Don’t Blame Travel Insurers If a Canadian Hospital Won’t Accept You

Because Canada’s acute care hospital capacity is lower than that of almost every other industrialized nation, don’t expect that your travel insurer can always air ambulance you home after you’ve suffered a medical emergency while on vacation in the U.S. or some other foreign country. They’ll try their best, but it doesn’t always work.

Earlier this year, for example, a Toronto area resident who suffered a heart attack in St. Louis, Missouri, was forced to lie in a hospital bed in that city for 10 weeks because neither the health ministry nor hospital admissions personnel in the entire metro area could find a spare bed for him.  No matter how hard the insurer tried, the health ministry said it couldn’t help, that such placement was the insurer’s job, and hospital personnel said their emergency rooms were full, it was flu season.  Finally an opening appeared at North York General hospital, and the patient was repatriated by air, after his family spent thousands of dollars travelling back and forth to St. Louis to be with their husband and father, and the insurer got stuck with a huge hospital bill.

Travel insurance is designed and priced to cover unforeseen medical emergencies, not recuperative care.  That’s why insurers always prefer to handle the emergency, stabilize the patient, and if they still need care, get them to a hospital in their home community, even if they have to use an expensive air ambulance to do it.

But repatriation is often easier said than done because Canada has one of the lowest acute care hospital bed capacities in the industrialized world, and many of its hospital emergency rooms operate in crisis mode much of the year.

For example, among the 34 countries in the Organization for Economic Cooperation and Development (OECD) the average acceptable emergency room occupancy rate is 75 percent. In Canada, the average is over 90 percent, and often exceeds 100 percent. At that rate, patients must be left in hallways, treatment times become much longer, and hospital inpatient beds gets backed up and incoming patients often must be deflected to other hospitals.  Sound familiar?

Here’s another statistic: of 34 countries in the OECD, Canada is second last in terms of acute care hospital bed capacity at 1.8 beds per 1000 population; that’s just a shade better than Mexico at 1.6. All other countries have higher acute care hospital bed ratios. By comparison, Germany’s acute care bed per 1000 population ratio is 5.7, France 3.5; U.S. 2.7; Australia 5.6; and Japan 8.1.

With that kind of hair’s breadth margin, you can understand why getting Canadians back home to hospital beds in their own country, beds they paid for through their taxes all their lives, can sometimes be a tough job. At least you know who not to blame.

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