Bill Steigerwald
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If Canada's national health-care system is so dang wonderful, why are so many Canadians coming to America to pay for their own medical care?

Why is the hip replacement center of Canada in Ohio -- at the Cleveland Clinic, where 10 percent of its international patients are Canadians?

Why is the Brain and Spine Clinic in Buffalo serving about 10 border-crossing Canadians a week? Why did a Calgary woman recently have to drive several hundred miles to Great Falls, Mont., to give birth to her quadruplets?

It's simple. As the market-oriented Fraser Institute in Vancouver, B.C., can tell you, Canada's vaunted "free" government health-care system cannot or deliberately will not provide its 33 million citizens with the nonemergency health care they want and need when they need or want it.

Courtesy of the institute, here are some unflattering facts about Canada's sickly system:

Number of Canadians on waiting lists for referrals to specialists or for medical services -- 875,000.

Average wait from time of referral to treatment by a specialist -- 17.8 weeks. Shortest waiting time -- oncology, 4.9 weeks. Longest waiting times -- orthopedic surgery, 40.3 weeks. Average wait to get an MRI -- 10.3 weeks nationally but 28 weeks in Newfoundland.

Average wait time for a surgery considered "elective," like a hip replacement -- four or more months.

Hello, Cleveland.

The Canadian system is horribly short on consumer choice and competition. But it isn't all bad -- if you don't mind waiting to access it. As health policy analyst Nadeem Esmail of the Fraser Institute said last week, it does "a decent job of saving your life but treats you terribly in the process."

Esmail says no one knows exactly how many Canadians go to the United States each year for medical care. His best estimate for 2006 -- a conservative one -- is 39,282. Whatever the actual number is, however, it is growing.

Clinics in Detroit and Buffalo market speedy MRIs, CTs or ultrasounds to Canadians which, by law, cannot be purchased privately in some provinces, including Ontario.

Ontario residents have three options: wait months for their free public MRI, travel to a province like Quebec where it is legal to buy one privately or travel to the U.S.

It's no wonder private medical and surgical brokers like Timely Medical Alternatives of Vancouver have sprung into existence. Rick Baker said his three-year-old company refers about 100 Canadians a month to U.S. clinics and hospitals for such things as MRIs and knee replacements.

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Bill Steigerwald

Bill Steigerwald, born and raised in Pittsburgh, is a former L.A. Times copy editor and free-lancer who also worked as a docudrama researcher for CBS-TV in Hollywood before becoming a reporter for the Pittsburgh Post-Gazette and a columnist Pittsburgh Tribune-Review. Bill Steigerwald recently retired from daily newspaper journalism..