only way that there really wasn't a whole lot of pain," he said. 

His doctor told him his wait for surgery through Alberta Health Services would be 18 to 24 months. He got into the Duval clinic in just two months. 

Hip and knee replacements are among the most frequently performed surgeries in the Canadian health system, and come with some of the longest wait times. 

Hospitals did nearly 139,000 joint replacements in 2019-2020, according to the Canadian Institute for Health Information (CIHI). Its research puts the average cost per operation at $12,223, which means the private clinics are charging patients roughly double what the surgery costs provincial medicare systems.