European cross-border medicine example touted as a solution for Canada

The Montreal Economic Institute and SecondStreet.org are advocating for Canadian governments to allow Canadian patients to get reimbursed for healthcare received outside of the country. A system akin to that established in the European Union would help reduce waiting times, they state. 

Since 2011 European patients are permitted to seek treatment in any EU member country and receive reimbursement of their medical expenses up to what their national health insurance plan will cover at home. “The mechanism is known as the cross-border directive or the patient’s rights directive,” the researchers write in Can cross-border healthcare be the safety valve for waiting lists in Canada? 

Notable barriers 

Some notable barriers to accessing the programs include language barriers, a complete lack of pricing transparency and the need for authorization if there is to be any specialized treatment or more than one night’s stay in a hospital. “Out of the 27 EU member states only seven allow patients to seek treatments in another EU country without any prior authorization,” they write. “Just five have an online system allowing patients to request approval for treatment abroad. In the member states for which data was available, the average processing time of reimbursements for care received in another country was 82 days in 2022.” In Germany there is also a five per cent administrative fee on reimbursements for treatment abroad, “further disincentivizing cross-border treatments.” 

The quality of data on treatments abroad is limited, they add, due to the lack of harmonized reporting systems. When outpatient and urgent care treatments are included, approximately 2.24-million patients were treated – about 0.5 per cent of the population – representing about 0.1 per cent of total healthcare spending.  

The numbers are low, they say, in part because France and Germany have no significant waiting lists.  

Reducing wait times 

“A streamlined system in which Canadian patients can seek out medically-elective services abroad,” they write, “would help reduce wait times and give patients more choices.” The report also looks at wait times for hip and knee replacement surgeries in Canada. It adds that 450,000 European patients accessed elective surgeries outside of their country of residence in 2022. “Nearly 80 per cent of the requests submitted that year were approved.”  

The report concludes saying there would also be an opportunity for Canadians to purchase supplementary insurance to offset price differences between their own province’s health system and that of their destination country. “The result would be fewer patients on waiting lists.”