Winnipeg man invoices Manitoba health minister with $14,431 medical bill due to elective surgery backlog

Max Johnson is 65 years old but feels about half his age after flying to Europe for a medical procedure.

The Winnipeg travel consultant flew to Lithuania last month to have left knee-replacement surgery because of the elective surgery backlog in Manitoba. He returned home Sunday and on Thursday sent Manitoba Health Minister Audrey Gordon a letter and an invoice of the $14,431.85 medical bill he incurred.

CBC was unable to reach Gordon for a comment late Thursday night.

The cost of Johnson's surgery, including two weeks of rehabilitation with twice-a-day treatments and physiotherapy sessions, was still about $7,000 less than the $21,439 average cost of a knee replacement in Manitoba, according to 2019 statistics from the Canadian Institute for Health Information.

"My reimbursement would, of course, be extremely welcome but is not the primary purpose" of writing the letter, Johnson said from his North Kildonan home.

"The primary purpose is to have exactly this discussion. When it is feasible to go outside the jurisdiction for treatment, I believe that our government should reimburse people to the amount that it would have cost in Manitoba."

According to a report from Doctors Manitoba released last month, the backlog of surgeries and diagnostic procedures has grown to nearly 130,000. 

Johnson was part of that growing number. He was referred for a knee replacement about a year ago but with waiting lists for some elective surgeries reaching two years, Johnson made the decision three months ago to look beyond Canada for the surgery.

His research led him to the Nordorthopaedics Clinic in Kaunas, Lithuania, which has a "very, very active online presence," he said. "Really, they found me."

He also said reading the testimonials of people who previously had knee-replacement procedures done on the clinic's site, which was a de facto patient support group on Facebook, "really made me feel pretty confident."

Johnson was offered the chance to have surgery in three weeks. He scheduled the surgery for three months later and said he was shocked by the efficiency of the Lithuanian clinic.

"I mean, you get to a point that you really don't expect anything much to happen within [our] medical system unless, of course, it's catastrophic.

"The idea that if somebody could make a decision today or tomorrow to go [to Lithuania], they could be back by Christmas with a new hip or knee … is quite absurd, but it's possible," he said.

Suggests following Ireland's lead

Johnson believes the provincial government's ability to provide elective surgeries is outstripping its ability — both to pay for the surgeries and to organize them.

He's in favour of Manitoba adopting a policy similar to the one Ireland has.

If a surgery isn't able to be completed within a specific timeline, the Irish government grants its citizens eligibility to travel outside the country to have the procedure completed before reimbursing those costs.

Johnson said he could have waited longer to have his surgery in Manitoba but worried about becoming more immobile and the possibility of needing to use a wheelchair.

"What I could not have done was to work, and I like working, and the government likes me working. It means I pay tax and it simply would have become enforced idleness," he said.

"It got to a point that I thought it was an option and I was going to take it."

He said his granddaughter and his ability to participate with family factored into his decision.

"Elective surgery seems to cover virtually everything from a debilitating hip to an earlobe enlargement, and everything in between. But there's somehow something about that word that makes it feel as if it's not quite necessary," Johnson said. 

"But let me assure you, every one of the thousands of people who are on the waiting list do not feel that it's elective. They feel like it's necessary."