More and More Canadians Looking Abroad for Health Care

Fed up with waiting for an appointment with a specialist? Frustrated by the lack of access to advanced technologies and treatments you’ve seen in the news but can’t seem to get in Canada? Unnerved by the prospect of waiting nine weeks to find out if you have cancer?

Then join the growing lineup of Canadians opting to leave the country to receive non-emergency medical care. It’s a line that has been forming for a long time.

According to the Centre for Health Policy Studies at the Fraser Institute—a B.C.-based research centre and think tank that has been tracking hospital and specialist treatment wait lists for over two decades—more than 52,500 Canadians received non-emergency medical treatment outside Canada in 2014, up from 41,800 in 2013.

These numbers are based on a survey of 2,382 Canadian doctors from 12 clinical specialties whose patients sought treatment abroad. But the annual survey excludes individuals who made their own arrangements directly with providers, without their specialists’ knowledge, or the many thousands who were treated abroad for unforeseen emergencies while travelling. Consequently, the survey’s figures likely underestimate the true numbers of Canadians seeking medical care abroad.

The issue of Canadians leaving home for treatment abroad, especially in the U.S. (where costs of care are considerably higher), has long been politicized and sensationalized. For example, American media outlets have emphasized that the Canadian health care system can’t take care of its own, while vociferous defenders of Canada’s publicly funded system have portrayed U.S. hospitals and provider organizations as predatory profit centres that capitalize on vulnerable families. As usual, the truth lies somewhere in between.

What the Fraser Institute studies have established over many years is that the number of Canadians forced into waiting lines for medically necessary diagnostic or treatment services has grown despite unremitting promises by provincial and federal governments that wait lists will be shortened.

The Fraser survey’s results are not encouraging, and they clearly suggest that wait lists have simply become an inherent fact of life in Canada’s health care environment. They show that in 2014, Canadian patients could expect to wait an average of 9.8 weeks for medically necessary treatment after seeing a specialist, having already waited 8.5 weeks to see the specialist. This 9.8 weeks is three weeks longer than what designated boards of physicians consider clinically “reasonable.”

In some of these cases, health ministries have been paying for patients to be treated abroad (mostly in U.S. border communities) due to lack of available resources or technologies within their provinces. B.C. and Ontario, for example, have long maintained contractual relationships with U.S. provider groups in border areas such as Washington State or northern New York or Ohio. The Fraser study found that in 2014, 26,252 Ontario residents and 9,799 British Columbia residents under the care of specialists at home ultimately left the country for treatment, the great majority of them paying out of pocket for care they couldn’t get at home within an acceptable time frame.

Admittedly, this is still a small segment of the Canadian population on medical care waiting lists. But is it insignificant that B.C. neurosurgeons saw 5.4% of their patients drift off to find care abroad, or that 5% of New Brunswick urologists’ patients and 5% of Manitoba medical oncologists’ (chemotherapy) patients felt obliged to seek care outside of Canada?

Is this a sustainable or acceptable trend? Is this an option that you may want, or need, to consider?

Certainly, American health care provider organizations—among them centres of excellence not only in border regions but also throughout the U.S.—are well equipped and anxious to attract foreign patient business. They have been doing so quite expertly for generations. It would folly to neglect their biggest potential market right across the largest and, for the most part, friendly border in the world.

Over coming weeks and months, we’ll be reporting on this cross-border medical traffic, and not only between Canada and the U.S. but also between Canada and other, more distant locations. How can you judge the quality of care of foreign hospitals and doctors? How do you make contact? What does it really cost? Can your health insurance apply? Are there bargains to be had? Can you negotiate costs? What about follow-up care when you return home? What role can your own physicians play?

There are lots of things to consider when considering medical care abroad. Without help, it’s not easy. But it’s not insurmountable, either.

 

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