Medical Tourism--Montreal Choice Versus University of Vermont Medical Center

The University of Vermont Medical Center (UVMC) $600+ base cost for a routine dermatology appointment last year—it took six months to get that appointment—seemed way beyond reason after a routine one in Montreal in 2008 cost $75 Cdn in cash. So called the same Montreal physician's office two weeks ago and got my choice of morning or afternoon just six days later when planning a getaway visit to the True North. Made sure I brought some Canada cash and after the appointment the very pleasant receptionist gave me the bad news—the cost of the appointment over the last decade had gone up--$5--to $80 Cdn! That's medical inflation fo you! That is $60 US even after paying the ATM $3 fee. Quality of care?  Well, noticed this doctor, a McGill University Associate Professor of Medicine and researcher, displayed a plaque commemorating his presidency of the Canadian Dermatologists Association. Fortunately my State of Vermont supplemental insurance coverage allows 80% of the $60 US so I will get a check for $48.

Seems like everyone gets a benefit from this simple example of medical tourism. No claim at all against Medicare, very likely a smaller claim against the State insurance. Even my lower copay will cover a couple of trips to one of my favorite coffee shops—where I am writing this story.  Of course if a Canadian the government health care pays all--no copay, no-deductable (and no blizzard of mail from Medicare, Blue Cross Blue Shield, the physician, etc., etc.)! 

And UVMC? Well, wonder why except for the big stuff, a trip to them makes little sense if it can be avoided.   Besides, it is fun to travel!

Six Months Wait for Simple Medical Appointment--$652 Bill

The American Medical System—Routine Skin Appointment after Six Months Wait

      ....and a $652 bill for routine services

At a regular yearly physical examination last summer at the Burlington Community Health Center my doctor and I agreed it was time for a routine dermatology appointment. Being a very white person, am vulnerable to pre-cancerous lesions which routinely can be “frozen” off in a non-painful way by a routine dermatologist session.

Contacted University of Vermont Medical Center (UVMMC) and surprise, the first open date for the routine appointment was in six months! Previous U.S. appointment to a low-cost private physician (out-of-network) was in San Francisco, less than a week wait for an appointment.

Then the appointment came this year and must admit it was thorough and professional. Then got the bill! The base bill was $652 for the one-hour appointment. Then after all kinds of discounts and co-pays and deductibles—from both Medicare and my Vermont state employee supplemental coverage the first medical bill of the year came in at $217.49.

This caused me to recall my last similar routine appointment—it was in Montreal and, again, no wait to see a private physician, a McGill Medical School graduate. That appointment cost $70 Canadian at the time, and my Vermont insurance covered the out-of-network cost so my actual out of pocket cost was less than $15.

Then last month or so later came all the exciting paper work—from Medicare, from the Vermont state employee health plan, and, of course, the first bills from UVMMC. Oh yes, not one bill from UVMMC but two separate bills—one for the physician services and one from hospital itself.

Next time makes sense to me to get service in Montreal during a visit there. At least there one gets one simple one-page bill, make a simple one time payment.