Lin Gilbert, a Canadian single mother and veteran of their health care system, has advice for Americans who think that’s a good way for the United States to go: “Be careful what you wish for.”

Gilbert, 38, with two teenaged children, recently told an audience of American and Canadian journalists, bloggers and policy professionals “Waiting is the Canadian way” in their single-payer system.

She spoke at a one-day symposium sponsored by the Independence Institute of Boulder, Co., in Vancouver. The event featured other self-described “victims” of Canada’s system and experts who offered practical and policy alternatives.

In 1997, at age 27, Gilbert experienced severe back pain. Her primary care physician she described as everything you wanted in a doctor tried to treat her, but she ended up in a three-year saga of pain, drug addiction, disability and a suicide attempt.

Diagnosed with spondylolisthesis, in which a bone (vertebra) in the lower part of the spine slips forward and onto a bone below it, she wasn’t able to get necessary spinal fusion surgery until 2001.

Gilbert had to use a walker, became incontinent because of nerve damage, and in what she described as the lowest point in her life, attempted suicide by swallowing pain medication, one of 12 drugs prescribed throughout the ordeal. There weren’t enough pills in the bottle to kill her; they only made her sick enough to vomit them up.

“You’re made to degrade to a point where you can’t take it any longer, and then you’re made to wait some more.”

Gilbert described treatment by specialists as cold and impersonal. She recalled one doctor telling her that she hadn’t suffered enough to warrant surgery.  Aside from medication, a walker and incontinence products, Canadian Medicare didn’t provide her with any support or counseling.

“That would be the government admitting there was a problem,” she said.

She said she was “allowed to remain on welfare” while she became addicted to pain medication.

When she finally got surgery it would have been the end of the story except her son developed the same condition.

Spondylolisthesis can occur from numerous causes, such as an injury, or it can be inherited.

Whatever the cause, in June doctors at Vancouver Children’s Hospital told Gilbert her 15-year-old son, Braeden, had it. They told her he would have to wait a year before consulting a surgeon in the very same building. Who knows how long it would be, she asked, before the surgery itself?

Doctors said she could move him up in the queue by taking him home, then rushing him back to the hospital in an ambulance to “fake” the seriousness of his condition, which she took as a common practice.

That’s when she took matters into her own hands. And it’s when she heard about Medical Broker. Searching the Internet, she found Richard Baker’s Vancouver-based company, Timely Medical Alternatives, Inc.

Baker, who spoke at the event, founded TMA in 2003 to serve as a kind of “underground railway” to medical facilities in the United States for Canadians waiting for care.

Through Baker she scheduled an MRI in the U.S. for Braeden in days and surgery within a week after that.  She has decided after consult ting with surgeons to delay spinal fusion until he’s gone through his growth spurt.

The cost in the U.S. – between $30,000 and 40,000 – is also a factor because there is little hope of reimbursement from British Columbia.

“It bothers me that in supposedly ‘free Canada,’ with its high taxes, I have to come up with the money on my own,” she said.  Still, she’s not willing to toss Canadian Medicare overboard. “I still need it for other health care needs.”

She said she is not taking up a cause, “I just want care for my son,” adding Canada officially opposes what she’s doing. “I’m queue jumping. We’re supposed to wait. What I’m doing isn’t known in Canada, and I don’t want it known – I’ll get blacklisted.”

But because her son is more important to her than any trouble from her effort to access U.S. medical care, she’s prepared to take it. “I faced Medicare, so I can face anything.”

And she won’t face it alone. Other TMA clients told their stories. Cheryl Baxter from Alberta talked through tears of living on morphine and OxyContin while being lied to by medical officials before getting hip surgery this year in Oklahoma.

Christina Woodkey, also from Alberta, initially consulted with Baker, but then found a U.S. alternative on her own in Montana for spinal surgery. While the $55,000 cost took a big chunk out of her life’s savings, she said spending quality time with her four children and two grandchildren made it worthwhile.

Ontario’s Lindsay McCreith said Medicare wait times kill more Canadians than do bombs and bullets in Afghanistan. Facing an eight-month wait between consultation and surgery on a cancerous brain tumor, McCreith opted for $50,000 to have it removed in Buffalo, NY.  He is suing Ontario Province for violating his charter rights to security of person, much like an American suing for a violation of Constitutional rights.

Each of them reiterated Gilbert’s criticism of cold indifference at the hands of Canadian specialists. All four said treatment was degrading and humiliating. The ordinary or routine in Canada is dealt with well, said McCreith, but the complicated or special is pushed aside. “If you have anything difficult or special about your case, you’re out of luck.”

When asked his chances under any of the healthcare reform plans currently being evaluated in the U.S., McCreith said, “Say goodbye to me.”

What explains treatment these four describe? According to Baker and Nadeem Esmail, Director of Health System Performance Studies at the Fraser Institute, a Canadian free-market think tank, at any given point in time, 3 percent of Canadians are in a healthcare waiting situation.

In Canada, the system is more important than the individual, Baker said. It’s permissible to sacrifice a few hundred or thousand in order to maintain Medicare.

In a presentation at the symposium, Esmail said among 28 of the 30 nations in the Organization for Economic Co-operation and Development that have national healthcare programs (the remaining two, the U.S. and Mexico do not), Canada ranks at the top in cost and unfunded liability, and at the bottom in wait times, modern medical technology, and access to specialists.

He verified Gilbert’s sense that queue jumping is common, citing 80 percent of internal medicine practitioners and 53 percent of hospital CEOs admitting to involvement in it for other than medical reasons. Certain categories of individuals jump as a matter of course. Prisoners, for example, go to the head of the queue.

One person joked the best way to get early specialized care in Canada is to first rob a bank – not for the money, but to queue jump.

Essmail said Canada is in the minority among OECD nations in not having any type of cost sharing, such as co-pays, which often results in a visit to the doctor being more a social call than a medical necessity.

Baker said a significant difference between the current U.S. and Canadian systems is money follows the patient in the U.S; in Canada patients drain the money. In the U.S., he said, health care providers welcome patients because patients bring fees. In Canada, patients drain a fixed pool of funds, so everyone who walks in the door doesn’t add to the bottom line but takes away from it.

In Canada it’s illegal for a hospital or doctor to charge, Baker said, which is one reason he created TMA. There was a need to get Canadians across the border for care.

But it’s not just getting them across the border that concerns Baker. Once here they need quality care at reasonable prices, which is what brought him to form North American Surgery, Inc., to negotiate rates. He said the answer is, “charge less.” He asked why so many surgeons here charge so much?

Dr. Keith Smith, co-founder of Surgery Center of Oklahoma in Oklahoma City, said lack of transparency is a major cause of high costs.

The Surgery Center is wholly owned by 40 surgeons and anesthesiologists. Smith said it’s a state-of-the-art multispecialty facility that has been accredited without interruption since its founding in 1997.

At the symposium he said the relationship between hospitals and insurance companies is a price-fixing cartel, and price transparency could drive costs down. He said he has eliminated administrative overhead and put prices for surgical procedures on-line

Baker does the same for North American Surgery, and offered price comparisons. The U.S. average cost for coronary artery by-pass is $100,000. North American Surgery charges $15,000. A hysterectomy is $20,000 versus $7,500. He said he deals only with professionals in states that do not have anti-competitive “certificate of need” requirements, which he described as a restraint of trade.

He said by shopping for best price and dealing only with healthcare providers transparent about services and prices, he uses market forces for positive results.

What about health care plans under consideration in Washington, D.C.? Smith said he probably would get out of medicine rather than be regulated by the federal government. He said many of his partner-physicians agree.

Gilbert stressed her concern is for Braeden. Today, she knows that he can get the care he needs in the U.S. even though she has to pay for it. But what if the law changes?

“Where will I go to get care for my son?”

Scott St. Clair is a reporter for the Evergreen Freedom Foundation