Linda Slater waited two years to walk with her grandchildren to the playground down the street from her Calgary home.
She’s finally able to do it. She just had to pay $33,000.
“I can walk without pain,” she said.
In June, the 83-year-old emptied her retirement savings to have her left knee replaced at a private, for-profit surgical clinic in Toronto.
Slater made the decision to go private after spending two years on a waitlist to see an orthopedic surgeon in the public system.
“I felt I was in a place where I didn’t know what to do,” Slater told Dr. Brian Goldman, host of CBC’s White Coat, Black Art.
Some Canadians like Slater are resorting to withdrawing retirement savings and using GoFundMe campaigns to pay for joint-replacement surgeries in order to relieve the pain.
But not everyone can afford or wants to pay.
Canadians who spoke with White Coat, Black Art shared their reluctance to pay out-of-pocket for joint replacement surgeries they should be able to get done in a timely manner in the publicly-funded health-care system.
“We should be getting this. We’re not America, we’re Canada. We get health care when we need it,” said Linda Bestard, who nevertheless paid to have her hip replaced at a private surgical clinic in Quebec.
Faster surgeries
Depending on the province, patients can wait more than the recommended 26-week maximum that Canada’s provincial health ministers agreed to back in 2004.
Data from 2024 shows that about 39 per cent of Canadians waiting for a new knee, and about 32 per cent of those waiting for a new hip, weren’t treated in that timeline.
Physicians say issues like staff shortages, limited operating room time, and an increase in trauma cases are behind the long waits for many patients.
Dr. Bernard Ho, an emergency and family physician, and vice-chair of Canadian Doctors for Medicare, says health authorities should invest more dollars to improve the public system so patients don’t feel the need to pay out of pocket.
“No one should have to make that decision,” he said.
It’s hard to get an idea of how many Canadians are paying for joint replacement surgery, as there is no publicly-available data.
Dr. Rick Zarnett, an orthopedic surgeon and medical director of Surgical Solutions Network’s Dixon Road clinic — the same clinic where Slater had her surgery — said his clinic does about 400 joint replacement surgeries each year.
Zarnett, who works both at the clinic and performs surgeries in the public system at Toronto’s Humber River Hospital, says stories like Slater’s are common.
“These patients’ quality of life has been affected detrimentally, and they’re just at wit’s end, and they need something done,” he said.
Linda Bestard was hesitant to pay for hip replacement surgery.
Initially, Bestard was told by an orthopedic surgeon she didn’t need it. Instead, for two years she got cortisone shots, did physiotherapy and tried medications.
Bestard was put onto a waitlist for another orthopedic surgeon in 2023. By that point, the now 63-year-old was walking with two canes.
Unable to do favourite activities like hiking or kayaking near her home in Carleton, N.S., Bestard says she became depressed.
Inspired by a neighbour who used GoFundMe for a shoulder replacement, Bestard’s wife, Marla Stiles, started one of their own.
“She was bound and determined that I was going to get my life back,” said Bestard.
About 50 friends and family members chipped in $30,000 to cover private surgery at a Quebec clinic, plus travel expenses.
In March, she used that money to write a cheque for the surgeon for $5,700. She also paid for X-rays, an anesthesiologist and fees for the clinic.
“I have pets so I’m used to paying for my pets when they go to the vet. But that’s the only thing it reminds me of,” she said.
There are “a significant and growing number of private for-profit clinics” across the country delivering surgeries like joint replacement, according to a report published last year by the Canadian Medical Association.
Derek Bley, regional director for Ontario, Alberta and B.C. for Surgical Solutions Network, a chain of private clinics, says demand at their Toronto clinic has been stable for joint replacement surgeries over the last four years.
After patients are medically assessed, he says they typically receive surgery within two to six weeks. The clinic’s staff only do low risk surgeries.
He adds most of the patients travelling to Toronto for private joint replacement surgery are from the Prairies, with a small percentage from the Maritimes.
“These patients receive exceptional care. They get the one-on-one treatment they deserve,” said Bley.
In addition to private rooms, Bley says patients are given access to a 24-hour hotline and affiliated practitioners in their home province should they need follow-up care.
Federal legislation means patients like Slater and Bestard need to travel out of province to get surgery at these private clinics.
The Canada Health Act prohibits extra billing and user fees for services included under public insurance plans. That means physicians are banned from charging patients in their own province more than the medicare rate for a medically necessary procedure covered by provincial health plans.
Private clinics in most provinces get around that ban by operating on patients from other provinces.
But for those like Susan DesRoches, paying out of pocket for a hip replacement isn’t an option. DesRoches says she would need to remortgage her home in P.E.I., something the 68-year-old widow isn’t comfortable doing.
“I’m a senior on a very limited income. I have some savings, but certainly not enough to pay for it,” she said.
In hopes of lessening the wait times for patients, politicians in Alberta are turning to private surgical clinics — and footing the bill — to take on some joint replacement surgeries.
But some say that doesn’t always happen. Research from the Parkland Institute into Alberta’s contracts with private, for-profit centres said costs and wait times increased significantly.
Ho suggests provincial governments need to hire more staff, and then increase operating time into evenings and weekends.
Other physicians say it would be much faster to get a hip or knee replaced if there was a central waitlist.
Linda Slater’s left knee may be fixed, but now she believes her right knee needs to be replaced. She meets with an orthopedic surgeon this month.
But this time, if she does need surgery, it’ll have to be through the public system.
“I don’t have any more money left,” she said.
