If ever you’re stuck in a foreign hospital waiting for your travel insurer to get you back to Canada for continuing medical care, don’t blame your insurer for putting you on hold. You can be darned sure your insurer would like to get you back home where your medicare picks up the tab. In a foreign hospital, it’s the insurer who pays.
The problem with repatriation now, as in the past 35 years, lies in the inability of health care bureaucrats to break the hospital bed logjam that bedevils doctors, nurses and floor staff working in most of Canada’s hospitals.
How bad is it?
On November 30, 2016, the Ontario Auditor General released its most recent report on lengthening waits for beds in the province’s community hospitals. I note that this is a provincial report and not all the findings translate exactly to other provinces. But the similarities are still striking.
Why can’t you be flown home immediately for an emergency heart bypass in Ontario to avoid a $250,000 fee for same procedure in a Miami hospital?
Read on, from the Auditor General’s own press release.
Hurry up and wait.
At hospitals sampled by the AG, 90 percent of emergency room patients requiring intensive care were transferred to ICU, on average, in 23 hours. The health ministry target is 8 hours. Ninety percent of patients needing an acute care bed waited in emergency for 37 hours.
In 2015/16, 90 percent of urgent neurosurgeries were completed within 63 days, twice as long as the ministry’s target of 28 days.
47 percent of patients who should have undergone emergency surgery within 2 to 8 hours had to wait an average of 18 hours.
What? Gone fishing?
With many hospitals closing operating rooms on evenings, weekends and statutory holidays, during March break and for 2 to 10 weeks during the summer, elective surgeries are postponed and only limited operating rooms remain open for emergency surgeries. That’s right. Can’t forget vacation time.
It’s right here in the AG’s report. May be hard to believe, but you can read it for yourself.
Where are the beds?
As of March 2016, about 4110 patients in Ontario were occupying hospital beds they no longer needed. Half were waiting placement in long-term facilities or home care services. The health ministry estimates almost 38,000 patients could have been treated had these beds been available.
In 2015/16, Ontario taxpayers spent $17 billion to fund 31,000 hospital beds in 147 public hospitals.
Yet hundreds, perhaps thousands, of Ontario residents, long-time taxpayers vacationing abroad, can’t be transferred to a hospital at home because there are no beds available. And in this, Ontarians are not unique. The story is being retold in all provinces.
Money. There’s never enough. Ever since medicare was first established in the late ‘60s, provincial and federal governments have fought over funding responsibilities for provincial health insurance. But those providing the care, hospital administrators and physicians, are not in the same room suggesting remedies, reform, ways to fix what is obviously broken.
In response to the current AG report, the Ontario Hospital Association, spokesman for public hospitals commented, “Ontario hospitals are facing extremely challenging budget decisions aimed at containing costs while meeting the increasing service needs of patients. Recent investments by the government in 2016 were welcomed by the hospital sector. At the same time, significant investments will be needed in 2017 and beyond.”
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