Critics worry breakdown in cross-border relations might force an end to the program and urge B.C. to have a backup plan
A breakdown in the Canada-U.S. relationship has not yet disrupted the flow of British Columbians heading to Washington state for radiation therapy, but experts warn the program might not remain viable for long and want the province to focus more on building its own capacity.
Between June 2023 and June 2024, approximately 800 B.C. residents were treated for certain cancers at PeaceHealth St. Joseph Cancer Center and North Cascade Cancer Center in Bellingham, according to the B.C. Cancer agency.
The move to send patients, primarily those with breast and prostate cancers, to the U.S. was a response by the NDP government to the long waiting times many faced in B.C. for life-saving and time-sensitive care.
“Any patients currently receiving care under the contract B.C. Cancer has in place for out of country radiation therapy can have confidence their radiation therapy will continue uninterrupted,” the agency said in a statement.
According to B.C. Cancer, waiting times in the province have improved 11.3 per cent in the almost two years since the program was introduced, with 89.5 per cent of cancer patients starting treatment within the 30-day benchmark during the month-long period ending this Jan. 2.
Costs have been estimated at $16 million total so far, with $13.1 million of that going to treatment costs and the rest to cover travel expenses for patients.
On average, treatment for each patient has cost the government $16,000 in Washington state, compared to $3,854 at home.
The Ministry of Health did not respond to a request for comment by Postmedia in time for publication.
Jason Sutherland, a professor in UBC’s centre for health services and policy research, said that while the program may have had some positive results, it is still indicative of the wider problems with B.C.’s cancer care system.
He said that with the new U.S. administration taking an aggressive stance toward Canada through tariff threats, B.C. should be focused on improving its own capacity, not relying on that of another country.
“I know we’re doing more to improve capacity but we need to put pedal to the metal, so to speak, in terms of, let’s get it more quickly,” said Sutherland.
“From the patient’s perspective, I can imagine that there’s additional barriers at the border right now and additional scrutiny, which may prolong their trips.”
For some former participants in the program, the tensions between Canada and the U.S. means they likely would have refused the offer to travel to Bellingham for treatment if it were offered to them today.
Heather Bould is a 73 year-old Courtenay resident with her second bout with breast cancer. She travelled to Bellingham in September, first for a three-day consult and then a separate trip for the radiation therapy.
She said the care she received was excellent but the uncertainty around the changes being made by President Donald Trump to the American health-care system would make her feel unsafe if she were asked to go again.
“I don’t think it’s safe to go to that country because they don’t even know what’s going on with their own medical at this point. So no, I would decline, and I think people will start to decline,” said Bould.
“What needs to happen is we need to have a complete overhaul of the medical system and have a look at where it’s failing and where it’s failing the most is in our small towns.”
She said that besides the usual shortage of family doctors, there is only one walk-in clinic in Courtenay and residents often have to line up at 7 a.m. to get a spot. Likewise, she said it is almost impossible to get through on the urgent and primary care centre’s phone lines some days.
A University of Victoria nursing professor, Damien Contandriopoulos, said it is likely that some patients also wouldn’t feel safe travelling across the border right now if they belong to a minority population, given the increase in targeted deportations.
He said that premiers from across the country need to come up with a plan in case the option to travel to the U.S. for treatment is taken off the table.
“If one wants to have the capacity to provide radiation therapy services, it’s probably several years of investment. Currently, B.C. has a plan in place that they are going to build new facilities and have more isotope production capacity in a couple years,” said Contandriopoulos.
“We know we are not going to suddenly make the capacity to provide cancer patients with radiation therapy out of thin air. So if sending people to the U.S. is Plan B, what is Plan C, and that’s probably a conversation that could involve all health ministers from coast to coast in Canada.”
Outside of possible challenges with the current U.S. administration, the program as it exists suffers from other issues, according to Bould and Sutherland.
One challenge for those going through the program is the cost, with patients having to pay upfront for ferries, flights and car rentals, which are then reimbursed by the province.
Bould said she was able to afford it, but there might be patients who can’t afford those costs upfront. She also said the per diem she was offered per day was not enough to cover food due to rising prices and that the accommodations offered on the first trip were the “worst accommodations I have ever seen in my life.”
Sutherland added that the funding for the program does not cover the costs for family members to travel with patients.
“One of the things that I think would improve the program is that the program include family members as part of the treatment plan, such that it’s not just a patient going down to the U.S. to receive their treatment, but their families there with them.”
The Conservative rural health critic, Brennan Day, said it is a shame so much money is having to go into the program instead of focusing on building up the capacity domestically.
He said this should be the province’s No. 1 concern.
“Once they get into that program, it’s OK. The problem right now is everything from screening to diagnosis to treatment are delayed, and for many aggressive forms of cancer, that timeline is probably killing people, and I think that’s going to come out more and more as the system gets more jammed up,” said Day.
“It’s critically important that the province take cancer treatment more seriously and builds up that domestic supply.”
With files from the Times Colonist