Canadians are being offered a private health insurance plan that will provide a second opinion on diagnosis and treatment for serious illness at the Mayo Clinic south of the border.
The MyCare program, announced Monday by Assured Diagnosis Inc. of Calgary, will initially be available to Canadians outside of Quebec, up to the age of 75.
MyCare policyholders will have access to diagnostic expertise delivered remotely via an electronic second-opinion consultation as well as on-site care at the Mayo’s three clinics in Rochester, Minn., Jacksonville, Fla., and Scottsdale-Phoenix, Ariz.
The program is aimed at illnesses such as cancer and heart disease, with policies available for singles, couples and families, said Jim Viccars, president and CEO of Assured Diagnosis, who has long been involved in the insurance industry.
“I had wanted to bring forward a program that involved Mayo Clinic because I’d been exposed to how Mayo Clinic does health care,” said Viccars, who first approached the world-renowned, not-for-profit institution more than three years ago about setting up an insurance program for Canadians.
He said there are many stories of Canadians having difficulty obtaining a definitive diagnosis in a timely manner, resulting in a treatment lag.
“I think there’s enough evidence that the health-care system is strained in some cases to the breaking point, depending on which part of the country you’re in, and the delays in treatment have resulted in death … or resulted in situations for others who have to live in pain while they’re waiting for a diagnosis or joint-replacement surgery or for back surgery.”
While some Canadians may want to seek faster care at U.S. health centres, including at the Mayo, they may be unable to afford the cost. “So an insurance program would work to their benefit,” he said.
And MyCare is meant to complement, not compete with, Canada’s publicly funded system, he asserted, explaining that consultations and treatment plans are done in conjunction with a policyholder’s Canadian doctor.
But David Eggen, executive director of Friends of Medicare in Alberta, said the introduction of such private coverage “goes against the spirit if not the letter of the law of the Canada Health Act.”
“We see insurance companies trying to expand their markets all the time in Canada. It’s very lucrative to sell private insurance, as we see in the United States,” Eggen said Monday from Edmonton. “It’s part of a disturbing trend that I think we should protect Canadians from, quite frankly.”
Eggen said such companies profit by spreading the idea that Canada’s universally accessible system is irrevocably broken and that the care provided is somehow inferior to American private-sector health services.
“That’s not helpful and simply not true as well.”
The insurance program, underwritten by Lloyds of London, does not include deductibles or co-payments, but there are coverage exclusions for pre-existing medical conditions. In other words, a person with existing heart disease would not be covered for that condition, but would be eligible for electronic consultations and treatment for cancer and joint replacements, for instance.
The plan also pays travel and accommodation costs for the patient and in some cases for a companion, Viccars said.
Premiums depend on age, lifestyle and other factors: a non-smoking couple under age 40, for example, would pay C$60.90 per month in premiums; a similar couple who smokes would pay $102.90 a month. The premium for a single person over age 50 would be $87.50 per month if a non-smoker, $149.33 a month if a tobacco user.
Dr. David Hayes, a cardiologist at the Mayo in Rochester, Minn., said tens of thousands of Canadians have sought testing and treatment at the clinic’s three locations over the years.
For some time, said Hayes, its physicians and other staff have been providing diagnosis and second opinions through remote electronic consultations and Mayo is now looking to make that expertise available outside the United States.
Canada, which shares a common language and is geographically close, “seemed like an excellent opportunity for such an initiative,” he said. “But it’s really just to extend the ability of Mayo to try to reach out to more Canadian patients.
“We can offer a timely second opinion, so this will be up to the people offering the product when they reach out to us for the electronic second-opinion consultation,” he said, adding that if a patient and their Canadian health provider feel that treatment might be better done at the Mayo, then those arrangements would be made.
“But that will be decided on the Canadian end of things. I do want to make the point that … it’s not our goal to see these Canadian patients and then keep them as Mayo Clinic patients to deliver all of their care here. This is being done collaboratively, so we can work with the local health-care provider through MyCare to help get the best for the patient.”
Depending on the success of MyCare, Mayo Clinic may entertain hooking up with insurers from other countries, said Hayes. “So if we can reach out to more international patients, we’d love to do so.”
Eggen of Friends of Medicare – a member of the Canadian Health Coalition, which is dedicated to preserving and improving universal health care – is not knocking the Mayo Clinic, nor indeed U.S. health care overall.
“We do use that very clinic for some out-of-country procedures for Canadians and we have a sophisticated level of interaction between our health systems, in terms of technology and expertise and so forth,” he said.
It’s the continuing attempts to introduce different forms of private for-profit health care, undermining the bedrock of the universal-access system, that he finds objectionable.
“We find this a little bit more disturbing, companies like this, because they’re actively trying to sell a product,” he said.
“And it could be game-changing. It’s not necessarily difficult to go from selling private health insurance to go to the United States to selling private insurance to go to a clinic or a facility on Canadian soil.”