Sunday, October 07, 2007

Canadian firms offer Cuban healthcare to U.S. Canadian patients

Two Canadian companies are offering to send U.S. and Canadian patients to get healthcare in Cuba for reduced prices.

jdorschner@MiamiHerald.com

of Choice Medical Services

In the burgeoning business of traveling overseas for medical treatment, two Canadian companies hope to make an imprint by offering healthcare to Canadian and U.S. residents in socialist Cuba.

''We looked throughout Latin America or the Caribbean for a cheap source of medical services,'' says Daren Jorgenson, owner of Choice Medical Services in Winnipeg. ``Cuba is well known for high standards of healthcare.''

Some experts dispute the reference to high standards, but no one disputes the prices. Hip replacement, which can cost up to $38,000 in the United States, can be done in Cuba for $7,600, Jorgenson says. A tummy tuck can be had for $2,800, compared with $5,200 in the United States.

Soaring costs in the United States and a growing number of uninsured have emboldened patients to look overseas for healthcare. The Florida-based Medical Tourism Association estimates that several hundred thousand Americans now travel for health services each year.

Many countries -- from India to Mexico -- have become popular destinations for patients, and many entrepreneurs in the United States and elsewhere have set up companies to facilitate the process.

Cuba is a special case, because the U.S. embargo makes it illegal for Americans to spend money there for treatment.

Three South Florida experts on Cuban healthcare say foreigners with dollars receive much better care than Cubans, but still there could be problems getting treatment in Cuba. And a Miami ophthalmologist disputes the claims of another Canadian company, which says Cuba's doctors are able to prevent a type of blindness that Canadian and U.S. doctors can't.

Still, Milica Z. Bookman, co-author of Medical Tourism in Developing Countries, says Cuba has ''the infrastructure and a well-trained workforce. They're poised to take off'' as a major healthcare destination for Americans if or when the embargo ends.

''Cuba already is a destination for Spaniards and Italians and many others,'' says Bookman, who with U.S. government permission plans to travel to Cuba next month to study its healthcare system. ``. . . They're pushing this -- it's big and it's going to be much bigger.''

Leaders of both Canadian firms acknowledge the irony of Canadians, who have a government healthcare system in which everyone is guaranteed treatment, going to Cuba for surgery.

''It's a political scandal here,'' says Alexandre ''Sandy'' Rhéaume, of Health Services International in Frampton, Quebec. ``People are waiting 12 to 18 months for certain kinds of surgery.''

Rhéaume and Jorgenson say Michael Moore's movie Sicko did a fine job of describing Cuba's healthcare but was flat wrong about no waits for care in Canada. ''Moore is out to lunch'' in ''the stuff he says about Canada,'' Jorgenson says.

For Americans without health insurance, Cuba's lower prices are the lure. A Georgia carpenter says he was delighted to get Cuban care. ``I've been hurting, and I was looking outside the United States for something I could afford.''

The carpenter, who refused to reveal his name because he was violating U.S. law by breaking the embargo, talked with The Miami Herald in a phone interview set up by Choice Medical.

The man, in his early 60s, suffered from a torn rotator cuff that made working impossible. Without insurance, shoulder surgery could have cost him $14,000 to $20,000 in the United States.

After researching on the Internet, he found that Choice Medical could arrange for the same surgery for $4,000 at Clínica Cira Central García in Havana. The price didn't include airfare but did cover nine days in the country, a personal tour guide and some sightseeing while recovering.

Later, the man talked with The Miami Herald from Havana. ''It came out real good,'' he said of the surgery. The hospital was ``better than I expected. All the people are so friendly.''

MANY AMERICANS

Asked if he was given special treatment because it was rare for them to see a U.S. citizen, he said, ``No, there are a lot of Americans down here.''

Experts say the Georgia man clearly received the best care Cuba had to offer -- and far better than most Cubans get. ''There are three tiers,'' says Jaime Suchlicki, head of Cuban studies at the University of Miami. ''There's foreigners paying in dollars. The second is for the [Communist] party and the military, and then there's the common people,'' who often have to wait for treatment and have a hard time getting needed prescriptions.

But ''Cuba has a good foreign medical operation,'' which it has been promoting for years, Suchlicki says. ``Probably the doctors are as good as any doctors. The facilities are fairly good by Canadian or European standards. I wouldn't have a heart operation in Cuba. But a face-lift? Sure.''

Jesús Monzon, an obstetrician-gynecologist who left Cuba in 1995, says that while diagnostic tests were difficult for Cubans to get in Pinar del Río, where he practiced, they were readily available for foreigners treated in Havana. Regular doctors had no access to the latest clinical developments, but those dealing with foreigners did.

René Rodriguez, a Cuban-born physician now living in Miami, thinks Cuba would be a ''lousy place'' to have surgery. ``If anything happens to them there, what are they going to do? The doctors there are not responsible. We have a legal system that makes doctors responsible.''

In fact, legal recourse and follow-up care after surgery are issues for foreigners receiving care in many countries.

Both Canadian companies just started this year. Jorgenson, owner of Choice Medical, is a major pharmacist-entrepreneur in Winnipeg with investments in clinics, a hotel, a salon and a spa.

Jorgenson said he was exploring healthcare business opportunities in India when he realized how large medical tourism had grown there. He started to look at Western Hemisphere options.

''There are all sorts of rogue operations in Mexico along the U.S. border,'' Jorgenson says. ``. . . Cuba was clearly the safest place to deal with. . . . We've had Canadians go down and observe surgeries and stuff. They might say the equipment is not the latest and greatest, but the procedures and techniques are sound.''

''We are not taking high-risk patients,'' Jorgenson says. But surgeries for hip, knee, shoulder -- all elective procedures that Canadians have to wait for -- can be done in Cuba. Jorgenson called Cuba's healthcare system ''almost like Fidel's oil,'' because it attracts so many who have hard currency.

The people who run the other Canadian company, HSI, are considerably less known than Jorgenson. Its founder, Lucie Vermette, has described herself as a Quebec businesswoman who says she became interested in Cuba after waiting for six months to see a specialist.

Rhéaume, the company's vice president, says HSI is a nonprofit dedicated to getting people good, cheap care. Unlike Choice Medical, which attempts to get the entire medical bill paid upfront, HSI charges a $250 filing fee to set up the paperwork for a patient to go to Cuba. The patient pays the medical bill in Cuba, and HSI gets 10 percent of that as its fee, Rhéaume says.

The company promises a lot. An HSI press release says two of its clients were told by Canadian doctors that they would go blind because Canada had no treatment for their degenerative disease, retinitis pigmentosa. But after the two patients went to Cuba, the company boasted that ''these two clients of HSI will not go blind!!!'' The press release gave the full names of the two patients, but Rhéaume said they were not available for interviews.

SKEPTICAL OF CLAIMS

Doctors in Cuba have been treating retinitis pigmentosa for years, but U.S. experts are skeptical about HSI's claims of Cuba's prowess.

Nina Berrocal of the Bascom Palmer Eye Institute in Miami says she recently examined a patient in Puerto Rico who had gone to Cuba for treatment of the disease. He said his vision might have stabilized for a while, but then he went blind. ''Basically, the cells die, and nobody can stop that,'' Berrocal says.

Bill Doran, chief executive of Choice Medical Services, says the company thought that most of its customers would be Canadians. ``But almost 50 percent of the inquiries were from the United States. . . . We wouldn't be doing this if people didn't need the services.''


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