Going the extra mile to find medical services
| Derek Cassoff | |
Montreal Gazette - May 26, 2004
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Les Gaul spent most of his adult life crisscrossing Canada as an aircraft mechanic with the Canadian air force. But no matter how often he moved, his headaches followed him - debilitating headaches that would sometimes confine him to his bed for two days at a time.
Despite multiple visits to physicians - military doctors, family doctors, even neurologists - no one was ever able to pinpoint the cause of his pain or offer him anything in the way of a cure.
Exasperated, he finally placed a call to MedExtra, a St. Laurent medical brokerage that bills itself as a last resort for Canadians who are frustrated by their inability to access medical services.
In many cases, that means steering Canadians to the United States.
"I wasn't getting far with the medical system in Canada," said Gaul, now semi-retired and living in Nova Scotia's Annapolis Valley. "To make arrangements to go the U.S., it seems impossible unless you have connections."
Within a few weeks of the initial contact, MedExtra's staff arranged for Gaul to visit Brigham and Women's Hospital in Boston, where he underwent a series of diagnostic tests, including a magnetic resonance imaging (MRI) scan.
Though the results have yet to yield an exact diagnosis, they have ruled out some of Gaul's biggest worries, including a brain tumour.
"The peace of mind really helps," said Gaul, 55.
As the debate over two-tier health care rages in Canada, an increasing number of patients are choosing to bypass long waiting lists in favour of treatment in the United States.
Companies like MedExtra are sprouting up across the country to assist those who are willing to look beyond Canada's borders to solve their health problems.
In theory, anybody with deep pockets and access to the Internet can shop around for health care south of the border. But few patients have the know-how or the fortitude to seek out leading medical experts and top health-care facilities while coping with the physical and emotional strains of an illness, said Jeffrey Brock, a former emergency-room physician who founded MedExtra in 2001.
"They need somebody who can come in and quarterback their case, preferably somebody who is emotionally divorced from it," said Brock.
Since launching their business, Brock and partner Evan Savelson, a trained emergency medical responder, have helped more than 1,000 patients find answers to their medical concerns. Some come seeking a diagnosis or a second opinion to a nagging health problem. Others know exactly what ails them and are casting about for treatment options.
"Sometimes, they can get what they need in the public system," Brock said. "Sometimes we send them to private clinics in Canada or to the U.S. Or, it can be a judicious mix of both."
If a patient decides on care in the United States, MedExtra will use its pull to try to negotiate discounts off of the hospital's "rack rates."
The company generates its revenue by charging case-management fees, usually billed by the hour, and by claiming a percentage of any discounts that it manages to negotiate.
Though Brock and Savelson are careful not to disparage Canada's public health-care system, it is clear that companies like MedExtra owe much of their success to the system's shortcomings, said Nadeem Esmail, a senior health policy analyst with the Fraser Institute, which advocates a greater role for the private sector in the delivery of health services.
MedExtra "is another example of how innovative private entrepreneurs are making life better for patients in Canada," said Esmail, co-author of a 2003 report that measured the length of waiting lists in Canada's hospitals.
The report, which surveyed 2,800 medical specialists, found that Canadians are waiting, on average, more than 17 weeks for treatment after an illness or injury is diagnosed - longer than in most industrialized nations with universal health care.
For orthopedic surgery, wait times averaged more than 32 weeks. Waits for neurosurgery averaged 20 weeks.
The report also found that 1.4 per cent of Canadians who sought specialized medical treatment last year ended up leaving the country for services, despite the high costs.
For Gaul, he of the persistent headaches, the trip to Boston, coupled with his MedExtra fees, wound up costing about $5,000. He insisted that it was money well spent.
"What good is your money if you're not healthy enough to spend it," he said.
dcassoff@hotmail.com
On the Web: www.medextra.com
