Opinion: Shipping out surgeries a short-term solution
“Head, shoulders, knees and toes, knees and toes… ”
The singing game with those particular lyrics has been around since at least 1961, and it’s often described as a great way for children to learn about their own body parts. (If you’re not familiar with it, any two-year-old in your extended family can probably direct you to the correct Cocomelon episode and the almost-instant earworm it will create.)
But in Manitoba, there’s a new version, and it might more accurately be sung as, “Hips, shoulders, knees and toes, knees and toes” — because surgeries on all those parts can now be done out of province at the taxpayers’ expense.
Foot surgery, along with those for ankles and shoulders, are the latest to be added to hip and knee surgery in the list of procedures that can be done at approved sites in other Canadian provinces and at select U.S. medical facilities in North Dakota, Ohio and even California.
Is it humane to do something to keep people from languishing on wait-lists? Absolutely. The improvement in a patient’s personal quality of life after a successful knee or hip surgery can be remarkable. Delaying surgeries is close to cruelty.
M. Spencer Green / AP Files Knee replacements can be life-changing for patients in constant pain.
But is shipping surgeries out of province a financially responsible way to handle those operations, or health care in general?
Well, it might be worth thinking about the ever-politically-popular multiplier effect, something that political leaders like to trot out when they claim to be making “investments” in Canadian businesses. The argument is that, when dollars are spent building business infrastructure, the reach of those dollars goes much further than the actual dollar amount of the money spent. Spinoffs of that spending mean the impact of a government investment goes much farther, touching more people.
Loosely explained, the spending travels around the economy: a company gets funding, and so expands and hires more people. The people hired by that company might use their salaries to buy a used car, helping a dealership. And on it goes.
But the reverse can be said about buying surgeries in other provinces or other countries: in those cases, every health-care penny leaves the province. Permanently. And more.
This is from the province’s own information for prospective out-of-province patients. “Manitoba Health pays all out-of-province fees to the surgeon and hospital directly.” Ballpark figures for the cost of a hip replacement in the U.S. are around the US$40,000 mark, or near $54,000 Canadian. (American hospitals have a reputation, as well, of charging extra fees on everything from bandages to simple over-the-counter painkillers.)
If you can’t afford to front the money for accommodation and transportation, where does that leave you?
And then there are extra costs: “Patients are required to pay for all accommodation, transportation and meal expenses during travel. Any expenses incurred by the patient that are within the pre-defined limits of the program will be fully reimbursed by Manitoba Health after surgery.”
(Leave aside for a moment the question of fairness: if you can’t afford to front the money for accommodation and transportation, where does that leave you? Not everybody has the money to pay costs and wait for reimbursement.)
Money spent in North Dakota is also money that isn’t being spent (and taxed) here.
In the great health-care whack-a-mole game, every province in the country seems to be trying to find some way to use out-of-province medical care to solve in-province health-care shortages. But we seem to have lost sight of the concept that establishing proper health-care resources in our own province might be cheaper, closer and more cost-effective — while also keeping dollars cycling around in the Manitoba economy.
Unlike the ideal hip replacement, sending patients away isn’t a near-miraculous solution. It’s nothing more than a stop-gap.
On a provincial scale, a very short-term fix for hips, shoulders, knees and toes.
Knees and toes.
Credit: Opinion: Shipping out surgeries a short-term solution
