Globe and Mail: Ban sought on medical tourism

April 17, 2014
Kelly Grant, Globe and Mail

Ontario Health Minister Deb Matthews says the province must benefit from the hospital practice

Ontario's Health Minister has asked for an informal review of medical tourism in the province after The Globe and Mail reported on a major Toronto hospital's plan to solicit a small number of foreign patients as a way to raise revenue.

Deb Matthews has asked officials to examine the practice of publicly funded hospitals offering non-urgent care to wealthy or well-insured international patients.

She said in an interview that she is looking for recommendations on how to ensure that no public money goes into treating patients from outside the province; that no Ontarians wait longer for care; and that all money generated from fee-paying foreign patients goes back into the system.

"We have to make sure that we can be very, very clear and demonstrate that this is a benefit to Ontarians," she said. "If we can't demonstrate that we won't be doing it."

Ms. Matthews made her comments on the same day five health-care groups called on Ontario's Premier to ban medical tourism.

Canadian Doctors for Medicare, along with organizations representing the province's nurses, midwives, community health centres and some doctors and medical students, has sent a letter to Premier Kathleen Wynne asking her to provide a "clear signal" that Ontario's operating rooms and clinical facilities will not be used to treat international patients except in rare, compassionate cases.

"We call on our government to protect Ontario's public health care system, to focus on need - not ability to pay - and to close the door on two-tier health care. Please end this experiment and say that Ontario is closed to Medical Tourism," the organizations wrote.

Opening Canada's publicly funded health system to medical tourists is a divisive issue.

Supporters see it as a new, if limited, source of revenue for cash-strapped hospitals, especially in Ontario, where hospital budgets have essentially been frozen for three years.

Lisa Purdy, national health leader for Deloitte Canada, said Canada's strong global health brand, skilled physicians and respected health-care management mean the country would have little trouble attracting patients from abroad. "We can create access for Canadians by using the revenue we receive from foreign tourists who want to come here for services," said Ms. Purdy, who co-authored a 2011 Deloitte analysis of Canada's medical tourism market. "That's really a win-win."

But opponents argue that allowing international patients to pay for Canadian care - whether the money comes from private insurance, foreign governments or the patients' own bank accounts - sets the stage for wealthy Canadians to follow suit.

"We understand why hospitals are scrambling for revenue sources," said Ryan Meili, a Saskatoon family doctor and the vice-chair of Canadian Doctors for Medicare. "It's just that we ought not seek a cure that's worse than the disease."

The other signatories to the letter are the Association of Ontario Health Centres, the Association of Ontario Midwives, the Medical Reform Group and the Registered Nurses' Association of Ontario.

The Globe reported April 1 that Sunnybrook Health Sciences Centre had approved a pilot international patient program that, as of the end of last month, had treated two foreign patients: a woman from Barbados who paid $60,000 for radiation for breast cancer and a Jamaican man who paid $20,000 for radiotherapy for prostate cancer.

Sunnybrook declined an interview request Wednesday.

Toronto's University Health Network has a longer-standing international patient program which has treated 380 patients since 2011.