U.S. Republican Sen. Rand Paul coming to Canada for surgery

[Edge of Reason]

Although they may have to wait a while to get the surgery...this would be free for a Canadian....how ironic.

https://www.cbc.ca/news/world/rand-paul-hernia-canada-shouldice-1.4978260

[caffeine]

Given that, I'm confused by this older article in regards to the same clinic:

https://www.theglobeandmail.com/news/national/layton-defends-his-mid-90s-visit-to-private-hernia-clinic-in-toronto/article18152433/

It is a private, for-profit clinic that a Canadian politician who champions public healthcare was criticized for using.

[Edge of Reason]

Thanks for the link....I should have dug deeper.

The fact that this is a private clinic in a country with public healthcare being accessed by a private american citizen championing private healthcare in their own country makes it doubly ironic.

This should be "free" in both countries.

[GuitarStv]

To receive health care in Ontario, you visit a doctor.  Then you are triaged based on your needs.  If you have a non-life threatening issue that requires an in demand specialist of some kind, you are likely going to have to wait a while (several weeks, or even a month or two) to get treated . . . although you will eventually get treated and will get good treatment.

Rich people don't want to wait for treatment generally, so to prevent them from simply buying private health care and effectively forming two tiers of health care, it's not legal for private hospitals to run in Ontario.  Except when that bill was introduced several privately funded hospitals already existed . . . they were grandfathered in and allowed to continue running.  This Shouldice clinic (incidentally, it's supposed to be one of the best hernia repair place in the world) was one of them.

It exists in kinda a weird place in our system.  Much of the funding for the clinic today is public, but they do take private patients.  Canadians can receive treatment there paid for by our public health insurance when recommended by their doctor, or they can personally pay the cost of surgery and get treatment there.  The clinic has some odd policies (like refusing you treatment if you're over 20% of your ideal body weight).

So, it's likely that Jack Layton didn't know the place was private when he went there, and it's also likely that Rand Paul paid for his treatment at the clinic because he couldn't find a better US clinic.

[DadJokes]

America can't do anything "free" correctly. I've been in the VA system for several years now. I gladly pay out of pocket over what I have to deal with there.

[bacchi]

America can't do anything "free" correctly. I've been in the VA system for several years now. I gladly pay out of pocket over what I have to deal with there.

It must depend on the location. Spartana uses it regularly and my SO's dad (Vietnam vet) has no complaints. He's happy that he gets quality hearing aids courtesy of the VA.

[Cellista]

So, it's likely that Jack Layton didn't know the place was private when he went there, and it's also likely that Rand Paul paid for his treatment at the clinic because he couldn't find a better US clinic.

I bet Paul will pay considerably less than he would in the U.S.

The medications he will get will also be cheaper because it's Canada.

It's very odd for a U.S. patient with good (US federal government) insurance to go abroad for care. No disrespect to Canada but surely there are doctors in the U.S. who could provide the treatment he wants. 

I wonder if Paul is really paying for it.

[iris lily]

To receive health care in Ontario, you visit a doctor.  Then you are triaged based on your needs.  If you have a non-life threatening issue that requires an in demand specialist of some kind, you are likely going to have to wait a while (several weeks, or even a month or two) to get treated . . . although you will eventually get treated and will get good treatment.

Rich people don't want to wait for treatment generally, so to prevent them from simply buying private health care and effectively forming two tiers of health care, it's not legal for private hospitals to run in Ontario.  Except when that bill was introduced several privately funded hospitals already existed . . . they were grandfathered in and allowed to continue running.  This Shouldice clinic (incidentally, it's supposed to be one of the best hernia repair place in the world) was one of them.

It exists in kinda a weird place in our system.  Much of the funding for the clinic today is public, but they do take private patients.  Canadians can receive treatment there paid for by our public health insurance when recommended by their doctor, or they can personally pay the cost of surgery and get treatment there.  The clinic has some odd policies (like refusing you treatment if you're over 20% of your ideal body weight).

So, it's likely that Jack Layton didn't know the place was private when he went there, and it's also likely that Rand Paul paid for his treatment at the clinic because he couldn't find a better US clinic.

Thank you for that explanation of this clinic and why it is a private pay place.It was grandfathered in before that was disallowed. I had thought that Canadians didn’t allow anyone Private pay places, so this reinforces that I DID know a basic fact about healthcare services up north.

I really like Rand Paul. I like the fact that he was out mowing his own lawn when the idiot neighbor attacked him. I am so sorry that he was attacked. Rand also cuts his own hair, I like that. And if he wants to go to what he considers to be the world’s best hernia repair place, let him. I don’t really think much political hay  can be made of it but you all can continue to try.

[use2betrix]

Thank you @GuitarStv for pointing this out. I have have had 3 hernia surgeries as an active young adult/weight lifter, I have researched to the end of the Internet and back about hernias.

I don’t believe that ACA or our health system has really anything to do with it at all, and it’s somewhat petty that the media is spinning this into something it really isn’t.

The shouldice hernia technique is one of the most guaranteed hernia repair techniques and very, very few places perform it. I’m honestly not sure if any places in the US even perform this type of hernia surgery, maybe a couple. No places that I’ve been to.

I’ll be having a 4th hernia surgery at some point. It’s bit an emergency but will do it on a year that makes sense.

[Abe]

As a surgeon, I learned about and observed the Shouldice repair for historical reasons. Thanks for this article; I am truly surprised it's still running!

I'm kind of surprised he'd go to the clinic (unless he's had a lot of complications from prior repairs). We almost never do Shouldice repairs anymore since there are good trials showing it to be equivalent to technically easier, and less painful, mesh repairs in elective cases (which is what's done almost everywhere in the developed world). It's a good technique that is probably effective in select groups of patients who don't want permanent mesh. It's not useful in emergency situations since the tissue planes get messed up, and if the technique isn't done exactly the hernia recurrence rate is unacceptably high. That's probably why few people could replicate the Shouldice series' results due to the difficulty of the technique, even among extremely experienced surgeons.

Sorry you've had to have so many surgeries, use2betrix! Good luck on this one!

[Fomerly known as something]

America can't do anything "free" correctly. I've been in the VA system for several years now. I gladly pay out of pocket over what I have to deal with there.

It must depend on the location. Spartana uses it regularly and my SO's dad (Vietnam vet) has no complaints. He's happy that he gets quality hearing aids courtesy of the VA.

Our Administrative Assistant is very pleased with the VA care she has been receiving. 

[scottish]

As a surgeon, I learned about and observed the Shouldice repair for historical reasons. Thanks for this article; I am truly surprised it's still running!

I'm kind of surprised he'd go to the clinic (unless he's had a lot of complications from prior repairs). We almost never do Shouldice repairs anymore since there are good trials showing it to be equivalent to technically easier, and less painful, mesh repairs in elective cases (which is what's done almost everywhere in the developed world). It's a good technique that is probably effective in select groups of patients who don't want permanent mesh. It's not useful in emergency situations since the tissue planes get messed up, and if the technique isn't done exactly the hernia recurrence rate is unacceptably high. That's probably why few people could replicate the Shouldice series' results due to the difficulty of the technique, even among extremely experienced surgeons.

Sorry you've had to have so many surgeries, use2betrix! Good luck on this one!

Yep.  I had a hernia repair about 10 years ago & I considered shouldice, but the mesh results seemed a bit better and with a faster recovery time.

use2betrix, what is causing your hernias?   Is this from lifting?

[use2betrix]

As a surgeon, I learned about and observed the Shouldice repair for historical reasons. Thanks for this article; I am truly surprised it's still running!

I'm kind of surprised he'd go to the clinic (unless he's had a lot of complications from prior repairs). We almost never do Shouldice repairs anymore since there are good trials showing it to be equivalent to technically easier, and less painful, mesh repairs in elective cases (which is what's done almost everywhere in the developed world). It's a good technique that is probably effective in select groups of patients who don't want permanent mesh. It's not useful in emergency situations since the tissue planes get messed up, and if the technique isn't done exactly the hernia recurrence rate is unacceptably high. That's probably why few people could replicate the Shouldice series' results due to the difficulty of the technique, even among extremely experienced surgeons.

Sorry you've had to have so many surgeries, use2betrix! Good luck on this one!

Yep.  I had a hernia repair about 10 years ago & I considered shouldice, but the mesh results seemed a bit better and with a faster recovery time.

use2betrix, what is causing your hernias?   Is this from lifting?

Hernias are largely hereditary. My dad has had some, so had his dad. The lifting can contribute to them, but a person is typically predispositioned to them or they aren’t. I doubt I’d have as many if I hadn’t been lifting so hard my whole life. Many people lift 3x as much as me without ever a hernia in their life. Luck of the draw.

As I told my dad after he asked me if I planned to slow down my lifting after my last one. I’d have a hernia surgery every other year if it meant I still got to do what I love...

I have cut out leg press and dead lifts lately as those do seem to impact it more. They trade off didn’t seem worth it. I still squat a lot and push myself everywhere else. I’ve always told myself that as I get older my exercise will likely shift, which it slowly is. I’ve started running a ton and cutting back on the lifting. I’m way too muscular to be a really good runner yet, but can’t let it go quite yet.