Monday, November 5, 2007

Make U.S.-obtained healthcare 100% deductible from Ontario tax bill

This story from the Toronto Sun, Nov.5, 2007:

"After watching her son suffer, a distraught mom decides to foot a $65Gs bill for surgery in Detroit while OHIP drags its feet

By Michelle Mandel

If patience is a virtue, should it also apply to a mother watching her son suffer in pain?
Pat Hopkins thinks not.
So there is now a new bank loan on her house, strains in her marriage and worries as to how she and her retired husband will repay more than $65,000.
While OHIP drags its feet.
But her son Billy had the neck surgery he needed a few days ago. It meant taking him to a Detroit hospital that could fit him in right away, rather than the year it would have probably taken here at home.
Her son is 31, born with cerebral palsy that left him with a slight gait while walking and a right arm that was sometimes frozen at his chest in a bent position. Despite his physical disability, he was an award-winning athlete as a teen, an avid snowboarder and worked full time -- as a roofer, of all things.
In 2003, though, he slipped on stairs and injured his neck. It took almost 12 months before he finally underwent surgery at St. Michael's Hospital. After the operation, though, he was back walking and on the job.
Then last June, Hopkins fell again. He lost his balance on the stairs at home and when he went to grab the handrail, it came away from the wall, sending him reeling backwards and crashing to the floor. When he went to the emergency department in Oshawa, they told him the X-ray only showed his old injury and released him with Tylenol.
As the months went by, he felt increasing numbness in his hands and feet and walking became increasingly difficult. Finally, it got so bad that he could no longer work.
Their family doctor was having trouble getting him in to see a neurologist. On Sept. 5, Hopkins was in so much pain that he went to the emergency at St. Mikes and after nine hours of waiting, was told he needed an MRI and they would call him.
The call didn't come.
Meanwhile, his mother was helplessly watching her son's mobility deteriorate before her eyes. Pat Hopkins, 54, was confiding her anguish to her girlfriend in Michigan when her friend said she'd see what she could do.
A short time later, Hopkins had an appointment with a neurologist at Henry Ford Hospital in Detroit.
A $6,000 MRI showed Hopkins had suffered significant new damage to his neck from the fall in June. He needed an operation that would cost at least $40,000.
They tried to follow the proper procedure. On Sept. 27, Hopkins' family doctor applied to OHIP for pre-approval of the out-of-country surgery. According to its regulations, OHIP will pay for operations outside the country if the "delay in getting the same treatment in Ontario would lead to death or medically significant tissue damage."
To everyone involved, it was obvious that any further delays would mean Billy would soon not be walking at all. The odds of OHIP approving the operation also seemed to be in their favour -- last year OHIP allowed 5,799 out-of-country cases and denied 707 applications.
Since the family were told it takes about two weeks for a decision, the young man scheduled his operation in Detroit for Nov. 1, giving the bureaucrats five weeks to reply. But the date for the surgery arrived a few days ago and there was still no word from OHIP.
A spokesman at the ministry said they try to make their decisions as quickly as possible -- but they cannot comment on specific cases.
Without approval in time, Hopkins' mom had to write the hospital a $30,000 cheque as a deposit for the operation last week while his dad went to get a loan from the bank.
So she is calling to lament the poor state of our health-care system, of how months had passed without a proper diagnosis and months more would have elapsed before her son would have received the surgery he so badly needed.
And now she is left with a growing American hospital bill they can ill afford.
You ask, ever so gently, whether they should have postponed the surgery until they received approval from OHIP? His mom is defiant -- as surely as any mother would be in a similar situation.
"How long will we have to wait?" she asks in exasperation. "Until he's paralyzed before they make a decision?
"If I don't get reimbursed, I'll be a hell of a lot poorer," she adds, "but at least my son will still be able to walk. He's fought too hard all his life to go to school and work, to give up now."
So patience may be a virtue, but a mother's love trumps it every time. "

This from the Toronto Sun, November 4, 2007:

"Cross-border medicine
Shorter lines, more doctors, high-flying loonie has Canadians flocking south


A soaring loonie isn't just good news for cross-border shoppers looking for a good deal on running shoes and plasma televisions.
Suddenly private health care in the U.S. is 30% more affordable.
American clinics have always been an option for patients in this province who want speedier access to health care than our one-tier public system can offer. What's more, this province has a doctor shortage. The U.S. does not.
Joanne Thompson knows all too well the heartache that happens when a loved one needs care in this province -- and can't get it.
Thompson, city editor at the Sault Ste. Marie Star, needed to find an MRI in May for her sister, Jennifer Abbott. A partial paraplegic, Abbott was fearful of the enclosed type of MRI machine, but the wait for a test on an open MRI in the border city was three to five months -- far too long for the neurological condition she suffers from.
So Thompson checked the ads and found a clinic across the border in Michigan that offered same day service for an open MRI -- two hours away.
"Her condition was such that we were too worried to wait any longer," Thompson said in a telephone interview.
"We were able to get an appointment the next day. To me that was unbelievable," she said. And she didn't mind paying a few hundred bucks out of pocket.
"When you can get an MRI within a day, it's worth a few bucks," she said.
Of course, Canadians have shopped for health care in the U.S. for decades. What's new is now it's 30% cheaper.
Windsor family physician Dr. Albert Schumacher is a consultant for the Detroit Medical Centre (DMC). Associated with Wayne State University, DMC is the largest group of teaching hospitals in Michigan. It has nine hospitals three miles from the border. He worries that Canadians seeking care in the U.S. may be attracted by cut-rate clinics. Schumacher's been working with DMC to provide quality care at affordable rates for cross-border health care shoppers.
"You have a lot of peripheral and suburban places not affiliated with brand name institutions that are doing a lot of stuff," he says. Prices for MRIs, colonoscopies etc., at quality institutions in the U.S., are higher than those in Canada. An MRI can cost as much as $1,800. He's working to get Canadians what he calls the "Montreal price." If patients in this province are, in effect, bulk buying from DMC, then they get a better price than a one-off patient from, say, the Middle East would.
Bariatric surgery -- stomach stapling -- is another procedure that is popular with cross-border health shoppers, since there's a shortage of service here.
It's hard to get an accurate count of just how many Ontarians are looking south for treatment, because there's a reluctance to talk about it, Schumacher says.
"There is a huge politics of resentment in this country. If somebody can get care somewhere else, many people are resentful of that, so therefore they don't talk about it," he said.
"If the airline industry was like health care, we wouldn't have first class in Air Canada, because people wouldn't want that to happen. They get very resentful about that," says Schumacher, who is a former head of the Canadian Medical Association (CMA) and the Ontario Medical Association (OMA).
This province just doesn't have the medical staff or the resources to provide the same level of care as the U.S.
Essex County, where Schumacher practises, with a population of 400,000, until recently had only two CT scanners and one MRI machine. They just got a second MRI. Across the border in Port Huron, Mich., population 12,000, they had four MRI machines 10 years ago, Schumacher says.
He points out that despite the new satellite medical school in Windsor, the 2,400 doctors that will be enrolled starting in 2010 will still only give the country 80% of self-sufficiency for doctors.
"The simple math is for every five of me practising here, Western Europe has six and we are only training four to replace us, so the crisis gets worse on a daily basis," he says.
The OMA estimates this province is short more than 2,000 physicians -- all just numbers and statistics for politicians, perhaps. But for Joanne Thompson and her sister, these figures add up to one thing: Prolonged suffering. And the cure? A passport -- and shopping trip. "

Just as I wrote in my earlier blog (see: Liberal Healthcare Duplicity): get a passport ...and a lawyer, because you'll probably need one to fight OHIP or OHSARB, its appeals branch. Sadly, I bet they anticipate that by and large, patients will just be too sick to take it that far, or will have already died. Again I ask -why does it take so long for OHIP to process essentially life-threatening situations? The Billy Hopkins scenario isn't the only one I've read about that occurred under Dalton McGuinty's and Smitherman's watch. McGuinty's Liberals could care less about patients suffering - it's the appearance of having medicare they're trying to save. You know, the kind of medicare even Belinda Stronach "had" in Ontario, but actually got in the States. Doesn't George Smitherman know how many Ontarians are going to the States for healthcare?

Maybe American-delivered healthcare expenses should become a 100% deduction from the Ontario portion of our income taxes.

No comments: