Skip to comments.Critically ill [Canadian] patients rushed to U.S. for care
Posted on 01/20/2008 10:34:27 AM PST by John Jorsett
More than 150 critically ill Canadians many with life-threatening cerebral hemorrhages have been rushed to the United States since the spring of 2006 because they could not obtain intensive-care beds here.
Before patients with bleeding in or outside the brain have been whisked through U.S. operating-room doors, some have languished for as long as eight hours in Canadian emergency wards while health-care workers scrambled to locate care.
The waits, in some instances, have had devastating consequences.
There have been very serious health-care problems that have arisen in neurosurgical patients because of the lack of ability to attain timely transport to expert neurosurgical centres in Ontario, said R. Loch Macdonald, chief of the division of neurosurgery at St. Michael's Hospital in Toronto. Those problems, he said, include brain injury or brain damage that could have been prevented by earlier treatment.
Ontario has the worst problem, though it is not alone.
British Columbia has sent four patients with spine injuries to Washington State hospitals for care from May to September, 2007, though the recruitment of more staff and opening of new beds have helped alleviate the problem. Saskatchewan has sent patients to neighbouring provinces such as Alberta, which is working at maximum capacity for specialized neurosurgical services.
But nowhere is the problem of accessing neurosurgery more severe in this country than in Ontario. Since April of 2006, 157 people have been sent to Michigan and New York State hospitals for care. That includes the 62 patients sent so far in fiscal 2007-2008, according to David Jensen, spokesman for the Ontario Health Ministry.
When asked if any patients transported to the United States had died, Mr. Jensen said the ministry does not specifically record the outcomes of health services provided out of country.
Patients being sent to U.S. hospitals are in the midst of acute medical emergencies, including head injuries, broken necks and hemorrhagic strokes, such as a brain aneurysm that has ruptured.
Unlike other cases where patients have been sent to the U.S. for care such as radiotherapy for cancer patients this is the first time doctors have categorically equated delays in obtaining treatment with poorer patient outcomes.
Tim Rutledge, former chief of emergency medicine at North York General Hospital, said physicians are spending many hours trying to find neurosurgical services.
When someone starts to bleed in their head, you don't have a lot of time. You have to take these patients stat, said Dr. Rutledge, who was asked to represent the concerns of Ontario emergency-room physicians before a provincial panel studying access to neurosurgical services. Not only is waiting traumatic for patients and families, he said, but it's immensely stressful for emergency personnel to watch a patient deteriorate before their eyes while they try to access care. Deterioration, he said, comes in the form of loss of limb function, seizures and comas.
Despite the urgency of these cases, patients encounter barriers to accessing care at every turn. The problems include: limited access to teleradiology; limited operating-room time; too few intensive-care beds; a short supply of neurosurgically trained intensive-care nurses to staff them, and too few neurosurgeons.
In some cases, neurosurgeons are available to operate, but with intensive-care beds full, there simply is nowhere to put them afterward.
Even the method of funding neurosurgical services is an enormous disincentive. Neurosurgery is funded out of fixed, global hospital budgets and is viewed as a financial drain. Orthopedic surgeons, by comparison, are seen as money makers: The more operations they do, the more their hospitals are reimbursed.
Tom Chan, chief of emergency at Scarborough Hospital, said the process is frustrating for emergency-room doctors, who are the first to see these patients. Typically, the patients come in having had a seizure or complaining of severe headaches, numbness, confusion, or vomiting.
My hospital is 20 minutes from the best neurosurgery in the country if not the world and we can't get to it, said Dr. Chan, who described the situation as crazy.
When Alan Hudson, head of Ontario's waiting-time strategy, heard about the problem, he immediately struck a panel to study it. The solution to fix this is within sight, said Dr. Hudson, a former neurosurgeon and hospital president. What it requires is some organization.
To that end, the Ontario government in November provided an additional $4.1-million to Toronto's University Health Network, to do 100 more neurosurgical cases by October, 2008.
Catherine Zahn, executive vice-president, clinical programs and practice at the University Health Network, said the additional government funding is having an impact, though she conceded the pace is not sustainable as more neurosurgeons are needed. She stressed that the government and her institution are working together to address the problem.
And yet, governments were warned of a shortage of neurosurgical services five years ago. In August, 2003, a report co-authored by Chris Wallace, head of the division of neurosurgery at Toronto Western Hospital, said that increasingly, the resources are not available to handle neurosurgical emergencies.
At that time, in fiscal 2003-2004, fewer than five patients were sent to U.S. hospitals for care. One year later, 10 patients were sent. That number doubled in 2005-2006, according to Ontario Health Ministry figures.
Dr. Wallace's report mentioned four main areas of concern and made eight recommendations to improve access to neurosurgery and to plan for the unplanned.
It has started to reach capacities that are not tolerable and that's what has caused the groundswell and the concern, Dr. Wallace said in an interview. He described the situation of travelling to the U.S. for care as intolerable for the critically ill.
Two more reports on the difficulties of accessing neurosurgical services followed. An October, 2003, report by Charles Wright found there was a significant shortage of neurosurgeons in some centres. Two years later, a report by the Institute for Clinical Evaluative Sciences said demands were being met by very few surgeons with high workloads, which is not sustainable.
Now, a fourth report, authored by James Rutka, appointed by the provincial government to head the neurosurgery expert panel, has listed about 20 recommendations to solve the problem.
The report by Dr. Rutka, chairman of the division of neurosurgery at the University of Toronto, was provided to government in late December. It recommends a two-phased approach: allocating additional neurosurgical services to one hospital to address emergency out-of-country transfers immediately, and increasing capacity in more centres in Ontario.
Where will the poor Canadians go if Hillary wins?
Many of these poor souls, near dead to begin with, probably didn’t survive being transported 100 miles to the US.
But at least they had a chance.
At least they were not left to die like dogs in the street in the medical hellhole of Canada.
And speaking of hell, these is a special place in aforementioned nether region for the truly despicable, dishonest Michael Moore and the US demcrat party leadership propagandizing for Canada’s nightmarish plan.
Buffalo, NY is one of America’s great decaying cities. They really should take advantage of things like then however they can. Perhaps Buffalo can be rebuilt by Canadians who want out.
Not a bad idea.
Many new businesses sprang up in Buffalo when we had the socialist Ontario leader Bob Rae - he sent Canadian small business owners south of the border faster than our high dollar sends shoppers.
It is interesting in light of this that the Democrats are so focused on some form of nationalize health care.
Well spoken. If you want proof that the left intends to grossly underfund healthcare think Medicaid and the Indian Health Service.
Recently, I have been adding examples like this to the wikipedia article on Caandian health care. So I just added a quote from this article.
Here are the things that I added over the past few weeks. The quote from your article appears at the very end:
Health care in Canada
A March 2, 2004 article in the Canadian Medical Association Journal stated, "Saskatchewan is under fire for having the longest waiting time in the country for a diagnostic MRI a whopping 22 months." 
A February 28, 2006 article in The New York Times quoted Dr. Brian Day as saying, "This is a country in which dogs can get a hip replacement in under a week and in which humans can wait two to three years." In a 2007 episode of ABC News 20/20, host John Stossel cited numerous examples of Canadians who had difficulty accessing health care.
Medical professional shortage
According to a 2007 article, the Canadian medical profession is suffering from a brain drain. The article states, "One in nine trained-in-Canada doctors is practising medicine in the United States... If Canadian-educated doctors who were born in the U.S. are excluded, the number is one in 12." 
Restrictions on privately funded health care
In a June 13, 2005 editorial, the Wall St. Journal wrote, "Canada is the only nation other than Cuba and North Korea that bans private health insurance," ... the editorial provides an example to illustrate its point: "When George Zeliotis of Quebec was told in 1997 that he would have to wait a year for a replacement for his painful, arthritic hip, he did what every Canadian who's been put on a waiting list does: He got mad. He got even madder when he learned it was against the law to pay for a replacement privately." 
In 2006, a Canadian court threatened to shut down one private clinic because it was planning to start accepting private payments from patients. According to The New York Times, although privately funded clinics are illegal in Canada, many clinics are opening anyway, because patients don't like the long waiting lists in the government system. 
In a 2007 interview on ABC News, Professor Regina Herzlinger of Harvard Business School said, "Many clinics all across Canada are illegal for-profit... They know they can't get the health care they need from the legal system, so they're complicit in creating an illegal system that'll give them what they need." 
Canadians visiting the U.S. to receive health care
According to a September 14, 2007, article from CTV News, Canadian Liberal MP Belinda Stronach went to the United States for breast cancer surgery in June 2007. According to the article, Stronach's spokesperson Greg MacEachern said that the United States was the best place to have this type of surgery done. The article also says that Stronach paid for the surgery out of her own pocket. Prior to this incident, Stronach had stated in an interview that she was against two-tiered health care.
When Robert Bouressa, the Premier of Quebec needed cancer treatment, he went to the U.S. to get it.
In 2007 it was reported that Canada sends scores of pregnant women to the U.S. to give birth. In 2007 a woman from Calgary who was pregnant with quadruplets was sent to Great Falls, Montana to give birth. An article on this incident states, "There was no room at any other Canadian neonatal intensive care unit."
Champion figure skater Audrey Williams needed a hip replacement. Even though she waited two years and suffered in terrible pain, she still did not get the surgery, because the waiting list was so long. So she went to the U.S. and spent her own money to get the surgery.
A January 19, 2008 in The Globe And Mail states, "More than 150 critically ill Canadians many with life-threatening cerebral hemorrhages have been rushed to the United States since the spring of 2006 because they could not obtain intensive-care beds here. Before patients with bleeding in or outside the brain have been whisked through U.S. operating-room doors, some have languished for as long as eight hours in Canadian emergency wards while health-care workers scrambled to locate care." 
I hope we are not helping to subsidize those patients with US tax dollars or worse, with higher domestic rates as we do to subsidize their cheap meds.
Where will the poor Canadians go if Hillary wins?
forget the canucks....where will the US taxpaying public go???
They will die like dogs in the streets. Hillary and the crooked democrat politicians will be cared for in luxurious style, while you are kicked out of the ER, covered in blood.
YEP, exactly what YOU said. When we lived in Vancouver, BC there was a big hullabaloo over the local politicians being able to get in to see doctors, but not the everyday guy....why? Well...you figure it out....
Excellent work. Next time I get into an online argument about the merits of the Canadian system, I’ll be sure to arm myself with info from your Wikipedia collection.
I have not the slightest doubt about this. I would LOVE to have documentation, but I read Canadian "newspapers" enough to know how they are engaged in a colossal cover-up of socialist misbehavior.
The key point of failure for the US healthcare system is the rapidly increasing cost of any type of medical procedure. Competition of services is the only way that we will drive them down, and it simply isn’t happening.
This is work for the ailing Michigan economy.
I’m sure the Canada must pay to going rate.
A socialist country like Canada wouldn’t stiff the US hospital, would they?
How about facing the real problem head on: Deny all medical services (except for life-saving measures) to everyone in this country illegally.
Where will Americans go...
Or the VA...
Homer says, “MMmmmmmmm, socialized medicine.....aaaaaaaagghh”
I stopped by the hospital.
Access to a line is not the same thing as access to health care.
The whole tax structure of hospitals and ownership needs to be addressed. The American medical association needs to be run out of the country.
Lost my Canadian Aunt and Uncle within a year of one another. Uncle was having a simple hernia repair operation when he suffered a massive heart attack on the table...and they couldn’t save him.
Aunt had stomach cancer. By the time she finally got to the top of the list for surgery to remover her tumors, it was too late and she, too, died after they opened her up, shrugged, sewed her back up and sent her home.
Yep. I can’t WAIT for FREE health care in America. /sarcasm
2 related snippets from Germany:
-A dear friend of the family is from Germany. Her mother was visiting her in the States. The mother had been having chest pain but was being treated with medicine because seh was considered to old for surgery in Germany. American surgeons did bypass surgery.
-An acquaintance took a job working for a base in Germany as a local national employee rather than as a GS. The health insurance appealed to him. As a “local national” he is paying the German income tax of 50%. Oh, and then there is the 19% Value added tax, TV tax, church tax and on and on it goes.
After we get Hillary/Canadian care we can go to Mexico for emergency health care or Cuba. Moore says Cuba has world leading health care why doesn't the Canadian government send their very sick there?
I have an uncle in Manitoba that needed heart surgery. He lived in a small town 300 miles from Winnipeg. They (the ambulance) drove to the big city and the hospital examined him. He had had a heart attack. Sent him BACK to the small city for a week, then brought him back to Winnipeg, told him he needed a three way bypass, flew in a doctor from New York for the surgery, and he gave him a five way bypass. Of course, he had been a city counsel member some years back. My uncle is VERY fortunate that he is still alive and didn’t die.
Another uncle was not so fortunate and he could only get a bed just before he died. He had only been an average joe sales man.
My mom does not believe the city counsel uncle had any special treatment. I do.
I remember clearly when in Germany, and we lived in the German community rather than the Army base, the locals speaking of those who were deemed better made comfortable than treated.
Apparently, they practice planned obsolescence rather than repair.
It is far cheaper for Canadian socialized health care to issue a death certificate than to treat a live Canadian.
But, either way ...... It's FREE!!!
That’s an unthinking emotional statement typical of the very people I suspect you despise, democrats and communists and fascists. I think you shot from the hip and are NOT a liberal but that comment sure makes you sound like one.
The bill and the actual cost are of course different, and however high they are it is a direct result of what the fascists have already done by force over a period of YEARS to the free market in this land.
Moreover, the medical system would be happy to provide 1960s level care at a very cheap price but when people demand absolutely the best care with minimal risks, care that was not even possible a few years back, then why is it any surprise that it is expensive.
What're you living in a fantasy world? Those in office...just know how to pander to illegals and Mexico. It'll NEVER happen.
There has not been a free market in the medical profession for nearly all of my life. As long as the America medical association is allowed to control the number of medical schools and students. And thus the number of doctors and to further fix the market where a start up hospital would need to provide a certificate of need to be licensed, it is a fixed market.
You are right. No one will face the root of the real problem head on.
Nope...it’ll never, ever happen. Too late and too far gone.
Hasta la vista, America.
I am intentionally NOT a member of the AMA as it is most certainly fascist. However, you give it far more credit than it deserves as a force destroying the free market in medicine. It is not the AMA, but the US Government, with all its minions including the several United States of America, who hold the market hostage by illegally confiscating tax money and refusing to return it unless States “comply,” which by force has distorted the free market in medicine. And by insurance regulations. And by deceptions like taxing most medical expenses unless an employer provides them. The AMA is just a weak little pawn of those fascists. Any supposed lack of doctors and lack of hospitals because of regulation of medical schools and hospitals (again not done by the AMA, but by the Feds and coerced states) is not what makes medical costs high anyway.
The good guys (who by the way, include me as a member) sued Hillary and her secret task force in 1993 and were the most important medical organization in opening eyes about the Rat fascist plans are the AAPS (Association of American Physicians and Surgeons). Check out the AAPS for a Freep-o-licious breath of fresh air.
Controlling physicians is widely acknowledged to be more difficult than herding cats, and it drive the fascists crazy, and thank goodness, or else fascism in medicine would be much further advanced, and you would be scapegoating physicians and hospitals even more inappropriately.
The US do not just permit medical care. They subsidize it! The several United States of America, with Federal coercion, basically ALL have programs that INTENTIONALLY provide predictable, long-term, expensive services to aliens.
For example, in Texas there is a "Title V" program (link) that provides completely free pre-natal care and delivery to pregnant women who for some reason do not qualify for Medicaid, but would have qualified based on "income."
The alien mother-to-be is actually identified as a non-citizen (but no questions are asked about her lack of a valid social security number or whether or not she is here legally), and therefore, since as an alien she does not qualify for Medicaid, she is instead qualified into the "Title V" program. No one can say anything about an illegal immigration status because it would “violate medical confidentiality.” Then, after nine months of free services, she has her baby in a US hospital, and the baby is instantly a US citizen in the Medicaid program. There are hundreds of babies born in this manner every day in Texas, and in many cases the mother returns here over and over for each pregnancy. This kind of American kind-heartedness with utterly no political blowback here in the States or back to Mexico makes it even easier for the corrupt Mexican government to continue to mistreat its own people.
And what do you think, would anyone who questions this unconstitutional mess be branded a racist?
Remember Section 4507 of the 1997 Balance Budget Act on hillary’s health care?
Two years ago I had a stent put in. I was in the intensive care for two days after. The bill was 83 grand. Lucky enough that my wife had ins thru her place of work. I cant get ins on my own now because of this.
I dont konw what is the way to go. Certainly, they have to get after the lawyers first, then the insurance co second. Then if the medical com dont drop their prices get after them also.
I personally know of folks who are real sick and dont go because they would have to file for bankruptcy if they did go. The people of this whole country are living on the very edge in economic ways.
Oh I hear ya! The gull dam greed in this country is at a fever pitch.
I wonder what good all this money is gonna do them one minute after they die? Maybe a fancy hole in the ground?
As for me..gimme enough to live on and enjoy the simple things in life. Thats all I want. Except its getting so I cant even afford those.