6 things to know about medical tourism

The decision to pay for medical services outside the province is not one to be taken lightly, but I have done it twice.

Over five years ago I needed an MRI to diagnose the reason for severe knee pain. I didn’t want to wait two months for a local hospital appointment, so five days later I shuffled off to Buffalo and paid $465 for the procedure.

More recently, I had spinal  pain and for several months I couldn’t walk more than a few steps unaided. The first appointment I could get for an MRI was five months later. This time I was already planning to visit my daughter in Ottawa, so I arranged for an MRI in Gatineau, Quebec. The bill was $725 and I got a small amount back from OHIP.

Ironically, several weeks later I got a call that there was a cancellation at St. Mike’s which meant I could have had the test fully paid for. But I wasn’t sorry, because by then I had an appointment for the first of three cortisone shots for which the MRI was a prerequisite.

The Ontario government posts wait time information for various non-emergency procedures online. You can get an MRI at Markham Stouffville Hospital in as little as 35 days, but the wait time for York Central Hospital is 232 days. For cervical disc surgery nine out of 10 patients complete their procedures in 264 days, although the target wait time is six months.

But whether you need a diagnostic procedure, back surgery or cancer treatment, if your disease is progressive or you are unable to work while you are waiting for treatment, you may decide it is more cost effective to pay for care  outside Ontario sooner rather than later.

Rick Baker of Timely Medical Alternatives made the appointment for my initial MRI in Buffalo. Over the last eight years he has referred about 400 patients a year to 22 facilities in the U.S. and two in British Columbia for diagnostic procedures and surgeries. The caregiving facility pays his fees.

I asked him what you need to know if you are thinking about seeking care outside the province. Here’s what he told me:

Your facilitator:
Get references if you use a medical broker or facilitator to make hospital arrangements. You are handing over a large sum of money for your out-of-province procedure and you should be sure it will actually be paid to the facility that will provide the treatment you need. You also need to know what quality of care others have experienced.

Cost:
There is no single price across the U.S. for any procedure and it is harder for individuals to negotiate price directly. A cardiac bypass can cost between $80,000 and $120,000, which puts the surgery out of reach of many people. However, because of relationships he has built over the years, Baker says his clients pay much less at a top cardiac facility.

What’s included:
Make sure any quotes for the cost of your surgery are all inclusive. The price should cover the initial consultation, the surgeon, the surgeon’s assistant, the anaesthetist, the facility plus any implants or supplies. Otherwise, you could be in for a surprise when you get the final bill.


Where to go:

If possible, have your procedure done in Canada or the U.S. in case an immediate return to Canada is necessary due to surgical complications. Other considerations are the safety of the blood supply and the country’s political climate.

Furthermore, a Mayo Clinic study reveals the likelihood of experiencing a pulmonary embolism increases 30-fold when a surgical patient flies more than 5000 miles before or after surgery.

Bring your own drugs:
Drugs are much more expensive in the U.S. For example, if you have to fly to the city where your surgery will take place, you will need blood thinners before you return home. A typical course of blood thinners prescribed by an orthopaedic surgeon can cost $1,200 south of the border. Therefore it is preferable to have the surgeon talk to your Ontario physician so he can write prescriptions for any drugs you will need to take with you.

Follow up care:
If upon your return you have unexpected complications, you can go to the emergency department in any Ontario hospital to be treated as long as you have an OHIP card.

In some cases where treatment for a life-threatening condition are not available in Ontario or wait times are unreasonable, OHIP will agree to pay for all or part of the procedure. However for this to occur, permission from OHIP must be obtained in advance.