Healthcare

Canada’s Health Care ‘Refugees’

Sometimes, patriotism can be awkward.  Especially when it means admitting to an international TV audience that your nation’s broken health care system forced you onto welfare, into adult diapers, and hobbling with a walker. And all before the age of 30.

Embarrassing perhaps, but for Canadian Lin Gilbert, the time had come to share her story publicly this week.  Especially after her 15-year-old son was recently diagnosed with the same health condition leading to her suffering. “As a parent, I will do anything to help him.  I will borrow the money, I will do whatever it takes,” she said.  “If the Canadian system can’t take care of him, I’ll find a way.”

Specifically, Gilbert wants to prevent her son from enduring the agony of government waiting lists she has known all too well.  After first encountering excruciating back pain in 2001, she was forced to wait six months for an MRI.  Nearly three more years passed before she made it to the top of a waiting list for spinal fusion surgery.  Even then, she recalls, one surgeon refused to operate because she “hadn’t suffered enough.” Another, however, saw things differently, lobbying for Gilbert to get the procedure and successfully performing it himself.

At 38, Gilbert is now off public assistance, owns her home, and manages a financial services business. Life is good, though she still suffers immense guilt from memories of being “an absent mother,” agonized by being unable to play with her kids, and struggling to remain coherent as she downed morphine to drown the pain.

Fortunately, Gilbert’s son faces better prospects.  Enter Rick Baker, a Canadian determined to improve health care in his country.  Baker joined Gilbert Monday at a Vancouver hotel to speak with American reporters as part of a health care dialogue organized by the Colorado-based Independence Institute, a free market think tank where I am a public policy analyst.

Baker began by offering a blunt disclosure.  “I make my living sending patients to the U.S.,” he said.  “This is medical tourism, but instead of sending someone to Thailand, we’re sending them to Delaware.”

Through an innovative partnership with 22 independent American surgery centers and doctors in 13 states, Baker and his American counterparts transport Canadians to the U.S. for timely care at cost savings up to 80 percent. The partnership operates largely outside the traditional health insurance system.  And this isn’t just about helping Canadians. Baker now also provides a similar state-to-state service for Americans seeking more affordable or timely care.

Under Canada’s controversial federal health legislation, surgeons are prohibited from charging patients to provide “medically necessary” treatment.  In addition, they are limited to performing surgeries to six hours a week.  Gilbert recalled one surgeon telling her, “I spend six hours in surgery each week, less time than I spend explaining to sick patients why I can’t perform theirs.”

Currently, Baker is involved an Ontario lawsuit that could effectively eliminate such limits. “The Canada Health Act is responsible for more pain, more suffering, and more death than any other piece of domestic legislation in history,” he said.  “Imagine a law that prevents you from taking care of yourself and preventing your own death.”

The Vancouver gathering came as President Barack Obama continues his push to radically expand the role of government in administering American health care. But participants weren’t just focused on bashing Canada as a role model. It was also about explaining that America’s health care woes don’t come from an absence of government, but rather too much government and not enough consumer choice.

“The Canadian system is a Ponzi scheme is that is just a little further along ours,” explained Dr. Keith Smith, an Oklahoma anesthesiologist who partners with Baker and manages his own outpatient surgery center.  Baker believes real change will come only when patients are given the incentive to help control costs, freed from being forced to blindly abide by the decisions of insurance companies.

To attract patients, Smith lists the costs of all packaged surgery services on his center’s Web site, adding that if the center’s costs rise above the figures provided, patients aren’t required to pay more.  “If we are wrong, we eat it.”

Smith hopes the model catches on. “It’s radical.  But when people go to our competitor across town and pay $21,000 [for a procedure], and then find out we could have done it for a fifth of that, they start to ask a lot of questions, starting with ‘why didn’t my insurance company go there?’”

Smith says insurance companies opt to pay more at hospitals because of a “cartel” where both inflate the total costs of services as a way to increase profit. Smith’s approach, meanwhile, also includes a commitment to not accepting any federal funding, standing in stark contrast to the position espoused by the American Medical Association, which recently endorsed Obama’s plan.  Smith was unsympathetic.  “The reason the AMA is endorsing this plan is that 90 percent of its funding comes from the federal government,” he said.  “Less than 15 percent of AMA’s budget comes from physician dues, so they are seen largely as irrelevant.”

Hospital lobbyists argue that surgery centers like Smith’s are given an unfair advantage in that unlike traditional hospitals, they are not required to take every patient coming to their door. But Smith rejects this, saying hospitals often exaggerate costs associated with treating uninsured patients as a way to gain political sympathy and more public funding.  “They love to see the uninsured person come through the door,” he said.  “They run a bunch of tests and say it cost them $80,000.  Meanwhile, it probably really cost $1000.”  And while Smith’s center is taxed, his “not-for-profit” hospital competitors are not, a distinction Smith says helped net those in his city net up to $100 million in profit last year.

Despite the intense political opposition they face, Smith and Baker are soldiering on, building a new system that is transforming lives one at a time.  “I know it sounds a bit naive, but it’s true that reform is as simple as charging less for the delivery of health care,” Baker said.

Imagine that.

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