You can’t avoid the newspaper stories about our healthcare system in crisis. In the newspapers, it is vague and distant.
But when you experience it first hand with a family member or when your friend tells you about the delays and inability to access services, then it becomes real.
So how do smart and informed families manage their health risk.
These families understand the role of the healthcare advocate and navigator.
Companies like RCM Health have spent decades inside the plumbing. They know how it works in a very detailed and granular way.
So advocates from RCM Health will work as a project manager for the family to attempt to get access to the services inside Canada somewhere.
The provincial health plans in each province are portable. We can move a patient from PEI to Ontario and PEI will pay the bills. We call that patient arbitrage.
If our team can’t get access anywhere in Canada, then we have relationships with hundreds of centres of excellence in the US and Europe.
We source the service. We price the service and then we go to the provincial health plan with the ask. Will they pay.
And in most instances, the province will say no. They like to say no. Occasionally, they will say yes. But rarely.
Then RCM looks for funding sources for the services in the US or Europe.
We advise our informed families to purchase critical illness insurance if they can. Anyone over 70 can’t play in that arena.
If the person’s medical problem is new and is included in the policy, then the funds will be available. That is our budget for the care.
Alternatively, Canadian families living in Canada can purchase private health insurance. That is preferred.
This insurance pays out up to $5M per person per year if the person needs a new hip, a new knee, has breast cancer or prostate cancer. Any new condition is included in the plan.
RCM Health helps to find the best doctors at the best centres of excellence.
And we have up to $5M to fix the problem. It will never cost anything near that but having a big budget for the best of the best is reassuring.
So this is how smart and informed families are choosing to work with RCM Health on a retainer basis in order to manage their health risk.
This strategy will likely be in place until our healthcare system is fixed and can deliver world class care.