00:00:00.360Welcome to another True North Talk. My name is Andrew Lawton, fellow with True North, and wanting to turn for this edition of the program to healthcare.
00:00:09.560This has been an issue near and dear to my heart for over a decade. I've had my own very negative experiences within the Canadian healthcare system,
00:00:17.320and I've covered a fair bit about some of the battles we see going on in this system.
00:00:22.200But there was a really fascinating report that was just published this month by SecondStreet.org looking at the sheer number of Canadians who have left the country to the United States for healthcare,
00:00:34.920or leaving the country in general for healthcare. And I found this to be an important number because I think that healthcare is oftentimes a blind spot for Canadians.
00:00:43.340We assume that just everything's fine, everything's hunky-dory, but for a lot of Canadians that isn't in fact the case.
00:00:49.400I want to bring into this discussion the president of SecondStreet.org, Colin Craig. Colin, good to talk to you. Thanks very much for your time today.
00:00:58.780So tell me about this report here. You found the top-line number here, 217,500 Canadians left the country for healthcare in 2017.
00:01:08.840Did you go into it really with a specific number in mind where this comes and you think this is high or low or about on par with what you anticipated?
00:01:17.780You know, it was higher than what I thought, just based on some of the previous estimates that had been out there.
00:01:25.260The previous ones that I've read have been cautious. And, you know, this figure that we were able to calculate doesn't come without its own limitations, too.
00:01:33.900So, you know, 217,000 people specifically indicating that healthcare was the main purpose of their trip in 2017.
00:01:41.800That's a lot of people. And if you think about it, you know, if you're watching a Blue Jays baseball game at the Rogers Centre there and you imagine that place completely sold out,
00:01:51.960well, we're talking about at least four sellouts of the Blue Jays Stadium. That's a lot of people.
00:01:56.860If you think about Barrie, Ontario, the greater Barrie, Ontario area, I mean, it's more than that population.
00:02:03.580It's more than Kelowna, British Columbia. So, you know, it's a lot of people when you start to kind of really think of it in that perspective.
00:02:10.720And the way that we got the data was from Statistics Canada.
00:02:13.740And what they do is they will survey Canadians when they return back to the country and they'll ask them questions.
00:02:21.460And one of them is, well, what was the main purpose of your trip?
00:02:24.620And health care or medical reasons is one of the possible responses.
00:02:28.440So we said to StatsCan, OK, can we get some data? How many Canadians are reporting that?
00:02:33.360And so that number that you and I, we just talked about, the 217,000, that's on the low end.
00:02:38.380That figure doesn't include Saskatchewan, Newfoundland, Prince Edward Island or Nova Scotia.
00:02:46.220And the reason is because for those provinces, the sample sizes were a bit small.
00:02:50.300And so StatsCan said, here's the numbers, but we would caution against using them because you have to be careful.
00:02:55.180So we just said, OK, well, we're not even going to we won't include those.
00:02:58.720So it's actually higher. And for some other technical reasons, it would be higher, too.
00:03:02.900So that's sort of the low end. At the higher end, it's around three hundred and twenty four thousand.
00:03:08.400So, you know, to use the Rogers Center example, that'd be six sellouts for Blue Jays game.
00:03:13.180So we're talking about a heck of a lot of people that are getting in their cars or getting into airplanes and leaving the country for health care.
00:03:19.260And, you know, just know, too, that's just patience.
00:03:22.700Yeah. And that works out to be, I think, just shy of about six hundred a day as well.
00:03:26.740So we're not talking about an insignificant number here.
00:03:29.240And more importantly, I think it cuts to that issue of what do they need to go over there for?
00:03:35.740And I know that you're looking at the numbers, not the rationale.
00:03:38.820But I know that you've also done some supplementary research to this, looking at some of the stories of people that have gone.
00:03:45.000And I'm wondering what those key reasons are, because some people would say, oh, it's just impatience or something like that.
00:03:51.060But have you found there's actually been a rationale that you've been able to find is common or at least more common than others?
00:03:58.520Yeah. And I'm glad you mentioned that, because that is one of the limitations on the data is that we we have the numbers.
00:04:03.960We don't know the why. And, you know, stats cancels.
00:04:07.280Well, why are you going? But or what was the purpose of your trip?
00:04:10.560But it doesn't say, well, what type of health care are you receiving?
00:04:13.100So it's quite possible that some of those people left for dental.
00:04:16.660We've heard of cases of that where someone goes to another country for dental care because they can get a better deal.
00:04:22.380In some cases, some people are probably traveling for a procedure that's simply not offered in Canada.
00:04:27.480So I think of the MS treatments that some people were going to Germany for.
00:04:31.800So that would be an example. But, you know, those are anecdotal.
00:04:35.340And we've certainly heard a lot of cases where people are going for things that are offered by the Canadian health care system.
00:04:42.200But the waiting lists are just too long.
00:04:44.860Hip replacements, knee surgery, MRI scans, lots of things like that, where Canadians are kind of hitting this wall in our system.
00:04:53.480And then they look around. So the government saying you're going to have to wait a long period of time.
00:04:56.600And they look around and there's no private companies that offer it or are allowed to offer it because quite often the government in Canada will restrict private clinics from offering a lot of procedures.
00:05:08.160So then they think, OK, well, what are we going to do? We're going to have to leave the country for health care.
00:05:12.460And so we've seen a lot of examples of that.
00:05:16.580I've been talking to lots of different Canadian patients, hearing their stories about going off to Mexico and China and the United States and Thailand and Poland and so forth.
00:05:27.660It's it's happening. And, you know, the the stereotype that people will say is that, oh, it's just the rich doing it.
00:05:34.580Well, you know, obviously, if you got a lot of money, you're not going to wait in line for a year to get your your hip done here in Canada.
00:05:41.360So the wealthy are already doing this. But we've talked to a lot of middle income Canadians who are scraping the money together to go and get faster health care because they don't want to wait in pain for a year.
00:05:52.440They don't want to wait for months and months and months while a disease is potentially spreading throughout their body.
00:05:58.260It's very unnerving. And, you know, when it comes to your health, a lot of people put it first and they do what they can to make it happen to improve their situation.
00:06:06.260I'm glad you mentioned that line about the rich because you're right.
00:06:09.280And I've heard that a lot. People say, oh, it's just the rich doing that.
00:06:12.520But that doesn't really explain the need for it. I mean, sure, the rich might be the only ones that have the opportunity, but the rich and the poor and the middle class are the ones that are all dealing with that fairly equal problem that is incentivizing that behavior, even if not everyone is embracing the behavior.
00:06:29.160Yeah. And that's a very good point is that, you know, if the system was running as well as people like to suggest, then even the rich would wait, you know, a couple of weeks or, you know, maybe a month or whatever to get their procedure done.
00:06:43.160But the bottom line is it's not. We've seen a doubling of waiting lists in terms of the length of time that people are waiting.
00:06:51.320According to Fraser Institute data, they've been looking at the situation for 25 years, and that's the big picture.
00:06:58.000And certainly we've been talking to lots of Canadians in different provinces and hearing stories of people being told it's going to be a year, sometimes two years.
00:07:07.540In the case of Jenny McKenzie, we did a little video.
00:07:10.520We put it on our Facebook page and YouTube and website and all that.
00:07:13.260And we talked to her about her experience.
00:07:15.960So she's a senior citizen in Vancouver, and she was told that to get her hip operated on, the total amount of time that she'd be waiting would be upwards of a year or two years.
00:07:30.140And so, you know, in the meantime, you know, this was a lady who had a very active lifestyle before her hip problems really began.
00:07:37.260You know, she's a senior citizen that, you know, tried to get in her, I think it was 10,000 steps a day, she said.
00:07:43.560You know, she'd go to the gym regularly.
00:07:45.400She liked to go out to go to Spanish lessons and meet with her friends for coffee and so forth.
00:07:51.340She had grandkids that she liked to babysit and watch on that.
00:08:07.520I mean, it's just, it's incredible that governments will ration health care and they think that it's okay to just leave people on a waiting list for a year or two years or whatever it is.
00:08:18.180So there's lots of stories like that out there.
00:08:21.140And, you know, in her case, she couldn't afford a private hip operation.
00:08:25.120But certainly when you allow those procedures in the country, some people will decide.
00:08:30.100They'll pay out of pocket and then they come off of the waiting list and someone else gets bumped up.
00:08:35.720So, you know, that is the standard approach in most countries is, you know, you have that option where you have the public health care system and you have a private system if people want to choose.
00:08:47.100And countries that do that, that Canada competes with, their health care systems have better results.
00:08:51.820And I know you mentioned it before, but just to reiterate, this isn't just going from Canada to the U.S.
00:08:57.060This is theoretically anywhere in the world, correct?
00:09:00.440Yeah, it's anywhere in the world that people are going.
00:09:02.840But there is still, I think, for people that live near the border, probably an easier time getting to the U.S.
00:09:08.740And I wanted to touch on a little project you did with Chris Sims, who I'm sure a lot of viewers will be familiar with.
00:09:14.380You actually took a road trip to Bellingham, Washington, which is not far from Vancouver, not far from Abbotsford, B.C.
00:09:20.600And it was interesting because you went to a medical center and I saw the video.
00:09:23.980You're going around finding all these B.C. license plates in the parking lot.
00:09:27.900And I live about an hour from Port Huron, Michigan.
00:09:29.880So I see the Ontario plates in the Olive Garden and the Walmart parking lots.
00:09:33.620I've never gone to the hospital to look in their parking lots, but it stands to reason I might be able to replicate your results.
00:09:39.780But you were seeing this just on an ordinary day, no advanced knowledge, Canadians that clearly, for some reason or another, are at a U.S. medical center.
00:10:47.320So if you're in the middle of this thing and you've got BC plate, well, it's not like you're parking there and you're, you know, some store across the street.
00:10:54.840It was it was all health care, different types of clinics and and so forth.
00:10:59.860And, you know, we tried to talk to a patient, you know, getting into a car with a BC plate.
00:11:05.420But unfortunately, we just didn't see any.
00:11:21.200Do you get a lot of Canadian patients coming down?
00:11:23.300And she said, oh, yeah, yeah, a fair number come down and they go for, you know, I can't remember what procedure it was now.
00:11:29.100But, you know, they receive a certain type of health care at that complex.
00:11:32.680And, you know, it's sort of anecdotally what's backing up these big picture numbers that we've uncovered.
00:11:38.460And that is that there's a lot of people that are crossing the border for health care.
00:11:41.820So I guess the last thing I'd ask you then on that is that given this number lacks, as we talked earlier, that specific motivation for why each of those 217,000 have left, what is the real takeaway that you take from this research or you want others to?
00:11:56.740Well, we kind of looked at this as an economic opportunity perspective, because every time someone leaves the country for health care and pays for a procedure in another country, money is leaving our economy.
00:12:10.140And it's a lot. There's the cost of the procedure, for starters.
00:12:14.700There's the cost of transportation to get to that country, whether it's just over the border in the U.S. or whether you're going to Thailand.
00:12:21.140I mean, there's there's a varying range of costs there.
00:12:25.260There's also the cost of food and lodging.
00:12:29.620You know, there's a lot of different expenditures that go into these trips.
00:12:32.400And we thought, well, you know, just how big is this opportunity if Canadians had the right to choose to pay out of pocket for those procedures in Canada?
00:12:43.000And like I said before, I mean, you could maintain the public health care system, but just give people this option so that they could choose private care, which in many provinces, that's not the case.
00:12:52.160So I think there's a real economic opportunity.
00:12:55.340And, you know, just as food for thought for your viewers, you know, we talked about how many patients are leaving.
00:13:00.800Well, in many cases, patients don't go alone.
00:13:03.080They go with a spouse or a loved one or a friend or whatever the case may be.
00:13:07.280So you've got even more people that are having to pay for food and accommodations and travel costs and so forth outside of the country.
00:13:14.480And so, you know, the numbers get even higher and people can see them if they want in our report.
00:13:18.380But that was really what we were trying to do is just take a look at this through an economic lens and see how much money is leaving the country every day for health care, how many people are going and what type of opportunity that might present for Canada.
00:13:30.820Yeah. And obviously, I have no basis for this number.
00:13:33.160But even if each of those people was investing, say, $10,000 overall, I mean, we're talking about billions of dollars a year.
00:13:40.920And then over the course of several years that's being spent outside of Canada, I think that's a great point you raise.
00:13:45.760Yeah. And so we do have a few numbers in the report.
00:13:50.360And it's a bit tricky because, like I said at the beginning, a lot of the numbers and data that's out there, it's not complete.
00:13:58.400So we have some data on how much Canadians are spending a day in other countries on health care.
00:14:19.640But if you're getting, maybe you've got a sore shoulder and you're going to get that looked at, well, you might do some shopping afterwards, right?
00:14:26.060Because you can still walk around and do shopping and function and that, or maybe you go to a baseball game or whatever abroad.
00:14:33.660But, yeah, there's an economic opportunity there for Canada to keep some of these dollars here and even potentially become a medical tourism destination.
00:14:42.280You know, lots of people from around the world are going to the U.S. for health care because they think of it as good and quality.
00:14:46.540Well, Canada's got a good reputation as being a country that's, you know, a first world nation with high standards for lots of things.
00:14:54.700So, you know, there's no reason why we couldn't become a health care destination.
00:14:57.860And that could drive all kinds of innovation in the health care world.