March 12, 2007
Medical Tourism Puts Consumers First
The phenomenon of “medical tourism” is about to set up shop in Manitoba. Our healthcare system, a provider-oriented monopoly with weak incentives for consumer sensitivity, continues to stumble along, so any new option for accessing timely healthcare is welcome. The ability to travel in order to obtain effective and affordable treatment is a small step forward for the thousands of Manitobans who are ill-served by government health bureaucracies.
One of the fastest ways to shut down meaningful debate about better health policy in Canada is to utter the phrase "two-tier health care." But we kid ourselves when we describe our current system as single-tier. Our top tier of care, in fact, is delivered south of the border, and is accessible only to the wealthy. Within Canada, private care is enjoyed by a small elite, including politicians who have pledged to prevent ordinary Canadians from exercising the same choice.
The choice, therefore, is not between a single-tier system or a two-tier system. Rather, we have to decide whether true choice and access should be within the reach of as many Canadians as possible, or only available to the wealthy and well-connected. That was the stark choice faced by Britain’s National Health Service, and they made the right one. If they can’t get service at home, Brits can cross the channel, on the government’s dime.
Travel to India is significantly more affordable for Canadians than treatment in the U.S. Any family that can afford a second vehicle has the ability to finance a $6,000 hip replacement. Of course, many Manitobans can't afford even that – but every time a patient purchases care abroad, one more name is stricken from waiting lists here. When private health care is available, everyone benefits, whether or not they personally opt for it. The very availability of other venues of treatment lessens the strain on our overburdened public system.
Questions of quality in hospitals abroad are red herrings at best, prejudiced at worst. Many of Canada's practicing physicians trained overseas. Further, a hospital in India that is competing for Western patients will be at least as accountable our own healthcare monopolies.
Medical tourism is a step in the right direction for consumer-driven healthcare. For most Canadians, the cost of treatment at the Mayo Clinic is prohibitive. Travelling to India for therapy puts private care within reach of the middle class. Even more affordable than care in India, though, would be private care right here in Winnipeg, saving patients the cost of airfare and accommodation abroad.
Rather than spending thousands of dollars if and when we need care that the government fails to provide, why can't we buy private insurance to meet this need? At the moment, Canadians can obtain insurance for psychological counselling and chiropractic, but not for a prompt physical exam or necessary surgery. Private insurance can be used to make birth control pills more affordable, but not to purchase essential chemotherapy.
Many plans provide for frills such as a private hospital room, but it is impossible to use private insurance to move from a gurney in a hallway to an actual bed. What possible justification can there be for a system that permits the purchase of luxuries but forbids us from paying for essential care? The Supreme Court ruled two years ago that Québec could not forbid private insurance for core services, and a similar case in Alberta will force that province to do the same. It’ll come to Manitoba, too.
Europe, where private insurance was never illegal, is moving toward an open market in healthcare, in which citizens of any member state can obtain treatment anywhere in the EU. New Zealand has begun offering rebates to those who purchase private insurance, just as the Australians do. As persistently as provincial governments try to buy out private clinics in Canada, new ones open.
Government healthcare monopolies are no longer sustainable. The question before us today is whether top-notch, timely care will be accessible to as many Canadians as possible, or only to a lucky few. Consumer-driven care and private insurance are the leveling tools that will improve medical care for all Canadians.
was the lead researcher on the Canadian Healthcare Consumer Index, and the lead Canadian researcher for the Euro Canadian Healthcare Consumer Index in 2007 and 2008. She has an MA in political history from the University of Manitoba.