In 2021, Christine Tizzard, now 47, started experiencing a locking jaw, tinnitus-like symptoms, hearing loss and headaches. Tizzard’s oncologist told her that these symptoms were latent effects from radiation that she’d received years earlier for a benign tumour. But the symptoms kept getting worse.
In early April, a Toronto neurosurgeon said she wasn’t sure if it was cancer and that she might operate but would first need a biopsy, which would take several weeks.
Later that month, Tizzard’s pain and double vision got so bad that she went to an emergency room. This led to a quicker biopsy that confirmed she had chondrosarcoma, a malignant brain cancer. Tizzard was given an emergency surgery date in early May. Days later, the surgeon informed her that he couldn’t operate without the support of another surgeon, who was unavailable. The surgery was cancelled.
Panicking, Tizzard consulted with a Pittsburgh-based surgeon who told her that not only could he do the surgery that month, but he could nearly guarantee resecting the entire tumour, something the Toronto surgeons said they would not even attempt. But she needed to pay up front. On May 31, Tizzard received the 10-hour operation that fully resected her tumour. It cost her US$98,393 (C$133,000).
Canada’s health-care wait times are unacceptable and nearly everyone agrees the system needs serious reform. A good place to start would be to make it easier for patients to be reimbursed for care that they’re forced to undergo abroad because our overloaded systems can’t deliver on time.
B.C. Conservative Leader John Rustad has promised to do exactly that, telling reporters recently that, if elected, he would ensure that B.C.’s public health system will reimburse patients who go abroad when they can’t get care at home quickly enough.
The European Union already does this. Citizens can select a public or private health provider in another EU country, pay for surgery at that facility and then be reimbursed by their home country for the lesser of what they paid for the surgery or what their government would have paid to do it at home.
Provinces — including Ontario, Nova Scotia and British Columbia — already have programs that will sometimes pay for care abroad, but they’re extremely limited.
To qualify in Ontario or British Columbia, a patient must face an immediate risk of death or medically significant, irreversible tissue damage. The key word is “irreversible.” The provinces won’t pay so that someone can avoid tissue damage if that damage can eventually be fixed. They won’t pay even if a procedure is needed to avoid severe pain.
The services must also be generally accepted by the medical profession, which means that they won’t pay for treatments that are still considered novel in Canada, which often lags in adopting new procedures. The provinces also won’t pay if supposedly equivalent services are available, even if it’s not the procedure the patient’s own doctor recommends.
Provinces also generally won’t pay unless written approval is granted in advance, which is not always feasible. Tizzard is currently trying to get Ontario to reimburse her, but she faces a tough challenge since she didn’t fill out the required provincial paperwork before her surgery.
That’s understandable considering she needed to pay up immediately to secure a surgery date and didn’t believe she had enough time to wait for the province to respond. Tizzard was also suffering severe pain and nearly blind at that point, so it’s not surprising that she was unable to fill out the forms.
People like Tizzard shouldn’t have to choose between risking their lives or vision and getting treatment that costs them their life savings. If Canada’s health-care systems can’t provide timely care in Canada, they shouldn’t deny coverage to those who take matters into their own hands by getting their procedures abroad.
National Post
Josh Dehaas is counsel with the Canadian Constitution Foundation, a legal charity dedicated to defending Canadians’ rights and freedoms, including patients’ rights.