From: gld@cunixb.cc.columbia.edu (Gary L Dare)
Subject: Canadian Medical Travel, Myths & Reality (Was: new political platform)
Reply-To: gld@cunixb.cc.columbia.edu (Gary L Dare)
Organization: Curious Goods (formerly Louis Vendredi Antiques)
Date: Sun, 30 Aug 1992 18:09:51 GMT

In article <1992Aug29.215303.15423@leland.Stanford.EDU> muaddib@leland.Stanford.EDU (Rob Dorfman) writes:
>In article <1992Aug29.195729.2987@alchemy.chem.utoronto.ca> golchowy@alchemy.chem.utoronto.ca (Gerald Olchowy) writes:
>>
>>I encourage you to look at the health systems of European countries,
>>Japan, or Canada, and not through the propaganda put out in the
>>American media by vested health care industry interests that want
>>to keep raiding the American treasury of more dollars than the S&L
>>scandal.  The American people are being robbed of $100 billion dollars
>>a year by the health care industry.
>
>i agree that US health care is over priced. however my mother is from 
>canada and i know enough canadians who come to the US for heath care
>even at the higher cost. as well as europens coming here.

With all due respect, how long ago did your mother leave Canada?  Up
until health insurance became more than a frill about 20 years ago,
people both countries paid cash.  Given the acknowledged differences
in cost, your claim is headline news material in Canada and Europe for
which you could be paid handsomely for information that you might be
sitting on, unless you're someone who has contact with medical folks
and then there would be legitimate reasons not involving the different
way that we do health insurance ...  (By the way, I'm from Western
Canada, originally; have been around)

Travel between Canada and the United States is purposefully built-in
due to the fact that both our systems are the same other than the way
that we do insurance, and highly subject to how the population is
distributed plus market forces on where doctors locate, thus resulting
in medical travel in *both directions* as well as over domestic state/
provincial borders.

The reality is that the numbers of Canadians coming to the U.S. for
care are in the one or two dozens (Dennis G. Shea can back me up with
hard numbers here, since I don't have any more Canadian newspapers
handy after recycling day), and fall into two categories:

1. Very wealthy Canadians who will not wait a week despite what their
own doctor tells them.  A very small number, done outside of their
public health insurance (out of pocket).  More often, it's ...

2. Canadians who don't have a practicioner close to them, and a trip
to the States would be faster than a trip into Ontario or Quebec (the
two provinces with ~2/3rds of our population, from the Great Lakes and
through the St. Lawrence).  Going to California is often faster from
western provinces than going to Ontario for a rare procedure that's
not found in the West.  A second aspect is that while there is nothing
to stop any private Canadian doctor from doing practice any sort of
obscure procedure, certain locations especially in Western Canada will
not get them very much in the way of business, and thus billings!
Demands for such a procedure would dictate that such a doctor should
locate to somewhere with a high population density and let patients
from a large zone come to them.  For example, the western province of
Saskatchewan is the size of 3 or 4 midwestern states but has a total
population of 800,000; each of the cities of Edmonton and Calgary in
neighbouring Alberta have 800,000 people - but so does my girlfriend's
home county in New Jersey (or for that matter, the Upper West Side of
Manhattan where we now live).  Since the "Canadian system" begins and
ends with insurance then it is really the market (location of private
doctors' practices vs. a whackily skewed population distribution) that
kills it in terms of access to uncommon procedures (relative to the
population).  Quick check of any junior high school atlas and some
market common sense bears out my assertions above ... our geographic
lopsidedness has historically severely affected Canada's political
landscape and even now plays a big part in our constitutional debate;
its impact on availability of certain health services is not a problem
for Canadians, but a common sense fact of life.

Divorcing the insurance aspects of our two countries, medical travel
is consistent with the continental population patterns and market-wise
location of private medical practitioners (assuring them of an even,
constant supply of work) -- this includes Americans from border areas
getting prenatal checkups in Eastern Canada with authorization from
their insurers.  In true socialized medicine as Britain has, they'd
put a civil servant doctor into Saskatchewan for brain surgery and let
them do one procedure a year while playing golf (or hockey (-;) the
rest of the time -- that would be highly inefficient!!

In CNN's series looking at the real health care system in Canada this
past June, a Toronto woman who had to go down to Washington, D.C. for
a procedure was interviewed by Catherine Crier and no matter how hard
Crier pushed her, would not criticize OHIP (Ontario Health Insurance
Plan) for her plight -- nobody in her province nor Quebec (forget
about the smaller-population provinces next door like Manitoba) was
practicing in that medical area, and that even Americans had to travel
to D.C. for it.  She also reminded Crier that the USA is ten times
bigger than Canada and would likely have more stuff ...

Waiting lists have been debunked by Vancouver's conservative Fraser
Institute, and CNN could not find any convincing ones during their
June focus series on the health care system in Canada.  It was also
one of the first times in the U.S. that I've seen the distinction that
we have private doctors in Canada, and that the only public portion is
centered on provincial (not federal - surprise! (-;) health insurance.

It might be hard for Canada to privatize its health insurance because
our private insurers would balk; they're making too much money on
non-medical supplementary health insurance benefit plans (private bed,
telephone, cellular phones, etc.) for individuals and private
companies.

gld


PS: Addressing comments made by another writer, just how much worse is
Canada's material standard of living under public health insurance?
Things do seem to be all right if one watches the "Kids in the Hall"
(HBO/Comedy Central, but prime time broadcast in Canada); "E.N.G."
(Lifetime); some of the CBS "Crimetime" programs opposite The Tonight
Show; Aaron Spelling (90210, Melrose Place) has set up a Canadian
production office in Vancouver for "The Heights" and "The Roundtable";
or, various other Canadian programs that show up in syndication or
(esp.) cable.  Looks pretty generic North American (usually in a
no-name city (-;)

--
~~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare				Elections 1992-93:
> gld@cunixB.cc.columbia.EDU		* Jean Chretien (Canada)
> gld@cunixc.BITNET			* Perot^H^H^H^H^H Elvis! (USA)
Newsgroups: talk.politics.misc