New kind of Canadian-style care comes to United States

A company that negotiates discounts with American doctors and hospitals to treat Canadians is getting calls from Americans who want those prices, too.

By Pamela Lewis Dolan — Posted Nov. 5, 2007

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

For years, there has been talk about reimporting drugs from Canada to cut pharmaceutical costs. But now, the conversation has turned to reimporting patients from Canada to cut procedure costs.

Richard Baker, a Vancouver native and a public critic of Canada's single-payer health care system, started his business, Timely Medical Alternatives, in 2003 to negotiate rates with American doctors and hospitals so fellow Canadians could avoid long queues. But earlier this year Baker expanded his business to match Americans with U.S. doctors and hospitals, a subsidiary he calls North American Surgery. Baker said uninsured Americans were calling him, looking for the same discounted deals he got for Canadians.

Technically, U.S. patients don't have to go to Canada and come back, like with reimported drugs -- but the effect is the same.

Baker negotiates rates with U.S. hospitals, similar to the discounted rates insurers negotiate. He adds a percentage onto that rate for his own fee, collects the money from the patients, then pays the hospital cash up front before the patient is treated. In most cases, the negotiated rate is a package deal that includes facility fees as well as payment to all the surgeons and ancillary staff, and the hospital distributes the lump sum appropriately.

With more complicated procedures, such as neurosurgery, where the price might not be as straightforward, Baker negotiates rates with each party that are subject to change. The patient is responsible for any charges associated with unforeseen complications, which Baker says has not happened once in his company's four-year history.

Nicholas Terry, a Saint Louis University School of Law professor and co-director of the school's Center for Health Law Studies, said this is the first he has heard of such an arrangement but he finds nothing legally wrong with it. If anything, "it's a sad commentary on how the U.S. health care market isn't a good market."

Scott Edelstein, a health care attorney at Squire, Sanders & Dempsey's Washington, D.C., office, agrees there is nothing illegal with Baker's business -- unless there are state regulatory issues that would define the business as an insurer.

Baker is not aware of any such regulations and said he doesn't act as an insurer, because he does not collect premiums and accepts payments only on a case-by-case basis.

Back to top



Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

Read story


American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn