CANADIANS THROW IN THE TOWEL

They foolishly think that going private is a better option than living in pain or dying. How could they?

"Patients fed up with long waiting lists in Canada are fuelling a fast-growing demand for brokerages that arrange speedy service in the United States as well as in Quebec's burgeoning for-profit medical industry. Brokers and other similar companies say business has as much as tripled over the past year as Canadians apparently become more comfortable with paying for diagnostic tests, second opinions and even surgery. They say their patients include not only the wealthy but also middle-class people willing to take out second mortgages or lines of credit to pay for faster care.

Driving the move are Canada's lengthy waiting lists for many medical procedures. A study last year found Canadians waited an average of 8.4 weeks from their general practitioner's referral to an appointment with a specialist in 12 different medical specialties, then waited another 9.5 weeks for their treatment. Those wait times are almost double what a similar study found in 1993.

An increasing number of patients looking to skirt the public system are being referred to physicians in Quebec's private health care sector, where operations such as hip replacements can be bought out of pocket -- and where the federal government has done little to intervene.

Patients approach the agencies in need of everything from joint replacements to diagnostic work and cancer treatment. The number that OneWorld Medicare of B.C. sends to the United States for at least a consultation has jumped three-fold over the past 12 months, while the company fielded twice as many inquiries between January and March as it did in all of 2004. "We have seen a very large growth in the last year," said Mike Starko of OneWorld. "We shouldn't have to be sending people down to the U.S., we really shouldn't. But that's the unfortunate reality at this point."

Some of the companies act simply as brokers, locating an appropriate private hospital or clinic to perform the needed procedure and negotiating what they call a discounted price. They take a portion of the savings as their fees. Another company, Medextra, provides a broader service, helping people navigate the system by getting them expert second opinions, a private-sector procedure or the right care within the public system in Canada. Its basic rate is $180 an hour. Business has doubled over the past year, with about 100 patients being served at any given time, said Dr. Jeff Brock, co-owner of the firm, which is also based in British Columbia. "There's been a really big shift in public sentiment," said Evan Savelson, another co-owner of Medextra. "There's been a shift from people having very negative feelings about alternatives to solving their medical problems to people welcoming it and being willing to pay for it."

Rick Baker, who started Timely Medical Alternatives in B.C. about 18 months ago without a client in his first month, says business is now thriving, with half a dozen e-mails and as many phone calls from patients waiting for him every morning. One of them was Velma Sutter, 68, of Edmonton. Two Alberta specialists had told her the excruciating pain she was feeling was a result of back trouble, but she'd have to wait a year to get into a pain clinic. Mrs. Sutter headed to the Mayo Clinic in Minnesota in January, where doctors said she had been wrongly diagnosed and really needed a hip replacement. She retained Timely Medical, which got her into surgery in Bellingham, Wash., within two weeks. She said she feels worlds better now. "It's the way to go," she said of the brokerage service."

Mr. Baker's clients -- such as an eight-year-old girl who went temporarily deaf from an ear infection in January, 2004 -- may continue to look elsewhere for help. The relatively straightforward surgery she needed to clear it up was not available until last July, then was postponed until September, then March. Mr. Baker's company stepped in last fall and arranged an appointment with an ear, nose and throat specialist in Washington. The doctor took one look and told the girl's father that if he waited for surgery any longer "your daughter will be dead." The infection had spread alarmingly during the long wait.

A client at OneWorld needed a double knee replacement but was told he could only get one knee done at a time in B.C., with a year-long queue just for the first one. The broker found a hospital in the United States to operate on both knees almost immediately, and within a couple of months he was walking without even much of a limp, Mr. Starko said.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

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