SUN NEWS COLUMN: COVID-19 Issues Highlight Need For Broader Healthcare Reform

By: Colin Craig 

A recent news story out of Buffalo, New York, illustrates the challenges COVID-19 restrictions have caused Canadian patients who have to travel abroad for health care. The article also reinforces the need for health care in Canada.

The Buffalo Newsrecently reported that Terry and Diane Dick, from Fort Erie, Ont., ran into a hassle at the border when they went down for Diane’s cancer treatments. 72-year-old Diane had scheduled her treatments over the phone and didn’t have paperwork to provide to border officials.

According to the news report, Canadian patients have even had to leave friends and family members at the border before entering the United States. One health care official noted that a Canadian patient had to drop someone off at a Walmart in Canada before they could enter the United States for treatment.

Just imagine struggling with cancer, and having to go to the U.S. for timely treatment only to find out you have to leave an adult son or daughter at the border to limit the number of people in your car to two.

Thankfully, a U.S. politician has stepped up to try to inject some compassion into such situations. Interestingly enough, Congressman Higgins also told The Buffalo News, “Canadians spend about $10 million a year on health care in Western New York” alone.

While getting across the border can be a challenge, in Mr. Dick’s opinion, the real problem occurs once you’re back in Canada and have to quarantine for 14 days. If you’re going to the U.S. for regular chemo treatments, one can see how this requirement would become a rather onerous proposition.

All this begs the question “why?”

In Canada, the government lets you spend as much money as you want on activities that harm your own body.

You could literally chow down on fast food for breakfast, lunch and dinner every day and follow up each meal up with a joint or a few rum and Cokes. Depending on where you live, the government might even allow you to visit a local drug treatment facility and shoot up with some heroin.

But spend your own money on a life-saving health procedure? In most instances, governments in Canada don’t allow it.

Statistics Canada data obtained by SecondStreet.org showed that in 2017, Canadian patients made over 217,500 trips abroad specifically for health care.

Defenders of our state-run health care system claim that it’s just the rich who travel abroad for health care. Yet, we’ve spoken with many middle-class Canadians who have traveled abroad for health care – a teacher’s assistant from Alberta who went to Germany for neck surgery, a nurse from Nova Scotia who went to Mexico for back surgery and more.

Canada is not only missing out on an economic opportunity by blocking private health care options in our country – we’re also missing out on an opportunity to help patients receive the treatment they need.

Studies such as the one conducted by the progressive Commonwealth Fund in 2017 show that countries with better health care outcomes than Canada – Australia, New Zealand and Norway to name a few – offer patients a choice between using the country’s universal public health care system or visiting a private clinic.

Clearly, the troubles Canadian patients are facing right now at the border only reinforces the need for broader health reform.

Colin Craig is the President of SecondStreet.org, a start-up Canadian think tank.

This column was published in the September 21th , 2020 print addition of Sun Newspapers (Toronto, Ottawa, Winnipeg, Calgary, and Edmonton). 

Share on Facebook
Share on Twitter

You can help us continue to research and tell stories about this issue by making a donation or sharing this content with your friends. Be sure to sign up for our updates too!

Prevention – reduce demand in the first place

If Canadians lived healthier lives, we could reduce demand for emergency services, orthopaedic surgeries, primary care and more. 

For instance, if you visit the Canadian Cancer Society’s website, you’ll read that “about four in ten” cancer cases are preventable. The Heart and Stroke Foundation notes that “almost 80 percent of premature heart disease and stroke can be prevented through healthy behaviours.” A similar number of Diabetes cases are also preventable. 

Many joint replacements and visits to ERs and walk-in clinics could also be avoided through healthy living. 

To be sure, not all health problems can be avoided through healthy living – everyday the system treats Canadians with genetic conditions, helps those injured in unavoidable accidents and more.  

But there is an opportunity to reduce pressure on the health care system through Canadians shifting to healthier lifestyles – better diets, more exercise, etc. 

To learn more, watch our Health Reform Now documentary (scroll up) or see this column. 

Partner with non-profits and for-profit clinics

European countries will partner with anyone who can help patients. 

It doesn’t matter if it’s a non-profit, a government entity or a private clinic. What matters is that patients receive quality treatment, in a timely manner and for a competitive price.  

In Canada, governments often delivery services using government-run hospitals instead of seeing if non-profit or private clinics could deliver the services more effectively. 

When governments have partnered with non-profit and private clinics, the results have often been quite good – Saskatchewan, Ontario and British Columbia are just a few examples of where partnerships have worked well. 

Canada should pursue more of these partnerships to reduce wait times and increase the volume of services provided to patients.  

To learn more, watch our Health Reform Now documentary (scroll up) or see the links above. 

Make cross border care more accessible

In Canada, citizens pay high taxes each year and we’re promised universal health care services in return. The problem is, wait times are often extremely long in our health system – sometimes patients have to wait years to see a specialist or receive surgery. 

If patients don’t want to wait long periods, they often have to reach into their own pocket and pay for treatment outside the province or country. 

Throughout the European Union, we also find universal health care systems. But a key difference is that EU patients have the right to go to other EU countries, pay for surgery and then be reimbursed by their home government. Reimbursements cover up to what the patient’s home government would have spent to provide the treatment locally. 

If Canada copied this approach, a patient waiting a year to get their hip operation could instead receive treatment next week in one of thousands of surgical clinics throughout the developed world. 

Governments benefit too as the patient is now back on their feet and avoiding complications that sometimes come with long wait times – meaning the government doesn’t have to treat those complications on top of the initial health problem. 

To learn more, watch our Health Reform Now documentary (scroll up) or this shorter video. 

Legalize access to non-government providers

Canada is the only country in the world that puts up barriers, or outright bans patients from paying for health services locally. 

For instance, a patient in Toronto cannot pay for a hip operation at a private clinic in Toronto. Their only option is to wait for the government to eventually provide treatment or leave the province and pay elsewhere. 

Countries with better-performing universal health care systems do not have such bans. They allow patients a choice – use the public system or pay privately for treatment. Sweden, France, Australia and more – they all allow choice. 

Why? One reason is that allowing choice means some patients will decide to pay privately. This takes pressure off the public system. For instance, in Sweden, 87% of patients use the public system, but 13% purchase private health insurance. 

Ultimately, more choice improves access for patients. 

To learn more, watch our Health Reform Now documentary (scroll up) or watch this short clip on this topic. 

Shift to funding services for patients, not bureaucracies

In Canada, most hospitals receive a cheque from the government each year and are then asked to do their best to help patients. This approach is known as “block funding”. 

Under this model, a patient walking in the door represents a drain on the hospital’s budget. Over the course of a year, hospital administrators have to make sure the budget stretches out so services are rationed. This is why you might have to wait until next year or the year after for a hip operation, knee operation, etc. 

In better-performing universal health systems, they take the opposite approach – hospitals receive money from the government each time they help a patient. If a hospital completes a knee operation, it might receive, say, $10,000. If it completes a knee operation on another patient, it receives another $10,000. 

This model incentivizes hospitals to help more patients – to help more patients with knee operations, cataract surgery, etc. This approach also incentivizes hospitals to spend money on expenses that help patients (e.g. more doctors, nurses, equipment, etc.) rather than using the money on expenses that don’t help patients (e.g. more admin staff). 

To learn more about this policy option, please watch our Health Reform Now documentary (scroll up) or see this post by MEI.