Juno News - Canadians are heading to other countries for healthcare

00:00:00.360 Welcome 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.

00:00:09.560 This 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,

00:00:17.320 and I've covered a fair bit about some of the battles we see going on in this system.

00:00:22.200 But 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,

00:00:34.920 or 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.

00:00:43.340 We assume that just everything's fine, everything's hunky-dory, but for a lot of Canadians that isn't in fact the case.

00:00:49.400 I 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.

00:00:57.420 Well, thanks for having me, Andrew.

00:00:58.780 So tell me about this report here. You found the top-line number here, 217,500 Canadians left the country for healthcare in 2017.

00:01:08.840 Did 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?

00:01:17.780 You know, it was higher than what I thought, just based on some of the previous estimates that had been out there.

00:01:25.260 The 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.

00:01:33.900 So, you know, 217,000 people specifically indicating that healthcare was the main purpose of their trip in 2017.

00:01:41.800 That'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,

00:01:51.960 well, we're talking about at least four sellouts of the Blue Jays Stadium. That's a lot of people.

00:01:56.860 If you think about Barrie, Ontario, the greater Barrie, Ontario area, I mean, it's more than that population.

00:02:03.580 It'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.

00:02:10.720 And the way that we got the data was from Statistics Canada.

00:02:13.740 And what they do is they will survey Canadians when they return back to the country and they'll ask them questions.

00:02:21.460 And one of them is, well, what was the main purpose of your trip?

00:02:24.620 And health care or medical reasons is one of the possible responses.

00:02:28.440 So we said to StatsCan, OK, can we get some data? How many Canadians are reporting that?

00:02:33.360 And so that number that you and I, we just talked about, the 217,000, that's on the low end.

00:02:38.380 That figure doesn't include Saskatchewan, Newfoundland, Prince Edward Island or Nova Scotia.

00:02:46.220 And the reason is because for those provinces, the sample sizes were a bit small.

00:02:50.300 And so StatsCan said, here's the numbers, but we would caution against using them because you have to be careful.

00:02:55.180 So we just said, OK, well, we're not even going to we won't include those.

00:02:58.720 So it's actually higher. And for some other technical reasons, it would be higher, too.

00:03:02.900 So that's sort of the low end. At the higher end, it's around three hundred and twenty four thousand.

00:03:08.400 So, you know, to use the Rogers Center example, that'd be six sellouts for Blue Jays game.

00:03:13.180 So 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.

00:03:19.260 And, you know, just know, too, that's just patience.

00:03:22.700 Yeah. And that works out to be, I think, just shy of about six hundred a day as well.

00:03:26.740 So we're not talking about an insignificant number here.

00:03:29.240 And more importantly, I think it cuts to that issue of what do they need to go over there for?

00:03:35.740 And I know that you're looking at the numbers, not the rationale.

00:03:38.820 But I know that you've also done some supplementary research to this, looking at some of the stories of people that have gone.

00:03:45.000 And I'm wondering what those key reasons are, because some people would say, oh, it's just impatience or something like that.

00:03:51.060 But 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?

00:03:58.520 Yeah. And I'm glad you mentioned that, because that is one of the limitations on the data is that we we have the numbers.

00:04:03.960 We don't know the why. And, you know, stats cancels.

00:04:07.280 Well, why are you going? But or what was the purpose of your trip?

00:04:10.560 But it doesn't say, well, what type of health care are you receiving?

00:04:13.100 So it's quite possible that some of those people left for dental.

00:04:16.660 We've heard of cases of that where someone goes to another country for dental care because they can get a better deal.

00:04:22.380 In some cases, some people are probably traveling for a procedure that's simply not offered in Canada.

00:04:27.480 So I think of the MS treatments that some people were going to Germany for.

00:04:31.800 So that would be an example. But, you know, those are anecdotal.

00:04:35.340 And we've certainly heard a lot of cases where people are going for things that are offered by the Canadian health care system.

00:04:42.200 But the waiting lists are just too long.

00:04:44.860 Hip replacements, knee surgery, MRI scans, lots of things like that, where Canadians are kind of hitting this wall in our system.

00:04:53.480 And then they look around. So the government saying you're going to have to wait a long period of time.

00:04:56.600 And 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.

00:05:08.160 So then they think, OK, well, what are we going to do? We're going to have to leave the country for health care.

00:05:12.460 And so we've seen a lot of examples of that.

00:05:16.580 I'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.

00:05:27.660 It's it's happening. And, you know, the the stereotype that people will say is that, oh, it's just the rich doing it.

00:05:34.580 Well, 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.

00:05:41.360 So 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.

00:05:52.440 They don't want to wait for months and months and months while a disease is potentially spreading throughout their body.

00:05:58.260 It'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.

00:06:06.260 I'm glad you mentioned that line about the rich because you're right.

00:06:09.280 And I've heard that a lot. People say, oh, it's just the rich doing that.

00:06:12.520 But 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.

00:06:29.160 Yeah. 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.

00:06:43.160 But 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.

00:06:51.320 According to Fraser Institute data, they've been looking at the situation for 25 years, and that's the big picture.

00:06:57.120 Waiting lists have doubled.

00:06:58.000 And 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.

00:07:07.540 In the case of Jenny McKenzie, we did a little video.

00:07:10.520 We put it on our Facebook page and YouTube and website and all that.

00:07:13.260 And we talked to her about her experience.

00:07:15.960 So 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.

00:07:30.140 And so, you know, in the meantime, you know, this was a lady who had a very active lifestyle before her hip problems really began. 1.00

00:07:37.260 You 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.

00:07:43.560 You know, she'd go to the gym regularly.

00:07:45.400 She liked to go out to go to Spanish lessons and meet with her friends for coffee and so forth.

00:07:51.340 She had grandkids that she liked to babysit and watch on that. 0.94

00:07:54.100 So she had a very active lifestyle.

00:07:56.620 And since her hip problems have began, now she's largely confined to her apartment.

00:08:01.580 It's very hard for her to get around.

00:08:03.140 She walks with crutches.

00:08:04.300 She's living in pain.

00:08:05.160 She's been prescribed medication.

00:08:07.520 I 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.

00:08:18.180 So there's lots of stories like that out there.

00:08:21.140 And, you know, in her case, she couldn't afford a private hip operation. 1.00

00:08:25.120 But certainly when you allow those procedures in the country, some people will decide.

00:08:30.100 They'll pay out of pocket and then they come off of the waiting list and someone else gets bumped up.

00:08:35.720 So, 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.

00:08:47.100 And countries that do that, that Canada competes with, their health care systems have better results.

00:08:51.820 And I know you mentioned it before, but just to reiterate, this isn't just going from Canada to the U.S.

00:08:57.060 This is theoretically anywhere in the world, correct?

00:09:00.440 Yeah, it's anywhere in the world that people are going.

00:09:02.840 But there is still, I think, for people that live near the border, probably an easier time getting to the U.S.

00:09:08.740 And 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.

00:09:14.380 You actually took a road trip to Bellingham, Washington, which is not far from Vancouver, not far from Abbotsford, B.C.

00:09:20.600 And it was interesting because you went to a medical center and I saw the video.

00:09:23.980 You're going around finding all these B.C. license plates in the parking lot.

00:09:27.900 And I live about an hour from Port Huron, Michigan.

00:09:29.880 So I see the Ontario plates in the Olive Garden and the Walmart parking lots.

00:09:33.620 I'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.

00:09:39.780 But 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.

00:09:48.600 Yeah, exactly.

00:09:49.780 And, you know, it wasn't the most exciting of road trips.

00:09:53.040 It wasn't like a thank you over the border.

00:09:55.480 But, yeah, I had a great, great time.

00:09:57.160 Chris is a great person to work with.

00:09:59.580 Yeah, I can imagine the border guard, purpose of your visit.

00:10:01.580 So we want to look at license plates in a hospital parking lot.

00:10:04.200 But, OK, sure.

00:10:06.300 Yeah, not the most exciting of trips, but, yeah, it was good.

00:10:09.500 You know, we got up at the crack of dawn and we left and got in a car and we didn't know what to expect.

00:10:13.820 We thought, well, let's see.

00:10:15.400 So we drove down to Bellingham, Washington.

00:10:17.520 And like you say, we drove around the parking lots.

00:10:19.680 We tried to be careful because there are some staff parking lots versus patient in them.

00:10:24.220 So we tried to think, well, you know, we don't want to look at the staff side.

00:10:27.800 And we did actually see some Canadian license plates on the staff side, including one in a physician spot.

00:10:34.540 But, yeah, in the patient side, even on the street, we saw lots of BC plates.

00:10:40.940 And, you know, just to be clear, this was a health care campus or a major complex kind of thing.

00:10:47.200 Right.

00:10:47.320 So 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.

00:10:54.840 It was it was all health care, different types of clinics and and so forth.

00:10:59.860 And, you know, we tried to talk to a patient, you know, getting into a car with a BC plate.

00:11:05.420 But unfortunately, we just didn't see any.

00:11:08.700 So, you know, we did look for that.

00:11:12.440 We're unsuccessful.

00:11:13.400 But what we did find is we went into one of the clinics that we talked to a lady there and we said, well, you know, this is interesting.

00:11:19.660 We're seeing lots of BC plates.

00:11:21.200 Do you get a lot of Canadian patients coming down?

00:11:23.300 And 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.

00:11:29.100 But, you know, they receive a certain type of health care at that complex.

00:11:32.680 And, you know, it's sort of anecdotally what's backing up these big picture numbers that we've uncovered.

00:11:38.460 And that is that there's a lot of people that are crossing the border for health care.

00:11:41.820 So 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?

00:11:56.740 Well, 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.

00:12:10.140 And it's a lot. There's the cost of the procedure, for starters.

00:12:14.700 There'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.

00:12:21.140 I mean, there's there's a varying range of costs there.

00:12:23.880 There's accommodation costs.

00:12:25.260 There's also the cost of food and lodging.

00:12:29.620 You know, there's a lot of different expenditures that go into these trips.

00:12:32.400 And 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?

00:12:43.000 And 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.

00:12:52.160 So I think there's a real economic opportunity.

00:12:55.340 And, you know, just as food for thought for your viewers, you know, we talked about how many patients are leaving.

00:13:00.800 Well, in many cases, patients don't go alone.

00:13:03.080 They go with a spouse or a loved one or a friend or whatever the case may be.

00:13:07.280 So 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.

00:13:14.480 And so, you know, the numbers get even higher and people can see them if they want in our report.

00:13:18.380 But 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.

00:13:30.820 Yeah. And obviously, I have no basis for this number.

00:13:33.160 But even if each of those people was investing, say, $10,000 overall, I mean, we're talking about billions of dollars a year.

00:13:40.920 And then over the course of several years that's being spent outside of Canada, I think that's a great point you raise.

00:13:45.760 Yeah. And so we do have a few numbers in the report.

00:13:50.360 And 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.

00:13:58.400 So we have some data on how much Canadians are spending a day in other countries on health care.

00:14:03.880 It's about $1.9 million a day.

00:14:05.840 But those figures wouldn't include some of the other activities that people sometimes do on a health care trip.

00:14:12.600 And that is that, you know, if you're getting open heart surgery, you're not going to a rock concert that night, right?

00:14:18.000 If you're in another country.

00:14:19.640 But 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?

00:14:26.060 Because you can still walk around and do shopping and function and that, or maybe you go to a baseball game or whatever abroad.

00:14:31.960 So those costs aren't included.

00:14:33.660 But, yeah, there's an economic opportunity there for Canada to keep some of these dollars here and even potentially become a medical tourism destination.

00:14:42.280 You 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.

00:14:46.540 Well, 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.

00:14:54.700 So, you know, there's no reason why we couldn't become a health care destination.

00:14:57.860 And that could drive all kinds of innovation in the health care world.

00:15:01.080 Great perspective.

00:15:01.920 Colin Craig joining me, president of SecondStreet.org.

00:15:05.140 SecondStreet.org, of course, where you can find this.

00:15:07.200 And we'll also have a link up at True North.

00:15:09.300 Colin, thanks so much for your time and really great work on this.

00:15:12.200 Okay.

00:15:12.560 Thanks a lot, Andrew.

00:15:16.540 Thank you.

Juno News - March 18, 2019

Canadians are heading to other countries for healthcare

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