Fact check/Did 52,000 Canadians leave Canada for healthcare in 2014?
Fact check: Did 52,000 Canadians leave Canada for healthcare in 2014?
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March 9, 2017
By Cory Eucalitto
At a CNN town hall debate between Sen. Ted Cruz and Sen. Bernie Sanders, Cruz responded to what he said is Sanders' frequent praise of the Canadian healthcare system by claiming that many Canadians "vote with their feet." "In 2014," Cruz said, "over 52,000 Canadians left Canada to get health care in the United States and other countries."[1]
Is Cruz correct?
According to research by the Vancouver-based Fraser Institute, a total of 45,619 Canadians sought non-emergency medical treatment outside of Canada in 2015, the latest year of available data.[2][3] However, a total of 52,513 Canadians did so in 2014, as Cruz claimed.[4]
The Fraser researchers suggest that wait times for specialty services may prompt many Canadians to travel elsewhere for treatment. A lack of data prevents comparisons with other countries.[5][6]
Canadian healthcare system
Canada's healthcare system, referred to as Medicare, is made up of 13 provincial and territorial health insurance plans that must meet federal standards, including a requirement to insure all Canadian citizens for medically necessary services.The services that qualify as medically necessary are determined by the publicly administered plans in consultation with physician groups. Most medical services are provided by private hospitals and physicians.
Medicare generally does not cover vision and dental services, prescription drugs, ambulance services, or in-home care.[7] As a result, roughly two-thirds of all Canadians hold supplemental coverage from private insurers.[6]
The claim
Sen. Cruz's office told Ballotpedia that his claim is based on an annual series of Fraser Institute reports titled "Leaving Canada for Medical Care."[8]
The Institute surveys physicians in 12 medical specialties, and asks, "Approximately what percentage of your patients received non-emergency medical treatment in the past 12 months outside Canada?” Those responses are then considered in relation to the number of procedures performed in each province.[3]
The researchers estimated that 45,619 Canadians received non-emergency medical treatment abroad in 2015, down from 52,513 in 2014.[3][4]
Urologists, neurosurgeons, and oncologists reported the highest percentage of patients who received care outside of the country in 2015 (between 1.6 and 1.3 percent of their patient population). Cardiovascular surgeons reported the lowest percentage of patients who received care outside of Canada (0.4 percent of patients).[4]
Comparable estimates
There is no official accounting of the flow of patients between countries.[9]
Most of the available research focuses on "medical tourism," which according to the Organisation for Economic Co-operation and Development (OECD) occurs "when consumers elect to travel across international borders with the intention of receiving some form of medical treatment."[9]
The U.S.-based group Patients Beyond Borders estimated that 1.4 million Americans traveled abroad for medical service in 2016, based on a combination of data from foreign governments and surveys of U.S. medical centers, hospital networks, and clinics.[10] That estimate, though, includes primarily elective services. Roughly 50 percent travel to Mexico or Costa Rica for dental work, and 15 percent to the same countries for cosmetic surgery.[11]
Depending on the definition of “medical tourist,” the highest estimates range between 30 million to 50 million worldwide each year, and the lowest estimates range between 60,000 and 85,000. (The lower estimates typically exclude individuals receiving unplanned surgery and outpatient procedures, and expatriates.)[9]
Causes
Fraser researchers suggest several potential reasons other than wait times prompting Canadians to travel abroad for medical treatment, including the lack of service availability in one's province and concerns about quality of care.
The Fraser physician survey found that the median time between referral by a general practitioner to a specialist and receipt of specialist treatment was 20 weeks, although wait times vary across provinces.[5]
| Median wait from referral by GP to treatment by province, 2016 | ||||
|---|---|---|---|---|
| Province | Weeks | |||
| New Brunswick | 38.8 | |||
| Nova Scotia | 34.8 | |||
| Prince Edward Island | 31.4 | |||
| Newfoundland & Labrador | 26.0 | |||
| British Columbia | 25.2 | |||
| Alberta | 22.9 | |||
| Manitoba | 20.6 | |||
| Quebec | 18.9 | |||
| Saskatchewan | 16.6 | |||
| Ontario | 15.6 | |||
| Source:The Fraser Institute, "Waiting Your Turn: Wait Times for Health Care in Canada, 2016 Report," accessed February 20, 2016 | ||||
Wait times were also calculated in 2013 by the Commonwealth Fund, which found that 29 percent of Canadians who needed to see or saw a specialist in the previous two years had waited two months or more. A total of 18 percent of Canadians who needed elective surgery waited four months or more.[6] The 11 surveyed countries were Australia, Canada, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, United Kingdom, and the United States.
Conclusion
Sen. Ted Cruz responded to Sen. Bernie Sanders' praise of the Canadian healthcare system during a recent debate by claiming that in 2014, "over 52,000 Canadians left Canada to get health care in the United States and other countries."
According to a report by the Vancouver-based Fraser Institute, based on survey responses from medical providers in 12 specialties, 52,513 Canadians traveled abroad for non-emergency medical services in 2014. That figure fell to 45,619 in 2015.
See also
- Healthcare Policy
- Affordable Care Act
- Fact check/Could 36,000 people die if the ACA is partially repealed?
Sources and Notes
- ↑ CNN, "Transcripts, Sens. Bernie Sanders and Ted Cruz Debate over U.S. Health Care System," February 7, 2017
- ↑ The Fraser Institute's website describes the organization as "an independent, nonpartisan research and educational organization."
- ↑ 3.0 3.1 3.2 The Fraser Institute, "Leaving Canada for Medical Care, 2015," accessed February 17, 2017
- ↑ 4.0 4.1 4.2 The Fraser Institute, "Leaving Canada for Medical Care, 2016," accessed February 17, 2016
- ↑ 5.0 5.1 The Fraser Institute, "Waiting Your Turn: Wait Times for Health Care in Canada, 2016 Report," accessed February 20, 2016
- ↑ 6.0 6.1 6.2 The Commonwealth Fund, "2015 International Profiles of Health Care Systems," January 2016
- ↑ Government of Canada, "Canada's health care system," accessed February 17, 2017
- ↑ Cory Eucalitto, “Email communication with Phil Novack,” March 8, 2017
- ↑ 9.0 9.1 9.2 Organisation for Economic Co-operation and Development, "Medical Tourism: Treatments, Markets and Health System Implications: A scoping review," accessed February 20, 2017
- ↑ Patients Beyond Borders, "Medical Tourism Statistics and Facts," accessed February 20, 2017
- ↑ Cory Eucalitto, “Email communication with Josef Woodman,” March 8, 2017
Launched in October 2015 and active through October 2018, Fact Check by Ballotpedia examined claims made by elected officials, political appointees, and political candidates at the federal, state, and local levels. We evaluated claims made by politicians of all backgrounds and affiliations, subjecting them to the same objective and neutral examination process. As of 2025, Ballotpedia staff periodically review these articles to revaluate and reaffirm our conclusions. Please email us with questions, comments, or concerns about these articles. To learn more about fact-checking, click here.
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