Sask. should cover man’s U.S. surgery: ombudsman

Sask. should cover man’s U.S. surgery: ombudsman
Last Updated: Wednesday, November 3, 2010 | 1:04 AM ET Comments32Recommend13
CBC News

Poster’s Note:

Sadly this is the kind of thing which can happen when you have government running healthcare. Choice and access are removed from the equation. At MediBid, we’re all about access, choice, and quality.

A Saskatchewan man who went to the United States for urgent treatment of a brain tumour should have his bill paid by the province, the provincial ombudsman says.
Saskatchewan ombudsman Kevin Fenwick says a man whose brain tumour was missed by Canadian doctors but discovered in the U.S. should have his medical bills from there covered. (Saskatchewan Ombudsman’s Office)

Kevin Fenwick outlined the situation in his most recent quarterly report, released Tuesday.

The case of “Christopher,” a pseudonym assigned by Fenwick to protect the man’s identity, highlights a decision made by Health Ministry officials sometime in the last two years.

According to Fenwick, Christopher had been to several Saskatchewan doctors complaining of a variety of “worrisome symptoms, including migraine headaches, vision loss and low blood pressure.” However, neither his family doctor nor at least three specialists could figure out the problem.

Finally, Christopher decided to seek treatment in the United States. It turned out that he had a brain tumour that required an operation.

‘The ministry had an obligation to let Christopher know what his options were.’—Saskatchewan ombudsman Kevin Fenwick

He was told the clinic could operate or send him back to Saskatchewan with the diagnostic information and suggested remedy.

“Based on Christopher’s experiences so far, he chose to go ahead with the operation” in the United States, Fenwick noted.

Just prior to the surgery, Christopher applied to Saskatchewan’s Health Ministry seeking provincial coverage for the cost.

Officials rejected the request.
Decision faxed to man’s home

However, Fenwick noted that the response was not sent to Christopher in the United States but was faxed to his home in Saskatchewan, even though officials knew he was out of the country.

“The ministry knew that Christopher was not at home when they responded to him at his home address,” Fenwick said in his report. “The ministry had an obligation to let Christopher know what his options were so he could assess his financial risk and make an informed decision. It did not do so.”

Fenwick recommended the ministry cover the expense.

“When the ministry gave them their answer that ‘no we won’t cover you’ by way of a fax to a place where they knew he wasn’t at — that, to us, tipped the balance in favour of saying, ‘Look, these are special circumstances and you should pay,’ ” Fenwick told CBC News on Tuesday.

Officials from the ministry have told Fenwick they disagree with his assessment of the case and will not change their decision.

Read more: http://www.cbc.ca/health/story/2010/11/02/sk-ombudsman-health-tumour-payment-1011.html#ixzz14G0Pt6KM

One response

I live in Ontario. Multiple cases like this happen. Patients go off to the US or Europe to get treatment that’s either not available here or is only available after a long wait. Canada has good docs and hospitals like every other country, it’s the system that’s in desperate need for reform. Even prestigious (for Canadian standards) hospitals, like the Hospital for Sick Kids, are so reliant on budgets from the provincial govt. No wonder surgeries get cancelled, beds aren’t available, MRI waits take forever. Patients in this country do die waiting for care – or while they wait, their condition deteriorates to the point where things get worse. Even in an emergency, when waiting months or weeks is usually out of the question, patients sometimes die waiting for treatment. It’s a shame.

The US system needs reform too – but emulating a single payer system will only bring out the worst aspects. We need to return insurance back to it’s traditional role AND allow competition amongst health care providers. The US leads the world in medical innovation and research!

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