Record numbers of Ontarians are being sent to the U.S. by their government for routine health care that should be available at home.
A Metroland  Special Report  shows thousands of others  are funding their own medical treatments south of the border,  at high personal cost.
The numbers have been rising for the last 10 years. Government approvals for out-of-country health care funding are up 450 per cent.
Should Ontarians have to use a passport to get health care?  

TROY, Mich - At first glance, it looks more like a hotel than a hospital.

Carpeted floors and frosted glass line the hallways. Guests in the waiting room lounge in wingback chairs near a beverage station with complimentary Starbucks coffee.

In all the private rooms, medical equipment is carefully tucked away behind cabinets that look as if they’ve leapt from the pages of an Ikea catalogue.

Bowls of colourful candy rest within easy reach of smiling nurses and friendly office staff.

Soft jazz is piped through the hallway, where letters stencilled on the wall remind: “The future belongs to those who believe in the beauty of dreams.”

This is Unasource — a private day surgery centre in Troy, Mich. It’s only 40 kilometres from the Canadian border, but it’s a world away from any surgery facility north of the 49th.

“There’s a calming effect when you walk into Unasource,” said Michael Kuhn of Windsor, who made the trip to Michigan in 2007 to repair a torn tendon in his shoulder. “It’s just an absolutely pristine facility.”

Kuhn is one of many Canadian patients who found his way to the U.S. for care — a growing group that is fast feeding an industry that emerged in the last decade to help thousands of Canadians find medical help across the border.

As for just how many are going, it’s difficult to say. OHIP paid for 12,000 cases to be treated, diagnosed or tested in American hospitals and clinics last year. But those are only the patients from Ontario who qualified for OHIP pre-approval for a medical ticket south.

“For every one of those, there’s probably 10 who say, ‘I can’t wait,’” said Rick Baker of Timely Medical Alternatives, a B.C.-based medical brokerage, a type of business that’s sprung up to fill the gap as wait times put added strain on patients.

For a price they’ve negotiated in advance with U.S. hospitals, brokers can get you surgery or diagnostics quickly and, they say, cheaper than you might think.

For around $22,000, the cost of a mid-size car, you can skip the lines in Ontario and have your knee replaced in Michigan or Colorado with the Windsor-based medical brokerage, International Health Care Providers. The time from the call to their office to specialist appointment to surgical table can be as little as two weeks, said the firm’s president, Kelly Meloche.

For about $700, a broker can get you in to a private diagnostic clinic for a MRI in Michigan tonight — and many will even drive you there.

“The world is changing, and saying, ‘That free system that we were all so happy to have, well, it was great. But, unfortunately it’s not great anymore,’ and more and more people, as something happens within the family, are finding that out,” said Tracy Bevington, CEO of EcuMedical, another Windsor-based medical brokerage. “As they’re finding it out, they’re looking for options, and we’re here offering those options.”

Even though Ontario has taken measures to reduce wait times, the system is still sagging under pressure and generating patient angst.

 Need an MRI? The wait is 109 days, according to provincial wait-time figures. But many, such as Innisfil’s Wilhelmina Tuininga are waiting much longer than that. The 75-year-old Sandy Cove Acres resident waited 240 days for an MRI that showed she needs hip surgery. Royal Victoria Hospital’s website says its wait times are about 185 days. As of Nov.1, nearly 140,000 Ontarians were on waiting lists for CT and MRI imaging alone.

Centres such as Unasource are more than willing to welcome Canadians looking for expedited care.

The modern rooms, high-tech equipment and plush extras may not surprise choosy American patients. For Ontarians who are focused on faster care, the extras are an added comfort.

At Sky Ridge Medical Centre in Colorado, “we were really designed with a new philosophy in mind that really takes into account a healing environment,” said spokesperson Linda Watson.

The Denver-area hospital has recently started booking Canadian patients for orthopedic surgeries.

Every room in Sky Ridge is private, some with panoramic mountain views. Each is equipped with on-demand TV, allowing patients to take in the latest movie or learn more about their condition and treatment.

There’s in-room dining with filet mignon and create-your-own omelettes prepared by chefs.

At Sky Ridge, the wait time for a specialist appointment and joint-replacement surgery is measured in days. In Ontario, where more than 8,500 people are waiting for knee-replacement surgery, 90 per cent of patients will have the surgery within the provincial target of 182 days.

But, that wait only starts after the surgery is scheduled, a process which can add months to the timeline as patients wade through referrals and specialist appointments.

The waits can be agony, and many people look south out of desperation, said Janet Walker, a B.C. nurse who is researching the impact of wait times on patients.

“In Canada, we hear that, yes there are waits, but it’s only for elective surgery,” she said. “So, we imagine that it’s not important and not painful, and that is just not the case.”

Where the care is cushy

Private dollars and competition for patients have prompted private U.S. medical centres such as Unasource to go the extra mile when it comes to atmosphere and extras.

But even their sophisticated hallway chaises and in-room DVD players pale in comparison to the luxury offerings of some American hospitals.

Starting from around $300 a day more than what American insurance companies will pay for a semi-private room, patients on the 12th floor at Houston’s Methodist Hospital can be treated to room service, limo transfers, manicurists and high-thread-count sheets in private suites.

 “The whole philosophy behind it originally was security and privacy for VIPs,” said Alice Baker, the floor’s patient liaison. “But now, if you have that extra money — you know the baby boomers out there that want the Mercedes instead of the Cadillac — it’s about providing a higher level of service and amenities.”

Forbes Magazine recognizes Methodist on its list of America’s Ten Best Luxury Hospitals, which offer a select number of suites dedicated to above-average surroundings.

While hospitals on the Forbes list deliver highly reputable general care, they also offer some patients the little perks that make a stay more Five Star Resort than Anytown General.

Others on the list include Johns Hopkins Hospital in Baltimore, which boasts tuxedo-clad wait staff and oriental rugs, and The Phillips House at Massachusetts General, which offers panoramic views of the Cambridge skyline and flat-screen TVs.

At Methodist, patients receive a top-of-the-line amenity kit and luxury terry robes.

They can order favourite foods from the floor’s private gourmet kitchen, staffed by an executive chef. There is also a program set up so patients can visit with pets.

While most of the Texas hospital’s international patients hail from nearby Mexico and Guatemala, the floor has seen a few Canadians recovering in its high-thread-count sheets, Baker said. For many, the amenities and world-class medical care justify the cost.

“Some people spend more money on hotels on vacation,” she said. “We started putting it in those terms and we’ve been getting a lot more people who aren’t billionaires or millionaires, but they’re comfortable.”