Cross-border health tourism booming between Canada and USA

A new Buffalo based medical tourism agency is the latest to target Canadians seeking healthcare in the USA as lengthy wait times force more and more people south of the border for treatment. Cross Border Access has been helping Canadians book appointments and negotiate fees for a variety of procedures in upstate New York since May.

A new Buffalo based medical tourism agency is the latest to target Canadians seeking healthcare in the USA as lengthy wait times force more and more people south of the border for treatment.

Cross Border Access has been helping Canadians book appointments and negotiate fees for a variety of procedures in upstate New York since May. Unlike most rival Canadian or US based agencies, this US agency charges a $200-a-year membership fee and connects patients directly with service providers, rather than taking a cut of the fee paid to the hospital, getting an introduction fee from hospitals, or charging commission on top of the hospital fee, based on the amount paid.

Company founder Ed Meyer says, “Because of our experience in the American health care delivery system, we can do a better job of getting good prices and screening the provider to make sure they are qualified. As U.S. healthcare is a free-market system, the same diagnostic imaging scan can cost anywhere from $900 to $2,000. Most Canadians may not know that these great price differentials exist as they are focused on alternatives to waiting months for a CT scan, cancer treatment or knee replacement in Canada.”

Cross Border Access has relationships with diagnostic facilities, hospitals and physicians in Buffalo and Niagara Falls, New York, and targets Canadians from southwestern Ontario and the Toronto area seeking quality affordable care. Ed Meyer says, “We don’t take any money from health care providers in the U.S. and we don’t give any money to Canadian health care providers who refer patients to us. Our only source of revenue is the membership fees from patients so we don’t get into any ethical grey areas about sending people to specific providers or facilities.”

A competing agency Timely Medical Alternatives of Canada makes its money by charging a markup and pays Canadian doctors for referring patients. Richard Baker explains, “This is done in the best interest of patients -and doctors who do not want the marketing fee — about $1000 for a hip replacement patient, for example — can have it donated to a medical charity of their choice. A lot of our business comes from doctors who refer their patients to us because their hands are tied as far as being able to get them surgery.” The agency has helped thousands of people secure treatment since opening for business in 2003, most of them from Alberta, British Columbia, Ontario and Saskatchewan. The agency has partnerships with 22 hospitals in 10 US states and because the agency pays them directly for medical services up front, they are happy to get business they would not otherwise receive and offer their best rates. Timely Medical Alternatives do not charge a separate fee for their services and says, “ In almost every case, the care giving facility pays our fee and, in fact, we rebate a portion of our fee to our clients. There are surgical facilitators within Canada, who charge up to $180/hour for their time. This is on top of the cost of the surgery .we are NOT one of these firms. The exception is for urgent procedures, which are not elective such as cancer treatment, and cardiac procedures. We are frequently asked to expedite these procedures in the US-which we can certainly do. The reality is, however, that in many provinces, these procedures are readily available with short waiting times. Almost invariably, once we have organized treatment for these clients, they obtain a date in the public system and cancel their US appointment. Overtime, our US providers have come to take our requests for cancer or cardiac procedures less seriously. For this reason, we have had to put in place a $500 advance payment charge for requests of this nature. Should the US procedure take place, this pre-payment is credited to the cost of the procedure.”

Some Canadian doctors and organizations are concerned at the growth of agents targeting Canadians, particularly if offering innovative techniques in South America that are not approved in the USA or Canada. They accuse agencies of exaggerating the waiting times and problems of Canadian healthcare, and have concerns about continuity of care and the appropriateness of treatments.

While some agencies are well-run businesses, people desperate for treatment that they cannot get or have to wait a long time for in Canada, are vulnerable to rogues. Some new agencies simply fail due to lack of business, leaving hospitals and patients out of pocket.

A more extreme case is of a short-lived agency, where Windsor police are investigating the founders of short-lived agency EcuMedical Resources International that closed without warning, leaving behind a still-furnished office. The police press release says, “A Windsor couple is facing numerous fraud charges after a lengthy investigation conducted by the Windsor Police Financial Crimes Unit. A cheque had been written by the owner of Ecumedical Resources International (ERI) to a Michigan hospital for medical services provided to a patient. The financial institution reported that the cheque had returned NSF and that the cheque had been written on an account that had previously been closed. A local media outlet reported that a woman had paid ERI over $19,000 for medical treatment she had received at a hospital in Michigan. The woman learned that ERI had not paid her medical bills and presently, the hospital is seeking payment from her. To date, seven victims have contacted the WPS Financial Crime Unit to report similar occurrences involving failed payment by ERI to medical facilities in Michigan. ERI functioned as a go- between service for Canadian patients seeking health care in the United States but primarily in Michigan. ERI would arrange for medical procedures for their clients and in turn, their clients would pay all medical fees in advance to ERI including ERI’s 40-50% fee. The clients were assured by ERI that the fees paid would cover the costs for their treatment in the United States. Clients of ERI are now receiving invoices from medical practitioners and hospitals located in the United States as a result of ERI’s failure to pay as promised. These clients are not only subject to the loss of money paid to ERI but are now facing medical bills from creditors on behalf of the Michigan medical facilities. Tracy Bevington and Deborah Bevington are charged with six counts of fraud over $5000 and two counts of fraud under $5000.”