Hundreds of patients from Ontario have received medical care in U.S. hospitals and clinics since 2018, as per exclusive data obtained by CBC News. The costs, totaling over $212 million, were covered by taxpayer money through OHIP, Ontario’s publicly funded health-care plan.
The approved applications for out-of-country care included radiation treatments for children in Florida, inpatient treatment for eating disorders in Wisconsin, genomic cancer therapy in New York, Massachusetts, and Ohio, and consultations for gender-affirming surgeries in California.
Although the practice is deemed cost-effective and life-saving by most physicians and health economists, some suggest that gaps could be better addressed through interprovincial cooperation instead of relying on the U.S. private health-care system.
Ontario does not publicly disclose specifics of its out-of-country care program, such as the types of surgeries or treatments covered, costs, or destinations. CBC News obtained this information through freedom of information requests filed starting in 2023, revealing details on over 3,100 applications submitted to Ontario’s Out-of-Country Prior Approval Program between 2018 and 2024.
On average, approximately 54% of requests for out-of-country care were approved annually between 2018 and 2024. The main reason for approval in 80% of cases was the unavailability of the treatment in Ontario, while the remaining 20% were approved due to potential life-threatening delays.
Most approved requests (95%) were for treatments and surgeries in U.S. clinics and hospitals, with the highest cost in 2024 being proton beam therapy. Requests for gender-affirming surgeries, such as phalloplasty and vaginoplasty, notably increased in 2024.
The article discusses the case of Luke Serfas, a Canadian patient who had to travel to the U.S. for proton beam therapy due to its unavailability in Canada. Proton beam therapy, unlike other radiation treatments, minimizes damage to surrounding healthy brain tissue and is crucial for minimizing long-term effects.
In Ontario, proton beam therapy has been a significant expense under the Out-of-Country Prior Approval Program since 2022. The lack of such facilities in Canada has led to patients being sent to the U.S. for the treatment.
Experts suggest that investing in specialized equipment domestically could eliminate the need for patients to seek treatment abroad. The high demand for certain treatments indicates the potential benefits of having advanced medical facilities within Canada.
There are ongoing discussions in Alberta and Ontario about establishing proton beam therapy services within the provinces, aiming to enhance access to innovative and life-saving cancer treatments for patients nationwide.