Maureen Bader: Health tourism presents a great opportunity for B.C.

When B.C. health minister Kevin Falcon recently suggested that B.C.’s health-care system open its doors to foreigners with cash, the predictable and narrow-minded chorus of opposition followed. On the surface, this health tourism seems to benefit foreigners, but in reality the big winners would be British Columbians. Importing health tourists would bring in much-needed cash, help retain Canadian-trained doctors and reduce wait times for all.

Some seem to think the reason people suffer and sometimes die waiting for healthcare in Canada is because the system is overused. That’s only part of the story. People languish and die on wait lists because government rations—or limits—the amount of healthcare it supplies.

The government rations heath-care supply because healthcare costs money—the less it provides, the less tax it has to collect to spend on it. When government is the monopoly provider, and single payer, of what people believe is a “free” service, government must find the balance between providing enough healthcare to barely satisfy the majority, while avoiding having to raise taxes.

One way to bring more money into the system without raising taxes is to open it up to foreign citizens willing to pay cash.

According to a 2009 report by Deloitte, in 2007, an estimated 750,000 U.S. patients traveled overseas for health-care services. Deloitte estimates that number will grow by 35 percent each year and reach 1.6 million by 2012. In the U.S., employers and insurers are pushing health tourism as a cost-savings measure, and U.S. states are looking to pass legislation to create incentives for insurers to offer health-tourism options in their plans. Those are a lot of dollars that could be flowing into Canada rather than to other countries.

But wait, don’t we have a doctor shortage? Won’t this mean the limited number of surgeons in B.C. will leave the public system, start doing more private surgeries and leave British Columbians on longer wait lists?

Not at all.

In fact, more demand could mean the opposite—more surgeons performing more surgeries. Supply is rationed by government in a number of ways. For example, operating-room time is restricted—the government isn’t allowing surgeons to work. According to Dr. Brian Day, former president of the Canadian Medical Association, “Fifty per cent of our newly trained orthopedic surgeons and 50 per cent of newly trained neurosurgeons are leaving within five years of graduating because there isn’t enough work here.” It’s not that doctors couldn’t provide the service; it’s that government doesn’t let them.

Minister Falcon has a problem. If he were to openly explain that health-care rationing is the reason for long wait lists, he would expose what is wrong with B.C.’s health-care scheme. But, if he allows foreigners to purchase healthcare in B.C., British Columbians will soon demand the same right. When they do, the existing capacity will be used and increase the supply of health-care services. If operating-room time opens up to paying patients, some will leave the public wait lists and shorten the wait for others.

As long as people languish and sometimes die on wait lists, allowing access for foreigners remains politically unacceptable. This is a shortsighted miss of a great opportunity. The current dysfunctional economic model of health-care funding and delivery must be revised not only to allow the emergence of an international health-care industry, but to increase access for all British Columbians. Access to a wait list is not access to health care.

Maureen Bader is the B.C. director of the Canadian Taxpayers Federation.



Petey J

Mar 23, 2010 at 8:56pm

I wish She would run for Premiere of BC


Mar 24, 2010 at 5:57am

Why doesn't Ms. Bader and her team at the Federation consider a low-tax tourism holiday. They can lead groups through the lowest taxed countries in the world.

She could start with Somalia. I'm sure with no tax and little government their health-care model would be perfect. The tour would make her point so well they could wind down The Federation.

reality check

Mar 24, 2010 at 9:17am

That all sounds very nice in theory. However, foreign patients already come here for medical procedures, but has that resulted in expanded service for residents? No, because the BC government doesn't have proper payment procedures in place and has ended up with many millions of $$ in uncollectible bills.

glen p robbins

Mar 24, 2010 at 4:34pm

We need evidence where this has been successfully. Our research has indicated that there is a shortage of medical personnel not only in British Columbia but throughout the United States and elsewhere.

I don't believe this government's math--their budget's nor do I have confidence in the veracity of the Health Minister.

Ms. Badar's partial theory is not sufficient to make me change my mind.

We need a new set of 'impartial' eyes in government so that we can start with real numbers not predicate medical economics on assumptions -- that may be fabricated.

glen p robbins

Mar 25, 2010 at 10:28am

Thank you Ms. Bader

glen p robbins

Mar 25, 2010 at 10:35am

Maureen -- the link you gave me has come up "Broken" for me after a number of attempts.

thanks anyhow.

Maureen Bader

Mar 25, 2010 at 11:04am

Hi Glen. Be sure to copy and paste the entire link. It is broken in two in my previous post. If you copy the whole link, it should work.

glen p robbins

Mar 25, 2010 at 6:36pm

Thank you

glen p robbins

Mar 26, 2010 at 9:11am

The Deloitte study characterizes medical tourism as a global phenomenon. 500,000 U.S. patients went to places like India, Thailand and Singapore as medical tourists (2007). For example, a heart by-pass in the U.S. according to the study cost between 80-130 K. In India this same operation will cost less than 10K.

What is "fueling" global medical tourism? Access and affluence--the fact that everyone in developed countries are living longer {In Canada people over 60 years of age -- possess the vast majority of wealth}.

According to Deloitte "While there have been many media reports regarding the potential for this group" -- older affluent -- "to address unmet health care needs -- " -- "they have yet to be translated into actual results in the Asian medical tourism industry."

My question to BC Liberal health minister Falcon is "How do you expect British Columbia to have more success with medical tourism while Asian countries performing specialized surgeries for sometimes 10% of the U.S. cost--have yet to realize on this -- even though business is brisk--and how is the inclusion of Saskatchewan in the picture going to improve BC's chances?

How does the problem of constrained health care manifest any differently in debates about global medical tourism -- than it already does in current BC health care debates?

Was the inclusion of Saskatchewan in Mr. Falcon's model merely an opportunity to kick Tommy Douglas -- Canada's 'father of health care' and the Canada Health Act -- in the teeth.

To make any case for a different model or augmentation of our present model with new concepts for health treatment--we need significantly more math---and a number of doctors who have never been in 'private' health care to speak up -- not those who might benefit financially--they are not credible witnesses.