Leaving Canada for Medical Care
The best work on waiting for care in Canada and its consequences is done by the Frasier Institute. This is from their latest report:
- In 2011, an estimated 46,159 Canadians received treatment outside of the country.
- This figure constitutes roughly 1 percent of all patients for non-emergency medical care.
- At the same time, the national median wait time for treatment after consultation with a specialist increased from 9.3 weeks in 2010 to 9.5 weeks in 2011.
I’ve honestly only heard of people traveling from Canada to get health care, never the other way around.
Fraser does good work measuring it Waiting Your Turn series. It doesn’t surprise me that there are Canadians who seek care across the border. The U.S. is a safety relief valve for a beleaguered Canadian system. I would like to see medical care become more of a global marketplace, where providers from one country compete with providers from other countries to provide high-quality care.
Alex, there are anecdotes of rich foreign patients going to Canada for surgery. The reason is that the hospitals can charge them directly, which they cannot do for Canadians. Naturally, the facts are hard to uncover because the hospitals would suffer political outrage, for prioritizing foreign cash-paying patients over Canadians.
Also, because Canada is unique in forbidding private insurance from competing against the government’s monopoly health plan, Canadians cannot insure against the catastrophic cost of an illness that results in their being on a waiting list. If a private insurer could write an individual policy that would pay for treatment in a U.S. facility in case of a long wait, Canadians would line up to buy it.
This is the subject of a civil-rights lawsuit in Canada right now, which was just written about in a national newspaper yesterday (http://www.theglobeandmail.com/commentary/all-canadians-should-be-able-to-buy-private-health-insurance/article4408843/).
We have a similar issue in the US, where foreigners will pay a substantial amount of money to the transplant center to get one of the few slots for organ transplantation reserved for foreigners, even at state medical centers, ahead of Americans. There is little transparency on this. Ironically, many of these patients come from countries where there are religious bans on organ donation.
There is even a more perverse effect of the Canadian system on physician psyche. You can’t mentally survive practicing clinical medicine, explaining to patients who are outliers that the best care, the care they really need to reclaim their life, isn’t available at all in the Canadian system. So my physician colleagues in Canada, simply act as if lack of access under Canadian law means they don’t have to explain to their patients that the care is available, just not in Canada. Canadians frequently don’t even know what the care is that would transform their lives. In such situations, one of my colleagues in Nova Scotia informs his patients that being Canadian means you tough things out.
Devon is correct on the importance of the evolution of the global medical marketplace. It works both ways. I have international patients and Americans would be shocked at how really limited the care is in other developed countries. We have to ship a basic drug like Armour thyroid to our patients in Japan. There is rampant overuse of steroids in ways that our medical boards would never tolerate.
I think that Canadian healthcare will be, on average, better than U.S. healthcare within 15 years time.
Canada has a far greater inventory of “sickness” than we do in the US, as evidenced by the wait times.
The waiting times have an effect on the quality of life of Canadian citizens.