The senator isn’t the only American traveling north across the border in search of lower cost or specialized medical care.
Earlier this month, long-time critic of socialized medicine Sen. Rand Paul (R-Ky.) created quite a stir when news outlets reported that he was planning on undergoing hernia surgery in Canada.
Canada’s medical system is publicly funded and universally provided, which is very anti-Paul — he once compared the “right to healthcare” to “slavery” in a 2011 senate hearing.
“With regard to the idea of whether or not you have a right to health care, you have to realize what that implies,” he said at that hearing. “It is not an abstraction. I am a physician, that means you have a right to come to my house and conscript me. It means you believe in slavery.”
Contrast Canada’s system to that of the United States, where Americans are covered by a mix of private and government insurance programs, with 13.7 percent having no coverage at all as of the fourth quarter of 2018.
The story, though, turned out to be much less sensational than the initial hype — Paul will be visiting a private hospital and paying out-of-pocket.
Shouldice Hernia Hospital in Thornhill, Ontario, isn’t entirely private. It also treats Ontario residents who are covered under the Ontario Health Insurance Plan.
Paul struck back at critics saying that his was a free market decision.
“I’m actually choosing capitalistic medicine because they only take cash from foreigners,” he told the Louisville Courier Journal.
Healthline reached out to Paul’s office for further comment, but has not received an immediate reply.
Paul added in the interview that he chose Shouldice because it offers the surgery that he needed at the right price. The hospital specializes in hernia repair using natural tissue rather than artificial mesh.
The Louisville Courier Journal reports that the procedure in Canada will cost an estimated $5,000 to $8,000.
Healthcare costs in the U.S. are also notoriously difficult to determine prior to a procedure, and plenty of patients have received bills that can be thousands or tens of thousands of dollars over what they expected to pay.
Add to this the stronger U.S. dollar, and Paul could be saving money over an out-of-pocket procedure in his home state of Kentucky.
Another perk of going to Canada is that Shouldice offers a resort-like setting for recovery, with fresh meals, an exercise program, on-site massage, and relaxing views.
The story highlights an ongoing, and rising, trend of Americans leaving the country in search of medical care.
Americans cite cost savings as the main reason for seeking care in other countries. For people without health insurance — those who would be paying out-of-pocket in the United States — this can be a powerful incentive.
The top destinations for medical tourism were South America, Central America, and the Caribbean.
Canada, though, isn’t much of a medical tourism hotspot for Americans… or even for people from other countries.
“We don’t have nearly as much incoming medical tourism as we do departing medical tourism,” said Amy Zarzeczny, an associate professor in the Johnson Shoyama Graduate School of Public Policy at the University of Regina in Saskatchewan.
“Although robust data is difficult to obtain, the sense is that more Canadians leave Canada to receive care elsewhere than we have individuals coming here from outside the country for medical care.”
Some estimates suggest that Canadians traveling abroad spent $447 million on medical care in 2013, compared to $150 million spent on medical care by foreign visitors coming to Canada.
This data doesn’t detail how many of the inbound medical tourists were Americans.
Jeremy Snyder, PhD, a professor of health sciences at Simon Fraser University in Burnaby, British Columbia, said Canada has some advantages as a medical tourist destination for Americans.
“Right now the Canadian dollar is sitting at 75 cents to the U.S. dollar. Canada is very easy to get to for Americans. And it offers really high-quality services,” said Snyder.
The similarity between the two countries, in terms of language and the healthcare systems, also makes it easier for Americans to head north for medical care.
“There are some excellent hospitals in Central and South America, the Caribbean and Mexico,” said Snyder. “But it can be a little bit harder for patients to determine where the highest quality services are, because of language differences and differences in the regulatory environment.”
For many Americans living along the border, Canadian clinics and hospitals may also be closer than the nearest American facility.
Sarah Palin, former governor of Alaska, revealed that when she was young, her family drove to Canada from Skagway, Alaska, for health care.
But don’t expect lots of Americans to head north — or east or west, depending on where they live — to Canada for medical care.
“Canada historically hasn’t been as much of a hotspot, in terms of a destination for medical tourists,” said Zarzeczny, “in large part because of the way that our healthcare system is structured and the publicly funded nature of the healthcare system.”
Nonresidents, of course, can still get emergency medical care when traveling in Canada.
For some medical procedures, going to Canada might be cheaper than staying in the United States. But probably not cheaper than other countries.
“Canada isn’t able to compete on price that well,” said Snyder, “compared to other places — the Caribbean, Thailand, India — that are much more cost-effective.”
Americans seeking care in Canada will also have a harder time finding a private clinic that will let them pay out-of-pocket than they would in their own country.
“Canada doesn’t have the same kind of robust private system that the United States does,” said Zarzeczny, “so we don’t have as active an incoming medical tourism market.”
She added that anyone traveling outside of their country for medical care, whether to Canada or elsewhere, should keep in mind a few things:
- What the financial costs are, including for the procedure, accessory care, accommodations, and travel.
- What the standards of care in the destination country and at the clinic or hospital are, such as types of treatments that are routinely performed and infection control procedures.
- What the potential risks are, including during the procedure, while traveling after the procedure, and when receiving follow-up care after returning home.