A well used meme in the health care debate is that Canadians – frustrated by wait times and rationing – come to the United States for care. These are almost always anecdotal stories and, well, go to the about the blog page to see what I think of anecdotes.
We should rely on evidence and research; it does exist. The most comprehensive work on this topic was published in the peer-reviewed journal Health Affairs. This study examined Canadians crossing the border for care in a number of ways:
1) First, they surveyed United States border facilities in Michigan, New York, and Washington. It makes sense that Canadians crossing the border for care would favor sites close by, right? It turns out that about 80% of such facilities saw fewer than one Canadian per month. About 40% saw none in the prior year. And when looking at the reasons for visits, more than 80% were emergencies or urgent visits (ie tourists who had to go to the ER). Only about 19% of those already few visits were for elective purposes.
2) Next, they surveyed “America’s Best Hospitals”, because if Canadians were going to travel for care, they would be more likely to go to the most well-known and highest quality facilities, right? Only one of the surveyed hospitals saw more than 60 Canadians in one year. And, again, that included both emergencies and elective care.
3) Finally, they examined data from the 18,000 Canadians who participated in the National Population Health Survey. In the previous year, only 90 of those 18,000 Canadians had received care in the United States; only 20 of them had done so electively.
So there you go. Three different methodologies, all with a solid rationale behind them, all showing that the meme is a myth. Maybe that’s why the paper was titled, “Phantoms in the Snow.”