November 4, 2007
Cross-border medicine
Shorter lines, more doctors, high-flying loonie has Canadians flocking south
By CHRISTINA BLIZZARD, TORONTO SUN
American clinics have always been an option for patients in this province who want speedier access to health care than our one-tier public system can offer. What's more, this province has a doctor shortage. The U.S. does not.
Joanne Thompson knows all too well the heartache that happens when a loved one needs care in this province -- and can't get it.
Thompson, city editor at the Sault Ste. Marie Star, needed to find an MRI in May for her sister, Jennifer Abbott. A partial paraplegic, Abbott was fearful of the enclosed type of MRI machine, but the wait for a test on an open MRI in the border city was three to five months -- far too long for the neurological condition she suffers from.
So Thompson checked the ads and found a clinic across the border in Michigan that offered same day service for an open MRI -- two hours away.
"Her condition was such that we were too worried to wait any longer," Thompson said in a telephone interview.
"We were able to get an appointment the next day. To me that was unbelievable," she said. And she didn't mind paying a few hundred bucks out of pocket.
"When you can get an MRI within a day, it's worth a few bucks," she said.
Of course, Canadians have shopped for health care in the U.S. for decades. What's new is now it's 30% cheaper.
Windsor family physician Dr. Albert Schumacher is a consultant for the Detroit Medical Centre (DMC). Associated with Wayne State University, DMC is the largest group of teaching hospitals in Michigan. It has nine hospitals three miles from the border. He worries that Canadians seeking care in the U.S. may be attracted by cut-rate clinics. Schumacher's been working with DMC to provide quality care at affordable rates for cross-border health care shoppers.
"You have a lot of peripheral and suburban places not affiliated with brand name institutions that are doing a lot of stuff," he says. Prices for MRIs, colonoscopies etc., at quality institutions in the U.S., are higher than those in Canada. An MRI can cost as much as $1,800. He's working to get Canadians what he calls the "Montreal price." If patients in this province are, in effect, bulk buying from DMC, then they get a better price than a one-off patient from, say, the Middle East would.
Bariatric surgery -- stomach stapling -- is another procedure that is popular with cross-border health shoppers, since there's a shortage of service here.
It's hard to get an accurate count of just how many Ontarians are looking south for treatment, because there's a reluctance to talk about it, Schumacher says.
"There is a huge politics of resentment in this country. If somebody can get care somewhere else, many people are resentful of that, so therefore they don't talk about it," he said.
"If the airline industry was like health care, we wouldn't have first class in Air Canada, because people wouldn't want that to happen. They get very resentful about that," says Schumacher, who is a former head of the Canadian Medical Association (CMA) and the Ontario Medical Association (OMA).
This province just doesn't have the medical staff or the resources to provide the same level of care as the U.S.
Essex County, where Schumacher practises, with a population of 400,000, until recently had only two CT scanners and one MRI machine. They just got a second MRI. Across the border in Port Huron, Mich., population 12,000, they had four MRI machines 10 years ago, Schumacher says.
"The simple math is for every five of me practising here, Western Europe has six and we are only training four to replace us, so the crisis gets worse on a daily basis," he says.
The OMA estimates this province is short more than 2,000 physicians -- all just numbers and statistics for politicians, perhaps. But for Joanne Thompson and her sister, these figures add up to one thing: Prolonged suffering. And the cure? A passport -- and shopping trip.