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- Date: Fri, 18 Mar 2011 12:51:16 -0400
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Sick of waiting ; Hundreds of thousands of desperate Canadians have given up on Canada's backlogged public health-care system and opened their wallets looking for relief outside its borders. Mike Jubenville, who withstood crippling pain for years, is one of those people
The London Free Press
Mike Jubenville has many ways to track how long he's been in agony:
* Months waiting for a CT scan: Three
* Months waiting for an MRI: Six more
* Months waiting for meeting with neurosurgeon:19
* Number of pain-killers taken each day:25
* Months spent in bed unable to move:18
* Number of times he thought of taking his own life: At least once.
But the easiest way for him to track the long wait for help, and the hardest to stomach, is to look at his seven-year-old daughter.
"I haven't lifted my daughter since she was born. I have never picked her up. I have never been able to."
The latest number was too much to bear: A note from a London doctor saying Jubenville could indeed get an appointment to consider botox injections to alleviate his constant headaches and pain -- in 29 months.
Tired of waiting, Jubenville called a Windsor company that specializes in getting Canadians out of Canada for medical treatment.
The company, International Health Care Providers, found a U.S. doctor who does the botox injections.
Jubenville called the doctor's office.
A receptionist got back in an hour. What she said made him laugh.
"Well, first of all, I would like to apologize for the wait, but I can't get you in until Thursday."
Jubenville still laughs about it an interview a week later. "I was expecting months."
Jubenville is one of thousands of Canadians leaving the country each year to get medical help. Patients call it surgical or medical tourism, partly because many companies offer recovery in a resort.
Some companies that send patients abroad prefer to call it global health care.
Whatever it's called, it's a thriving business.
In a three-part series that begins today, The Free Press takes a look at the business and politics of medical tourism and profiles some of the ordinary Canadians seeking treatment elsewhere.
Companies that send Canadians to the U.S., India, Costa Rica, Europe and other places are springing up each year.
It's difficult to get a handle on the number of Canadians heading overseas or across the border in the U.S. for help, but it could reach the hundreds of thousands.
"Medical tourism has always been with us," says Dr. Jeff Nisker, co-ordinator of health ethics for the Schulich School of Medicine and Dentistry at the University of Western Ontario.
"It has always been a way for wealthy people to jump the queue. The difference now is that the queues are longer. Therefore, the number of people willing to jump the queues is greater."
Medical tourism is also growing because some countries offer services -- such as organ transplants, surrogate surgery or stem cell procedures -- that aren't offered in Canada and Europe, Nisker says.
Even within Canada itself, medical tourism is growing, he adds. More people -- the well-educated and well-off -- are leaving their community or province to get private health care elsewhere within Canada.
"It creates a two-tier system," Nisker says.
"It underlines the deterioration of our health-care system."
Despite studies dating from the 1970s calling for more funding, successive governments in Canada have refused to put in the money to educate enough nurses and doctors and open enough facilities to take care of Canadians, Nisker says.
"We have one-third the doctors and one-third the nurses (per capita) than the rest of the world."
Christine Elliott, health-care critic for the Ontario Tories, agrees medical tourism is a sign health care in the province is in trouble.
People shouldn't have to travel overseas to get care, she says.
"We are already paying a lot in taxes and, in Ontario, a health-care premium," she says.
But the system doesn't need more money. It needs more efficiency -- such as electronic record-keeping -- to move patients through more quickly, Elliott says.
As medical professionals and politicians wrangle what's wrong the system, people such as Kelly Meloche, head of Windsor's International Health Care Providers, are watching a sea change in Canadian culture.
"We don't have a precedence to acquire our own health care. We are not accustomed to questioning who gives health care. We just sit there and we wait," Meloche says.
That's changing, Meloche says, and she points to Jubenville, one of her clients, as a example.
Jubenville, 43, was born and raised in Windsor, and joined the family vision care business.
Thirteen years ago, he woke up one day with a stiff neck. Like many people, he just let it go, figuring it would work itself out.
After three weeks, he went to his family doctor and got a prescription for muscle relaxants.
"It never went away."
He started on the long and circuitous path of waiting to see a specialist, waiting to get a test after seeing the specialist, waiting for the test results, waiting for a consultation about the tests, then signing up for new tests and so on.
Meanwhile, the pain spread to his right arm.
"The only thing they could do for me was give me pain-killers, the whole family of nightmare pills. I was becoming an addict. But what do you do? What are your options? "
Jubenville had no intention of leaving Canada to get health care. First of all, he trusted the system.
And second, "I always had that notion it was going to cost millions of dollars to go somewhere else."
The pain in his neck became so bad he ended up spending days in bed. The days stretched into weeks and the weeks into months.
"I was 18 months in bed waiting for that first consultation. Then I couldn't take it anymore."
The pain grew so great he took an ambulance to the emergency department, quickly saw a neurosurgeon and two weeks later got surgery fusing some of the discs in his spinal cord.
"As soon as I woke up the next day, my arm was back. It was great. "
The relief didn't last long.
"I started getting migraine headaches like you wouldn't believe."
From 2005 to 2007, he took weekly shots of Demerol for the headaches and Gravol to prevent the side-effect -- vomiting.
Specialists told him there was nothing they could do because his spine had been repaired already.
"That's when I ended up going a little mental. I told my family, 'Guys, I don't know long I can do this for. Somebody better find somebody in the world, I don't care where.' "
A Google search turned up Meloche's company.
"Before I knew it, I was in Tampa, Florida, at the Laser Spine Institute."
There, doctors told Jubenville a narrowing of the main nerve routes, called stenosis, was pushing pressure on his spine.
And there, doctors did a laser procedure not available in Canada, Jubenville says.
"I walked off the operating table. I felt great. It was crazy. It was almost surreal."
As it turned out, the 2007 operation worked only for a time. Things looked great for a year and half, then the headaches returned.
Jubenville began another round of weekly injections to freeze the muscles in his neck and offered some relief. Once again, Jubenville had to cut back his time at work to half days. Every day, he had to lie down for several hours to relax his neck.
"It felt like my muscles are freaking out, like someone is taking a towel and twisting it and they just don't stop," he says.
More online research led him to London doctors, who offer botox injections for muscle spasms.
One doctor said he couldn't do it.
On March 4, he received a letter from the second doctor. Sure the doctor could see him -- in 29 months.
"Two and a half years and I am going to have to endure taking drugs I don't need to take. And again, possibly not being diagnosed then."
By then, Jubenville had already called up Meloche at International Health Care Providers and crossed the river to Detroit. In the space of three hours one day two weeks ago, he was tested and received a botox injection.
He's still waiting to see how well the injection works.
The botox injections cost him about $1,200. The laser surgery in Florida, which Jubenville still credits for relieving much of the pain, cost $17,000.
"We just took a loan. We bought a car we never got. That's how we look at the $17,000. It wasn't out of reach, but it wasn't something I would like to do once a year."
"I don't want to smash our (health-care) system," Jubenville says.
"Our system works if you don't have any serious issues. It works if the doctors know what you have. If you don't, the doctor refers you to a specialist, you wait one to two years, and if they don't know what's wrong, you are right back to square one, waiting."
- - -
A HEALTH-CARE EXODUS
According to Statistics Canada's most recent report on the issue in 2005, about 530,000 Canadians reported having trouble getting to see to a specialist, 208,000 had trouble getting non-emergency surgery and 280,000 had trouble getting diagnostic tests.
In Ontario, the jump in the number of applications to OHIP for out-of-country procedures jumped 25% to 30%, between 2001 and 2007, said a Health Ministry spokesperson.
Those numbers have levelled off -- to about 4,000 a year -- costing OHIP about $100 million a year. And that only represents Ontario residents who try to get funding for their procedures.
Detroit's Henry Ford Hospital handled 385 in-patient cases and 5,897 out-patient cases from Canada in 2009 alone, according to officials there. Detroit Medical Centre sees about 400 Canadians a year.
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