Azocar: Medical tourism is a sickness, not a cure

The following op-ed was published in the Calgary Herald on January 23, 2014. It can be found on the Calgary Herald's website here: 


The op-ed was written as a response to the following article:

Azocar: Medical tourism is a sickness, not a cure


Re: "Surgeons operate abroad; Doctors, patients bypass waiting lists by travelling," Jan. 20.


It is a sorrowful day when Canadians have to wonder if they too, can come up with $40,000 to get a quick knee replacement so as not to live in pain. Instead of trying to figure out how we can pay for services outside of our universal health-care system, we should be focusing on how we can expand and protect our cornerstone social program.


Dr. James MacKenzie from Calgary was among the first to perform a total hip replacement procedure in Turks and Caicos Island, thus setting up this premier paradise location for medical tourism. MacKenzie was brought to the island by Global MedChoices, a U.S.-based medical tourism agency.


InterHealth Canada built two surgical centres - one in Provo with 20 beds and the other in Grand Turk with 10 beds - under a public-private partnership, a model that has $80 million annually being paid out from Turks and Caicos Island government coffers.


Currently, there are concerns that InterHealth Canada may forfeit on the deal, leaving the Islanders paying approximate $125 million in penalties. How very Canadian of us.


Those who can afford this surgery, plus a few days at the beach, can count that our public system will be available to them in the event of infections or other post-operation care needs once they get home. There are powerful financial incentives for surgeons who have one foot in our public system and another firmly planted in entrepreneurial medicine. The rest of us have all the liability, but none of the benefits.


Private clinics, whether in Canada or Turks and Caicos Island, distort the public system. They don't save money; they fix no problem that the public system itself can't fix; and they introduce a whole world of new problems.


You cannot turn doctors into medical entrepreneurs with a completely different set of incentives and expect the system to work the same way. This private for-profit mix certainly does not work in a publicly funded and delivered single-payer system.


If we want to see an expansion and improvement of our public health care, we cannot continue to drain our system of our already scarce human resources.


It is a shame when Albertans have long wait times to receive treatment and have to wait an unacceptable amount of time before they can resume their normal lives. It is a shame that patients who cannot afford to pay for private health-care services must wait, while patients who can afford it, get access to services based on their ability to pay. This is clearly a blatant violation of the Canada Health Act and the government needs to respond accordingly.


As Albertans, we have not lost faith in our public health-care system, but we have lost faith in the manner that our system is currently being governed. Health Minister Fred Horne's inaction in addressing the wait time concerns reflects this government's agenda of privatization by stealth of our health-care system.


Starving the public health-care system so that Albertans are put into a situation where they have to pay out of pocket for a service that they have already paid for through their taxes is unnecessary and unfair.


The best solutions involve increasing both efficiencies and capacity within the public health-care system, for this government to explore why so few surgeries are being carried out, why surgeons and physicians are in some instances being denied hospital privileges, and why we have empty surgery rooms while people wait.


The purpose of such clinics is to get preferential access for the rich, at the expense of everyone else, both Canadians and the residents of Turks and Caicos Island. Private for-profit health care is a sickness, not a cure.


Sandra Azocar is Executive Director of Friends of Medicare.