News

Medical Tourism Boosted by Long Wait Times

Going abroad for surgery is becoming an affordable option for Canadians, with many firms turning operations and recovery periods into high-end exotic holidays.

By Brian Adeba

Four years ago when Suzanne Aucoin was diagnosed with colorectal cancer, she had to travel every week to the United States to buy life-saving cancer drugs at expensive rates. Ms. Aucoin, who lives in St. Catharines, Ont., said she was lucky because she lived in a border town and she was able to buy drugs that were not available in Canada.

"We are renowned for our health care system, and when I am in the deepest need as a cancer patient, and they don't have what I need to save my life, that's very sad," she said in a recent interview.

But Ms. Aucoin is not alone. Whether it is to get life-saving medication for cancer or a hip replacement, an increasing number of Canadians are travelling abroad for medical purposes. Long hospital wait times–it can take more than a year to get a hip replacement–have been identified as the reason most Canadians seek treatment overseas.

Leigh Turner, an associate professor of biomedical ethics at McGill University in Montreal, says that governments in Canada do not know how many Canadians are seeking expensive treatment abroad.

"There is very little reliable statistics on numbers, and sometimes they are inflated for marketing purposes," he says.

Part of the problem in keeping track of the number of Canadians seeking medical treatment abroad is because their journeys are facilitated by private entities, and the information is considered private.

"Medical tourism is an individual issue and these are independent private corporations, and they don't have any connection to the ministry," says A.G. Klei, a spokesman for the Ontario Ministry of Health and Long Term Care.

"There's no way that we can track that," he says.


Medical Tourists Increasing

Yasmeen Sayeed, president and CEO of Surgical Tourism Canada, a Vancouver-based firm that facilitates travel and treatment of Canadian patients in hospitals in India, says since she started operations two years ago, she has noticed that the numbers are increasing.

"When we started, we only did three cases. Then it went up to 30–then 50 in the next year," she says.

"This year, since January, we have already done 20 cases."

While the number of patients is increases, so too are the number of corporations involved in medical tourism. Mr. Turner says that this started in 2002. He estimates that about half of these corporations are based in British Columbia, and "maybe a quarter in Quebec, three in Ontario and one is about to set up shop in Manitoba."

While travelling abroad for treatment is expensive, the notion that only those with high incomes can afford it is a myth. Ms. Sayeed says her clients come from all walks of life because of the availability of medical finance companies giving affordable loans to any working individual.

So far, the favourite medical destination for Canadians seems to be India, but Mr. Turner says some companies are promoting Cuba. Worldwide, Singapore and Thailand rank high.

In India, patients can expect top-notch treatment from private high-tech facilities.

"It's almost like going to a top-end tourist resort," says Mr. Turner.

But behind the veneer of high-tech facilities, there are still questions about the care patients receive. Mr. Turner says it's hard to measure the rate of success in operations, and other treatment because finding reliable information is hard to come by.

"There's certainly a risk out there," he says, adding that in the U.S., the Center for Disease Control has published a report about patients who got infections after undergoing surgery in Venezuela and the Dominican Republic.

Ms. Sayeed says in her years of facilitating treatment in India, she has not received complaints from any patients.

But while Canadians are opting to travel to India to avoid chronic long wait times at home, the other compelling reason is the low cost of treatment. Ms. Sayeed says in Canada, the average cost for a hip replacement is $18,000.

"If you went across the border to the U.S., you could be paying anything from $26,000 to $40,000 (US)," she says.

"If you went to India, our total package costs $14,500, out of which only $8,500 is the surgery cost."


No Solution to Wait Time Situation

Surgical Tourism Canada also arranges travel and visa requirements, insurance, hospital stay and post-hospital recuperation in rehabilitation facilities where doctors can check on patients until they are fit enough to travel back to Canada.

On arrival in Canada, the medical reports from India are transferred to family physicians. However, patients are encouraged to stay in touch with their doctors in India by email and phone contacts so that their medical histories are monitored.

But even though they received treatment abroad, patients could still face problems in Canada because doctors may be unaware of the procedures and methods used in India, says Mr. Turner. In cases of botched-up operations, patients may encounter problems seeking legal recourse, though Mr. Turner says he hasn't heard of any such situation.

Ms. Sayeed says all the hospitals her company partners with in India have medical malpractice insurance coverage.

While travelling abroad raises questions about the kind of health care Canadians receive, it also raises questions about whether the government should step in to rectify the situation, says Mr. Turner.

"If Canadians face the choice of going on a waiting list for an orthopedic procedure for a year and a half, or going out of the country, do they end up getting inferior care?

"And if so, are there things we can do in Canada to reduce that from happening?"

As for Ms. Aucoin, she launched a campaign to have the Ontario Ministry of Health solve part of her problem. In February, the ministry reimbursed her medical and legal costs by giving her $52,000 for her medical bills and $19,000 for legal costs.

brian@embassymag.ca