“Ontario Funds $212M U.S. Medical Care”

Data exclusively obtained by CBC News reveals that hundreds of patients from Ontario have been receiving government-funded medical treatment in U.S. hospitals and clinics since 2018. The costs exceeding $212 million have been covered by Ontario’s publicly funded health-care plan, OHIP.

These patients have received various treatments in the U.S., including radiation therapy for children in Florida, inpatient care for eating disorders in Wisconsin, genomic cancer therapy in New York, Massachusetts, and Ohio, as well as consultations for gender-affirming surgeries in California.

The program, existing in all provinces, caters to patients requiring treatments or surgeries unavailable in Canada or facing life-threatening delays. While the practice is deemed cost-effective and life-saving by most experts, there are calls for better interprovincial cooperation to reduce reliance on the U.S. private health-care system.

Prof. Arthur Sweetman from McMaster University suggests that improved collaboration among provinces could enhance the system’s efficiency, emphasizing the need to look beyond U.S. options.

Ontario’s out-of-country care program lacks transparency, with limited public information on the specific treatments covered, costs, and destinations. Obtaining this data required multiple freedom of information requests filed by CBC News starting in 2023.

The analysis of over 3,100 applications submitted to Ontario’s Out-of-Country Prior Approval Program between 2018 and 2024 revealed that about 54% of requests were approved each year. The majority of approvals cited the unavailability of treatments in Ontario, with 95% of approved requests involving U.S. facilities.

Notably, proton beam therapy emerged as a significant expense in the program, with the most expensive procedure in 2024 costing $2.4 million for 29 approved requests. Requests for gender-affirming surgeries also saw a notable increase in 2024 compared to previous years.

Challenges Faced by Families Seeking Treatment Abroad

Patients like Luke Serfas from Alberta have experienced the challenges of seeking medical care abroad. Luke had to travel to Florida for proton beam therapy due to its unavailability in Canada, highlighting the emotional and financial stress faced by families during such treatments.

Proton beam therapy, known for its precision in targeting cancerous tissues, is sought after for its potential to minimize cognitive effects on young patients compared to traditional radiation therapy.

While grateful for the financial support from Alberta’s out-of-country care program, Luke’s family expressed concerns about the prolonged separation and hopes for future access to such treatments closer to home.

In Ontario, the lack of a proton beam therapy facility has led to increased reliance on U.S. centers, raising questions about the need for domestic access to advanced treatments.

Expert Insights on Meeting Healthcare Demands

Health economists suggest that despite the costs, utilizing specialized foreign facilities can offer quality care that may not be readily available domestically. The demand for certain treatments, such as gender-affirming surgeries, highlights the need for specialized expertise that may be scarce within Canada.

Experts emphasize the importance of balancing costs with the quality of care provided, acknowledging the benefits of centralized expertise in specific medical procedures.

Addressing the Growing Demand for Specialized Treatments

As the need for specialized treatments like proton beam therapy rises, provinces like Alberta are exploring options to establish such services locally. Alberta’s call for industry input reflects a shift towards enhancing domestic access to advanced medical treatments.

Ontario’s commitment to establishing its first hospital-based proton therapy facility signifies a step towards addressing the increasing demand for specialized cancer treatments within the province.