• The number of senior citizens has risen by 11.5% since 2001, to 4.3 million, and Canadians older than 65 now account for 13.7% of the population, compared with 7.7% just 50 years ago.
• At the height of the baby boom in 1961, 33% of Canadians were aged 14 and under. Today the proportion is 17.7% (5.6 million), a decline from 19.1% in 2001.
• The number of Canadians aged 80 or older has passed 1 million for the first time (1.2 million), an increase of 25% since 2001. Two-thirds of people in this category are women, and 4,635 are aged 100 or older (3,790 in 2001).
• Life expectancy has reached 82.5 years for women and 77.7 years for men.
• The fertility rate, 1.5 children per woman, has now been below the replacement level of 2.1 for almost 40 years.
• Within about 10 years, there may be more people reaching retirement age then those reaching the age at which they can begin working.
  

Physicians traditionally take the Hippocratic oath, but some of the staunchest defenders of single-tier health care in Canada - vote-trolling politicians - appear to have taken the Hypocritic oath.

In an honest and welcome speech that should raise the ire of anyone who has ever endured long waits for medical care, the presidentelect of the Canadian Medical Association called out Canada’s politicians.

Dr. Brian Day singled out Jack Layton for “hypocrisy” because he underwent hernia treatment at a private Toronto medical clinic. He added former prime ministers Paul Martin, Jean Chretien and Joe Clark to the list for eschewing public waits in favour of quicker private care.

In a different example,Day,whose outspoken manner will hopefully prompt an honest debate about health care in a country that sorely needs one, also called CAW head Buzz Hargrove a master at “queue-jumping” because he received an MRI at a hospital within 24 hours of injuring his leg. “Even I couldn’t do that,” quipped Day.

Hopefully, Day will continue applying pressure to Canada’s political leaders, especially the ones who carry a dog-eared copy of Canada’s Health Act in one hand and a credit card in the other.

Because, as Day’s predecessor,Windsor’s Dr. Albert Schumacher, repeatedly pointed out, the health care debate in this country is characterized by “inflammatory” rhetoric that avoids the reality our public system is already partially private and that more private options would serve to improve public access. “Like it or not, 30 per cent of health care in this country is paid for out-of-pocket.

Like it or not, the Supreme Court of Canada has issued a wake-up call to us all. Like it or not, the health care system is at a crossroads and it is time for leadership,” wrote Schumacher. “The CMA wants to ensure patients have timely access to quality health care. Some have said the CMA should not look at the role of the private sector in the delivery of health care services. Like it or not,we must.”

Schumacher was referring to the Supreme Court’s decision in the landmark Chaoulli case, where it ruled that health care delayed is health care denied.

The decision found unacceptable delays in the overburdened public system were widespread and that a ban on private insurance meant only the very rich could afford private care.

Defenders of single-tier health care maintain private options will erode the public system, but the court found the opposite to be true in countries that allow for a mixture of private and public care.

Day agreed with the court on this front, calling the status quo “unacceptable” and stressing that private clinics are already making the public system more cost-effective. “I believe the public system needs the support of the private sector,” said Day. “We can’t make it equal, but we can make it good for people.”

As Canada’s leaders have shown by using private clinics for quicker treatment, single-tier care in Canada is but a myth. There are actually several tiers, and those with money, prestige and power can access health services more quickly and easily than those without.

This isn’t a bad thing. Because people are accessing those private services, the queues in the public system shorten and care improves for everyone regardless of income or status.

The sooner our politicians admit that, the quicker this country can embrace innovative solutions that help ensure the long-term sustainability of its universal health care system. But if they continue to deny the obvious in a bid for votes, they’ll continue getting prompt care while you and your family stand in line.

The longer Canadians wait for specialized medical services, the more they consider the waiting time unacceptable, according to a new study published recently in the journal Healthcare Policy by Statistics Canada analysts.

Patients whose lives were affected by waiting for care were also significantly more likely to consider their wait unacceptable than those whose lives were not affected.

The study used data collected in 2003 through the Health Services Access Survey to explore the determinants of unacceptable wait times for three types of specialized care: visits to specialists, non-emergency surgeries and diagnostic tests.

The analysis showed that longer waits and adverse experiences during the waiting period significantly increased the odds of reporting an unacceptable waiting time for all three types of specialized services.

For example, patients who reported waiting one to three months for a diagnostic test were almost nine times more likely to consider the wait unacceptable as those who waited less than one month.

Similarly, patients who indicated that the wait for diagnostic tests had had an effect on their lives were 11 times more likely to report the wait was unacceptable than those whose lives were not affected.

Interestingly, the study found that some patient characteristics, such as age and education, play a role in determining acceptability of waiting times. In general, older patients and those with lower levels of education were less likely to consider their waiting times unacceptable than younger, more highly educated people.

Patients less than 65 years of age were more likely to consider their waiting times unacceptable for consulting a specialist and having diagnostic tests.

Age and education have been linked to patient expectations regarding health system performance. The results of this study point to the potential role of patient expectations in determining the acceptability of waits for specialized services.

The study found that the majority of respondents reported waiting fewer than three months for their services. The proportion of people who declared that their waiting time was unacceptable ranged from 17% for individuals seeking elective surgery to 29% of patients who sought help from a specialist.

Only 10% of those waiting for elective surgery indicated that waiting for care affected their lives. This increased to nearly 19% among those waiting for a consultation with a specialist.

The impact on their lives could range from experiencing worry, stress and anxiety to physical effects such as pain, problems in performing daily activities or deterioration of overall health.

The rise of private care in Canada
All the health services money can buy
ALEXANDRA SHIMO | Apr 25, 2006

Private medical providers are rapidly expanding their services across the country, but even the industry's own advocacy group lacks definitive numbers on the size and scope of the private health care sector. The new world of for-profit medical service has been crying out for a consumer guide to what's available, what it costs, who's offering it, and how to pay for it. Here it is: a Canadian first.

If all goes according to plan, this summer will see another watershed moment in the relentless march of private health care across the nation. The Copeman Healthcare Centre, which already operates a private clinic in Vancouver, is planning to open three more -- in Ottawa, Toronto and London, Ont. -- as part of its push to have centres open in every major Canadian city by next year. These are not facilities offering specialty surgeries, or red-carpet care for the jet-setting elite. Instead, they will let Canadians pay for quicker, better access to the central players in the health care system -- family doctors. For an initial annual fee of $3,500 per person (their children 22 years and younger are free), and $2,300 per annum for subsequent years, patients will be able to buy a health care package including unlimited visits with a family doctor, and counselling from a range of health professionals. Patients can phone up in the middle of the night and talk to a nurse, and if necessary, they'll be transferred to a doctor. In Ontario, Don Copeman sees a huge potential market in the estimated 1.4 million people who don't have a family doctor.

"The public system will never be able to afford the provision of comprehensive, preventive health services that we offer," he says. "Governments don't have the funding to provide these services and politically it's unfathomable. They would literally have to find billions of new health care dollars and the public is no longer willing to accept an ever- increasing tax burden."

Paying for access to family doctors would mark a monumental shift in Canadian health care, says Colleen Flood, the Canada Research Chair in Health Law and Policy. For many Canadians, they are the first and only point of access to the system. They expedite a patient's access to specialists in both private and public medicine, and act as the gatekeeper to cutting-edge care. They also have a lot of influence over how long a patient waits for treatment. "They can try and help their patients get faster service with specialists by making phone calls depending on their connections and depending on the patient's need," says Flood. Doctors who have fewer patients have more time to be a patient's advocate, and Copeman's clinics promise four times more doctors per patient than in the public system. Private medicine is rapidly altering the options available to patients in Canada. What once provided only cosmetic procedures and after-hours MRIs is now a dynamic, multifaceted industry serving thousands of Canadians and providing a host of treatment options. Cataract MD, for example, hopes to open its first Ottawa office this summer and one in Vancouver in the fall. The clinics will offer cataract surgery -- a procedure that was formerly available only in the public system in the province. Patients will be able to jump the public's median wait-list time of 34 weeks, for a cost of $1,500-$3,000 per eye. In Montreal, the country's first private emergency clinic -- Clinique médicale MD-Plus -- opened in October 2004. This month, the Westmount Square Surgical Center added total knee replacements to their menu of services, a complex procedure offered by only one other private facility in Canada. The Vancouver-based Cambie Surgery Centre plans to follow suit as soon as negotiations with the provincial government are completed.

It's difficult to estimate the full size or scale of private health care in Canada. Most provinces track only the services available in the public system, and though the private system has an advocacy group, the Canadian Independent Medical Clinics Association, it doesn't track the number of practitioners, patients or procedures. But the Maclean's complete guide to private health care reveals a growing industry: 23 private surgical centres offering medical services nationwide; 17 private cataract clinics; and in Quebec, 101 doctors have already opted out of the public sector entirely to work privately.

The Canadian Institute for Health Information estimates private-sector health care spending will reach $43.2 billion this year, up from $32 billion five years ago (with more than half of those dollars going toward drugs and dentistry). Those numbers have grown fast, and are only going to get bigger, says Brett Skinner, director of health policy research with the Fraser Institute. "There are more and more people being affected by the problems in the Canadian health care system, and that is driving acceptance of private for-profit care," he says. "The genie is out of the bottle, and there's no going back." Dr. Jeffrey Brock, who runs MedExtra, a medical consultancy firm based in Montreal, agrees. "Patients aren't getting what they need in the public system, and are looking for alternatives," he says. In part, it's a simple matter of supply and demand. At the moment, 875,000 Canadians are on waiting lists for medical treatment, and many expect those lists to grow as the population ages. In 2004, the Conference Board of Canada reported that health care already consumes close to a third of all provincial revenues, and by 2020 that will rise to 44 per cent, just to maintain current levels of service. With medical expenses already projected to rise by $5 billion a year without doing anything to reduce wait times or improve care, it seems unlikely that governments will be able to increase spending enough to meet all the demand for service. "Health care, as it is currently funded, is unsustainable," said Glen Roberts, director of health programs for the Conference Board. Not surprisingly, those with the means are looking for alternative, more expedient options. According to a Decima Research poll conducted in June, negative ratings of the country's health care system have now eclipsed positive ratings, increasing the pressure for change. And the qualms many Canadians had about "two-tier health care" are fading. The Decima poll found that a majority of Canadians now approve of private health care -- 51 per cent said they thought private family doctors were a good or very good idea. In Quebec and British Columbia, those figures were 58 per cent and 53 per cent respectively.

It seems the spreading dissatisfaction with Canada's publicly funded system has begun to break down Canadians' traditional hostility toward for-profit health. Maclean's recently polled 3,759 readers and found 64 per cent said they, or a family member, have waited what they consider to be an unreasonable amount of time for medical treatment or tests. And while many advocates of public health care have long decried the threat of a so-called "two-tier" medical service, many Canadians no longer see that as such a bad option. Respondents were closely split on the wisdom of establishing a parallel private/public system: 42 per cent in favour, 44 per cent opposed, and 14 per cent on the fence.

A recent Supreme Court of Canada decision has given the notion of private health care new legitimacy, says Peter Hogg, scholar-in-residence at the Toronto law firm Blake, Cassels & Graydon, and an expert in constitutional law. In June 2005, the Supreme Court ruled in favour of George Zeliotis and his family physician Jacques Chaoulli, striking down a Quebec law that said patients were not allowed to buy private insurance for health care procedures covered by medicare. Though the decision concerned private insurance, and ruled on a Quebec law only, the court did say that, in essence, if governments could not provide timely access to health care, they cannot prevent citizens from obtaining it on their own. "In some serious cases, patients die as a result of waiting lists for public health care," the decision said. "The prohibition on obtaining private health insurance . . . is not constitutional where the public system fails to deliver reasonable services. Life, liberty and security of the person must prevail."

This decision has created a fundamental shift in the legal landscape of public health care, Hogg says. "Governments are now on notice that they have to deal with their waiting lists. It's no accident that since the case there's been a tremendous amount of interest in the health care system and getting rid of waiting lists. None of that action occurred before Chaoulli. Governments were perfectly happy to just leave it all under the rug." The decision served to embolden private health care providers, causing some to expand their menu of services. The ruling encouraged orthopaedic surgeon Brian Day to offer more complex surgeries at his Cambie Surgery Centre. The decision also encouraged management at Winnipeg's Maples Surgical Centre to expand their services. They are currently in negotiations with Manitoba Health.

Private health care in Canada is about more than increased choice for the very rich. It's about providing options to people on wait lists who are suffering in pain and have had to put their lives on hold. For some, it's about gaining access to life-saving drugs or cutting-edge treatments that aren't funded by the public system. In this, the first-ever guide to the burgeoning industry of for-profit medical care, Maclean's details what is available, what it costs and where to get the services that are increasingly in demand. We also explore private sector firms that offer ways to access public care in a more timely fashion. The very term "private health care" often causes confusion. Some Canadians consider all for-profit facilities to be part of the private system, even when they bill the government for all services, and patients pay nothing from their own pockets. These sorts of facilities -- like the Gimbel Eye Centres in Alberta, and the Shouldice Hospital north of Toronto -- are now well-entrenched in the public system: so much so, in fact, that when NDP Leader Jack Layton had hernia surgery at Shouldice in the 1990s, he didn't realize it wasn't a purely public facility. In any case, the government paid the bill, and that makes it a public facility. "It's just part of the system,"

Layton said this year when questioned about the procedure. "The doctor says, 'Go there.' You pay with your [Ontario health] card. It never occurred to me [it was] anything other than medicare, which it is." For the purposes of this guide, private systems are defined, in essence, by who pays. If the patient pays, either for purely private care, or for faster care in the public system -- paying a consultant, for example, to jump the queue and gain quicker access to a certain specialist -- then the service he's paying for is considered private. The amount available across the country varies widely from province to province (see map, page 32). Some, such as New Brunswick and P.E.I., have no private health care providers. Others, namely Quebec and British Columbia, have seen an explosion in growth.

The discrepancy encourages those who want timely care to travel for it. Out-of-province patients have become an important market, and private providers usually cater their services accordingly. The Cambie Surgery Centre in B.C. tells its clientele when they'll be fit enough to travel home, given that so many of its patients come from out of province. Medical tourism, in other words, is not just about heading to India or the U.S., but is an industry we can call our own.

Quebec has the most comprehensive and advanced private health care in in the country. More doctors have opted out of public medicine in Quebec (101) than the rest of the provinces put together (6). There are more private cataract clinics in the province than anywhere else in Canada. Only in Quebec are there private PET/CT scanners, which are widely considered the gold standard in cancer diagnostic (page 46). The centre of all this activity is Montreal, which local media have dubbed "the private health care capital of Canada." The city is home to the country's first private emergency clinic (page 33), and the only private surgeon in Canada doing full hip replacements (at the Duval Orthopaedic Clinic, page 37). In this city, there are more private cataract clinics (5) and radiology clinics than anywhere else in Canada (16). Only in Montreal can you pay to have your vaccines done at home, or your blood work done from the office. "Quebec tends to look at European models rather than the American system. In France, they have a mixture of public and private health care, and Quebecers know they have one of the best health care systems in the world," says Zoltan Nagy, executive director of the Canadian Independent Medical Clinics Association. "They don't really believe in 'it's the Canadian way or the American way and there's no other option.' They are leading the way because they are more open-minded." British Columbia is also far ahead of the rest of the country. There are 14 private clinics in British Columbia doing operations complex enough to warrant a general anaesthetic. They offer a range of adult and pediatric procedures in orthopaedics, urology, gynecology, general, cosmetic, vascular and oral surgery.

And the largest and most technically advanced private hospital in Canada is located in downtown Vancouver (page 38). The Cambie Surgery Centre was founded by Dr. Brian Day, who will become president of the Canadian Medical Association in August 2007. Known as a private health care trailblazer, he also founded one of the country's only private specialist referral clinics. This service allows Canadians from anywhere in the country to book an appointment with a medical specialist within just a few days. Patients don't even need a doctor's referral. They just phone a toll free number, and arrange for an appointment with whatever type of doctor they need. Once the appointment is booked, the clinic arranges the transfer of the patient's medical file to that specialist. The service is extremely popular, Day says, and sees thousands of appointments made every year, many for patients from out of province. There are no private surgical clinics in Alberta, Saska tchewan,

Ontario, or Atlantic Canada. There are also no private family doctors in Alberta, Saskatchewan, Manitoba, Ontario or Atlantic Canada either. Premier Ralph Klein might have a reputation for opening the doors to private health care in Alberta -- letting for-profit companies become part of the public system -- but in terms of services that patients actually pay for, the province is a closed shop. When a private Calgary clinic with 24/7 access to family doctors announced plans to open earlier this year, the province's College of Physicians and Surgeons sent letters of objection and those plans were promptly shelved. Those patients who don't want to wait in line are often referred out of province. It's very likely that purely private care hasn't taken off in Alberta because the province has the highest per capita public health care funding in the country, which has lessened the demand for private medicine. In Ontario, the situation is very different. In June 2004, the Ontario government brought in the Commitment to the Future of Medicare Act. This law built on the existing provincial legislation that banned private clinics from charging for medically necessary services. It also made it illegal for patients to pay for medically necessary services, with a penalty of up to $10,000. Corporations were liable to a fine of $25,000. Doctors who facilitate the offence can also be fined $10,000, and anyone who knows it's going on and doesn't report it can be fined $1,000. Some private health services that aren't considered "medically necessary," such as expedited MRIs, or certain sports medicine or pain management services, do exist in Ontario, and that sector is growing. Because the law demands that, in essence, the government must pay for anything medically necessary, private operators are moving into those areas the province does not classify as such. The Provis Infusion Clinic, for instance, Ontario's first private cancer clinic, offers drugs that aren't funded by the public system (page 44).

The differing levels of private care from province to province are in part a function of how open provincial governments are to private medicine. Private clinics are not illegal under federal law. What does violate the Canada Health Act is charging patients for medically necessary services. However, what is considered medically necessary has changed and become more difficult to define, says Colleen Flood. "We used to have a boundary between what is medically necessary and what is not, but it was between whole categories of services, such as in vitro fertilization, or dental or cosmetic surgery that was considered unnecessary, and hip operations and MRIs that were considered medically necessary. Why else would a patient need a hip replacement unless it was medically necessary? But today, private clinics have started using this grey area of the law to muddle that distinction. Sometimes hip replacements are publicly funded and then they are considered 'medically necessary,' and sometimes they can be privately financed because they are not considered 'medically necessary.' These distinctions are more semantic than based in reality." In the past, there have been times when clinics have charged both patients and the government for the same medically necessary service. This is known as "double billing" and violates the Health Act. But enforcement has been spotty. (Last year, the British Columbia government kept track of private clinics charging for medically necessary services by looking through old newspaper clippings.)

Some clinics charge "facility fees" to patients, while passing the doctors' fees along to the government. Through the 1990s, Ottawa kept a lid on the practice by witholding federal transfer payments to provinces that allowed it. That effectively kept for-profit medical centres confined to elective procedures like laser eye surgery, MRI tests and plastic surgery. With the rise in patient demand, however, some private clinics have found innovative ways of billing patients. For example, Cataract MD combines laser eye surgery with cataract surgery as part of a package. But in the wake of the Chaoulli decision, there may be no more need for creative ways to stay within the law. Many private heath providers are anticipating that any and all medical services can now be provided on a for-profit basis, and are ramping up plans to expand services and open outlets across the country. "In the wake of the Supreme Court decision, a fully open parallel private system is now allowed," Brett Skinner says. "Previously, any province that said, 'We're going to allow a private payment option, forget what the Canada Health Act says,' would be punished with the reduction of federal transfer payments. Now I think they could successfully go before the courts and argue that that penalty is unconstitutional." There remain a number of other restrictions on private health care. For example, doctors are forbidden from providing medically necessary services in both the private and the public system, and provinces have been reluctant to give hospital licences to private providers. The legal restrictions have meant that not every medical service is up for sale. The most complex operations must be done in a hospital, and private hospitals are few and far between. Patients who can't access the care they need in this country can travel outside of Canada, and with wait lists growing, increasingly they're doing just that. This has spawned the growth of another industry in Canada -- medical brokers and medical travel agents. These middlemen help arrange travel and care at a private clinic, either in another province, or outside the country. Some medical travel agents, such as MedSolution, specialize in out-of-country care. MedSolution has business relationships with hospitals in France, Turkey and India, and arranges cosmetic and medical procedures at these locations. Other medical travel agents, such as Vancouver-based Timely Medical Alternatives, deal only with private clinics in North America. The company offers package deals on hotels and operations at U.S. clinics not more than a two-hour drive from the border.

Patients who pay out of pocket for medically necessary care may be eligible for government reimbursement, says Brian J. Cohen, a health law lawyer based in Toronto. Cohen has represented clients seeking reimbursements for medical services not covered by their government health plans and has won several precedent-setting cases for patients seeking treatment funding, both in Canada and in the United States, for care not previously covered by their provincial plans. Last year, he persuaded the Ontario Health Insurance Plan to pay for a patient to be treated with the colon cancer drug Erbitux at a Buffalo hospital. At the time, the drug had not yet been approved by Health Canada, but Cohen still won the case for reimbursement. "If the service is truly medically necessary, then the provincial health plan has to cover the cost, be it in Canada or out," Cohen says. Cohen has helped other cancer patients win funding for hospital-based drug treatments available stateside but not in Canada. The U.S. leads Canada by several years in both cutting-edge treatment and drug availability for cancers, stresses William Hryniuk of the Cancer Advocacy Coalition. For this reason, there are several services in Canada that help patients with access to the most advanced cancer care stateside. The consulting firm MedExtra arranges appointments and treatment plans with renowned oncologists in the United States. These treatment plans can either be followed once back in Canada, or if the treatment is unavailable, pursued at a clinic in the United States. The renowned American cancer clinic M.D. Anderson has a Toronto office, which co-ordinates the travel and treatment of patients seeking cancer care at their clinic in Houston (page 46).

Currently, Canadians still look abroad for the most advanced treatments, or to cut their own waiting times. Frustration with the public system has led U.S. firms to set up shop here in part to funnel patients south of the border. Canadian companies are now capitalizing on this same demand. For the hundreds of thousands of patients on wait lists and in pain, this is a welcome shift, Day says. "Canadians are looking to new treatments and technologies to keep them in optimum health, and are happy to pay for what cannot be provided in the public system. That leaves an important role for private health care. The public sector doesn't have the resources to purchase and utilize these new technologies. This is an interesting and dynamic time in this country. There's an enormous sense of frustration with the public system. There are close to a million on waiting lists, and these people are tired of putting their lives on hold."

American clinic offers surgery to Canadians who don't want to wait. By Joanna Frketich The Hamilton Spectator (May 1, 2007) Donna Robins welcomes Florida's Laser Spine Institute to Hamilton with open arms. She's lived every day in pain since falling down her stairs eight months ago, severely injuring her neck and back. "The pain is like someone hammering you full-fledge in the back of the neck over and over," says the homemaker. "I live pill to pill." The pills are the only relief she's been offered by Hamilton doctors. She's been told she's not eligible for surgery here. A desperate Internet search led her to the Tampa institute specializing in laser surgery for the back and neck. Robins has herniated and bulging discs that can apparently be treated with less invasive laser techniques.

Over the phone, she was told they'd do the surgery for $60,000 American. "We don't have that kind of money," she says breaking down in tears. "It seems so basic and simple, why don't we have this here? What's wrong with our country? Why are we suffering?" Robins plans to go to one of the free information sessions the institute is holding on Hamilton Mountain Friday and Saturday of this week. It's being brought here by Windsor-based company EcuMedical that helps American clinics attract patients facing long waits in Canada. In the last year, it has held six similar seminars in Toronto and Windsor.

It claims that has resulted in 110 Canadians going stateside for back surgery, as well as hip and knee operations. It's the first time it has brought a private clinic to Hamilton. "It's very much needed," said EcuMedical CEO Tracy Bevington. "People are paying for it to get out of pain. It's a wonderful option." Hamilton Health Sciences, which does the bulk of back surgeries in this area, doesn't agree. "Do we think it's a good idea to do that? No," said Dr. Mike Marcaccio, chief of surgery. "I think comprehensive care is better." Hamilton does comparable surgeries to the ones being flogged by the Florida institute. Marcaccio says the institute's advertising saying minimally invasive back surgery is rarely done here is wrong. But, he fully acknowledges, getting comparable surgeries in Hamilton can take years.

There's about a one-year wait just to see the surgeon and then another one-year wait to get the operation. As a result, more American clinics have been looking to recruit patients here. "There's no shortage of that kind of advertising," Marcaccio added. The waits are expected to improve now that the province has made back surgery a priority. But that's a slow process that won't be fixed before the Florida institute arrives Friday.

But, he fully acknowledges, getting comparable surgeries in Hamilton can take years. There's about a one-year wait just to see the surgeon and then another one-year wait to get the operation. As a result, more American clinics have been looking to recruit patients here. "There's no shortage of that kind of advertising," Marcaccio added. The waits are expected to improve now that the province has made back surgery a priority. But that's a slow process that won't be fixed before the Florida institute arrives Friday.

Questions raised over laser surgery. Why can’t OHIP cover costs of procedure in US?

More than 80 people showed up at a series of weekend seminars to see if American-style health care at a private Florida clinic is the solution to their back pain. The Laser Spine Institute of Tampa pitched its minimally-invasive laser surgery procedure to a Canadian audience that it hopes is either frustrated by long delays in treatment or curious about a surgical technique not available here. Lester Morales, chief operating officer for the Laser Spine Institute, said the people who attended the seminars at a Hamilton Mountain hotel have one thing in common — they are eager to get quick relief from their pain. “We had some people who wanted to give us deposits on the spot,” Morales said. “Most of them are eager to get back to a regular lifestyle. “What we sense is that underlying feeling that they’ve been waiting a long time just to see someone.”

While the institute’s laser procedures are designed to be minimally-invasive on the back, they’re also maximally-invasive on the wallet. Depending on the type of procedure, the cost ranges from about $22,000 to $33,000 US. Ironically, Americans, with their user-pay health care system, fare better financially at the Florida clinic than Canadians, who normally enjoy a system of universal health care access. The costs of the surgery for Ontario residents aren’t covered by OHIP, but the majority of Americans, Morales said, can receive reimbursement of some or even all of the costs of laser back surgery from their health insurance providers. Some of the people who attended the seminar were upset that the laser surgery option wasn’t available in Canada, or failing that, covered by OHIP. “Why can’t OHIP reimburse the money?” asked Ram Kamath, a Hamilton man who attended one of Saturday’s seminars. Kamath underwent conventional back surgery five years ago but he still suffers from problems. He can’t understand why the Laser Spine Institute’s procedures aren’t offered here by Canadian doctors. “If these people can do this, why not our doctors in Hamilton?” Kamath asked. “Is it a question of the doctor’s qualifications? Is it a question of equipment? “The people have to stand up.

Today it might be me, but tomorrow it might be you.” Dr. Michael Perry, medical director for the Laser Spine Institute, said the clinic’s success rate for lower back procedures is 80 to 90 per cent, and 90 to 95 per cent for neck procedures. Perry said the laser does three things – “like 3-in-1 oil,” he joked. It cuts, cauterizes and vaporizes to repair and seal ruptured or herniated discs and get rid of disc fragments that may be pressing against nerves. The small size of the specialized surgical equipment means that the incision is only one or two centimetres wide, which is far less invasive than traditional back surgeries. After the seminar, those who were interested were offered the opportunity of a free consultation, and a few people came prepared with their own X-ray charts. A Windsor-based company called EcuMedical Resources International is responsible for marketing the Florida clinic to Canadians.

Tracy Bevington, CEO for EcuMedical, said he hasn’t encountered any resistance from Canadians concerned about the implications of an American clinic looking north for prospective patients. “I think people are beginning to realize there are other answers to the problem,” he said. He also said that there were no specific health characteristics that caused Hamilton to be selected as a seminar site. Seminars had been conducted in Toronto in March 2006 and then in Windsor in January, “so we said let’s fill in southern Ontario between Windsor and Toronto,” Bevington added.

In April 2007 the Ontario Medical Association launched a campaign that irrefutably added institutional credibility to Bevtra Services and Associates 4-year awareness campaign. The OMA campaign, entitled “Six Principles of Healthier Care”, was advertised throughout Canada’s most populous province with a strong call to action for Ontario Residents.

It quickly became apparent that the six principles outlined by the OMA echoed strongly the key points that Bevtra Services and Associates and EcuMedical Resources International have been promoting for the past four years. We’ll go over the six principles here, as everyone at Bevtra considers the campaign launched by the OMA to be the beginning of the next stage of evolution in the Canadian healthcare system.

 The Six Principles

1. Keep Patients Front & Centre
EcuMedical Resources International was created for that very principle, our corporate mandate has and continues to be to find timelier, and where possible, more advanced medical care options for Canadians.

2. Focus on the Future
Our focus on the future began almost 4 years ago. Countless hours of research and planning were spent by the principles of EcuMedical Resources International. We are an Ontario-based company looking for the best options available to all Canadians for their Health Care needs. We saw the cracks in the foundation of our Health Care System back then and since have wanted to be a forerunner as part of the solution.

3. Be Specific
EcuMedical is constantly analyzing the data of what seems to be needed by Canadians for improved Health Care. In other words; what procedures are causing the longest waiting times or what procedures are there that may be better for the need? Where do we find these options; more research and travel to find these answers?

4. Think Investment not Cost
This has been the belief of EcuMedical from our conception, if someone in a family needs Health Care, and better options are out of country and have to be paid for, this should be considered as an investment into that family, not a cost.

5. Apply What We Know Faster
EcuMedical has been pursuing its vision and passion for almost 4 years to date.

6, Start Now
The principles in EcuMedical Resources started their NOW almost 4 years ago.

We do not believe nor tend to state that we are the only answer however we believe we started EcuMedical to be part of the solution, and according to the Doctors of Ontario, there is no one/simple answer but we must all be aware and involved. Bevtra Services and Associates is responding to the publicity campaign from the OMA with clarification ads promoting how EcuMedical and its partners are positioned to be part of the solution to the recommendations in the OMA program.

Media Release - April 24, 2007

Relief for Ontarians on Waiting Lists is Here! Area residents suffering from back pain have a new option!
Hot on the release of the new 6 Principles program from the Ontario Medical Association, EcuMedical Resources International announced a seminar targeting  Ontarians stuck on back surgery waiting lists. The free seminar will showcase the procedures of a Florida-based company, Laser Spine Institute (LSI), that has developed a minimally-invasive laser surgical technique that requires much less recuperation time than traditional techniques employed in Ontario and Canada. In addition, the LSI procedure can be scheduled very rapidly, within weeks, as opposed to the growing wait times for consultations and surgeries in Ontario.

The seminar is in response to the unrealistic timelines that are being projected for Canadian residents suffering  from spine disorders that require surgery.  Patients are being informed that they may need to wait three years and longer before they can expect relief from these painful conditions. These patients can add an extensive recuperation period to the timeline as Canadian surgeons are mostly using invasive surgical techniques. The seminar will also showcase the advances made in arthroscopic surgical techniques employed by LSI, which results in very little blood loss and scarring or scar tissue. Incredibly, LSI’s surgeries are performed on an out-patient basis, and in general, most patients are at the institute for less than a week.

The Laser Spine Institute is located in Tampa, Florida, and is home to award-winning, visionary surgeons, led by founder and chief surgeon Dr. James St. Louis. Dr. St. Louis and his team have developed and perfected their techniques that are so cutting eedge, that they are not even taught in medical schools yet. “It’s difficult to convey to patients that they will receive spine surgery under a local anesthetic, and that they will walk out of the institute”, says Dr. St. Louis. “These type of surgeries require large incisions, hospitalization, and long recuperations when performed in the traditional manner”. Dr. St. Louis was the 2005 Physician Of The Year for Orthopaedic Surgery as named by the American Association of Physician Specialists, and is a fellow at the International College of Surgeons, and the American Academy of Nuerologic and Orthopaedic Surgeons.
The four surgeons at LSI have performed ten thousand surgeries collectively over the past decade.

Ecumedical Resources International (ERI) is an international company with their head office in Windsor, Ontario.  The company specializes in connecting Canadians to United States health care establishments and practitioners for the quality health care they need, when they need it. Ecumedical is also committed to providing solutions to our health care crisis by bringing new procedures and more realistic timelines to our health needs.

The FREE seminar is at the Courtyard by Marriott Hotel, 1224 Upper James Street in Hamilton. (http://marriott.com/hotels/travel/yhmcy-courtyard-hamilton)
Session 1 is Friday May 4th from 6pm to 8pm
Session 2 is Saturday May 5th from 9am to 11am
Session 3 is Saturday May 5th from 1pm – 3pm
Reservations are recommended but not required.

To save a seat, please call Ecumedical at 866-277-9868, or e-mail malika@ecumedical.com
For immediate assistance, contact Terence Toohey at Bevtra at 519-890-8882 or terence@bevtra.com.