I live in Canada, but need help from both Canadians and Americans, please.
My wife needs a knee replacement desperately. She has been told by 2 doctors that she needed one, but one doctor said that she doesn’t need it. HealthCanada is taking the position that it is not medically necessary and are therefor not covering the procedure. We have filed appeals but have been told that physical therapy and pain medication would do just fine. My wife can barely walk, though, even with pain medication. She is using a cane and trying to do physical therapy, but it is too painful she said. Sometimes the pain is so bad I find her crying after a day of trying to walk.
We are thinking of going to the USA to get the replacement done, but we would really prefer to get it done in Canada since it will be cheaper. My wife has been out of work and we aren’t making as much money as we used to. I am an American citizen and I have American Health Insurance.
How can we coordinate all this with an American doctor? The doctor who said that she needs the replacement said he will send all records to a doctor in the USA, but we need to find one first.
We really need help badly.
Suggestions would be great. Thanks.
#1 by mistify on February 10, 2010 - 10:40 pm
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I hope Americans are taking a lesson from your story. As a PT, I see this situation frequently with our own “socialized” form of medicine…public aid. It usually goes like this:
A patient begins having severe knee pain due to OA. A single person who is no longer able to work due to the pain is now without insurance and files for public aid. Finding a physician who will even take public aid is a challenge. If you are so lucky and a knee replacement is required, you’ll get much the same response as yours in Canada…it’s not “medically necessary”…do PT and cortizone injections (funny how someone with private insurance will be offered a knee replacement from day one). One must try physical therapy for a great deal of time before it’s even considered….and its usually denied. So, the person winds up being on public aid and after two years of failing physical therapy, they wind up filing for permanent disability. Great, now they are on Medicare and can easily be offered a knee replacement! They get a knee replacement, do well and come out just fine…conceivably better than they’ve been in years. But will this person now go back to work and become a productive person? Probably not because they will probably slip through the cracks. My point: Socialized medicine is NOT the answer.
But I digress…Regarding your wife. If she is covered by your benefits, I see no reason why you cannot come to the US for the surgical procedure. As long as you are not on an HMO, simply make an appointment with a knee surgeon. If you are looking for recommendations, I’d stay with a University level surgeon. If your wife is elligible, there have been greatly reduced hospitalizations for those who have a minimally invasive procedure (you go home the same day). Dr. Berger at Rush University in Chicago does such a procedure. I’ve seen several of his patients who’ve had this…they turn out great.
#2 by Accutek & Co on February 10, 2010 - 11:16 pm
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…Welcome to Socialized Medicine…we are about to have it here so if you want to do it American Style you better do it quick…try filing for Indigent Medicare…tell them you are unemployed and broke…