By Colleen Fuller
With all the talk of two-tier health care in the election campaign, there has been increasing speculation about the number of Canadian patients going to the US for health care. It's a good question - and one about which there is not much real information. It may, however, miss the more important question: how much Canadian tax money is migrating out of Canada as investors pursue the US health care market?
A new website called Surgery Canada "www.surgerycanada.com/index_eng.html" doesn't claim to know the answer to that question, but is promoting more southward bound traffic - and is encouraging Canadians to demand the private insurance coverage they need to obtain non-emergency health care in the US.
"Canadians are facing very long delays as the number of patients on waiting lists for non-emergent surgery increases in hospitals across the country," reads the website's introduction. "Have you, your family or friends felt the pain, anguish and disappointment associated with long surgical waiting lists? ... Canadians are ready to listen. Acknowledgement will bring change." However, the kind of change the website is promoting won't shorten wait lists. What it would do is enable private health insurers to sell US health care directly to Canadians, thereby wiping out the 49th parallel and the last health care barricade against greed.
Most Canadians who get care in the US are in the US when the need for care arises. That is, they are holidaying, visiting family or doing business down there. So statistics that indicate the number of Canadians being admitted to US hospitals do not necessarily reflect the number who have been referred to a US provider due to waiting times.
The Surgery Canada website wants Canadians to raise a political stink about the limitations on private insurers who want to offer US "products" - like non-emergency care - to their Canadian clients. "Canadian insurance companies have had extensive experience with the American medical system" an anonymous voice on the website says. "Surgery Canada believes that there is an opportunity for private industry to generate new business while helping Canadians find the treatment that they require in hospitals in the United States of America".
The real story about cross-border health care traffic is not how many Canadians are being hospitalized in the US, but rather how many public health dollars have left the country via Canadian investors investing in the US health care market.
Perhaps Doug Bassett, head of CTV, could answer the question - after all, he's got a foot in both the media and the health care crisis his television station covers. Bassett is on the Board of Directors of CPL REIT, Canada's biggest nursing home chain. CPL (aka Central Park Lodge) is owned by the Reichmans and is investing the publicly-subsidized profits it earns in Canada in the NE corner of the United States.
Similarly, MDS, Canada's biggest health care conglomerate, is now listed on the NY Stock Exchange. In 1997, according to Canadian Business magazine, this company earned 40% of its profits (not revenues) from the public purse. A growing portion of this money is being re-invested in the US health care market.
Private health insurers and US providers want Canadians to believe the answer to long waiting times is to obtain needed health care south of the border. Repeated studies clearly suggest, though, that providing adequate funding to our own public health care providers is a better use of our money. If companies paid more taxes instead of taking their publicly-subsidized profits to the US, Canadian patients would be able to stay in their own communities to get the health care they need.
Websites with info on public/private efficiencies and quality:
www.baltzer.nl/hcms/contents/1999/2-3.html
This links to a study by Bruce Hollingsworth, P.J. Dawson and N. Maniadakis entitled "Efficiency measurement of health care: a review of non-parametric methods and applications" sponsored by the Health Economics Group, Department of Epidemiology and Public Health, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH, UK. It compares US and European health systems and concludes that public health care provision is more efficient than private.
Physicians for a National Health Program at www.pnhp.org is an excellent website and has many articles and opinion pieces about public and private health care. Supports single payer (ie., Canadian) model of health care.
"Patients' Rights Bills and Other Futile Gestures", The New England Journal of Medicine June 1, 2000 -- Vol. 342, No. 22, at www.nejm.org.
"The American Health Care System - Wall Street and Health Care" by Robert Kuttner, The New England Journal of Medicine, February 25, 1999, Vol. 340, No. 8 at www.calnurse.org/cna/news/nejm22599.html.
"Privatisation and the Health Care Sector: Re-negotiating the Social Contract by Chan Chee Khoon, Sc.D., School of Social Sciences, Universiti Sains Malaysia, September 1996, available at prn.usm.my/chi/archive96.html.
The Restructuring of the American Health Care System, Health Politics and Policy, 3e. By Theodore Litman, Delmar Publishers, Albany, New York, Copyright 1997 health.upenn.edu/~bioethic/library/papers/donald/litman4.doc.html
A Single Payer Health Care System for the United States, A Primer written by and for medical students by David Hackney and Debra Rogan, American Medical Student Association, www.amsa.org/lad/sp.html.
Health, Health Care and Social Cohesion (Social Capital) from: Public Success, Private Failures: market limits in health reform by (ed.) Drache, Daniel and Sullivan, Terrence J. Toronto: Routledge. This chapter is available on line at: www.founders.net/fn/papers.nsf/... (Yes it's long, but it works).
[ Front Page ]
