The federal government is indirectly subsidizing a variety of sometimes
unproven medical treatments in other countries, as multiple sclerosis
sufferers and other patients claim thousands of dollars in medical tax
credits for foreign health-care costs.
Any non-cosmetic treatment offered by a licensed medical professional outside Canada, whether
officially accepted here as safe and effective or not, is eligible for
credits that cover about 20% of the expense, tax experts say, citing in
part a 2008 Canada Revenue Agency policy statement.
For MS patients who undergo the controversial “Liberation” therapy in places
like Costa Rica or Poland, that would mean a credit of as much as $4,000
— considerably more, some argue, than medicare would have to pay if the
same procedure were performed in Canada.
“You have people who are very incapacitated who are travelling abroad, which increases the cost.
It also increases risk,” said Rebecca Cooney, an Ottawa MS patient and
advocate. “You’re putting them through this. The least you can do is
give them the tax credit.”
The multiple sclerosis patients are travelling abroad to obtain a procedure that widens veins in the neck,
usually by inflating a tiny balloon inside the vessels. Employing such
“angioplasties” in MS was pioneered by Dr. Paolo Zamboni, the Italian
vascular surgeon who has theorized that multiple sclerosis is caused by a
narrowing of neck veins, contrary to the prevailing scientific
hypothesis.
Evidence of the link between the vein problem and the disease is considered inconclusive, though, and no rigorous trials have
proven the efficacy of the treatment. Mahir Mostic, 35, a St.
Catharines, Ont., resident with MS, died recently of complications from a
vein-widening procedure he underwent in Costa Rica.
Ms. Cooney said she is preparing to claim the tax credit for the $15,000 in costs
she racked up to obtain an angioplasty in Albany, N.Y., and then return
for a different procedure — the insertion of a metal implant called a
“stent” — when the widened veins started to narrow again.
She said most of the 200 people who belong to her MS Liberation Group and have
had the procedure themselves intend to make claims.
It is not just MS patients, though, who are seeking out the tax credit for foreign
health care. Travelling outside the country and paying out of pocket for
treatment — whether to get speedier or cheaper service, or to obtain
therapy not available here — appears to be growing in popularity. The
numbers are unclear but several thousand Canadians likely head abroad
annually for health services, said Ian Youngman, a U.K.-based analyst of
the medical-tourism market.
Eileen Reppenhagen, a Vancouver tax accountant with a focus on disability, said she had clients who sought a
variety of treatments for their autistic son in the Washington, D.C.,
area that were not offered in Canada. They successfully claimed the
credit on $250,000 in costs, she said.
Peter Weissman, an Ottawa tax accountant who also has multiple sclerosis, said he flew to Israel
and Greece to obtain an experimental stem-cell therapy — which is being
studied here but is not yet approved — and is claiming the expense.
The practice raises questions, though, abut whether the tax department
should indirectly subsidize foreign health care that might not be
approved or funded at home. MS advocates and some tax specialists argue
it is a justified add-on to an overburdened domestic health system.
“It’s in the best interests of Canada to have as healthy a population as it
can,” said Mr. Weissman. “The government, indirectly funding this
through tax credits, is in line with the spirit of what universal health
care is all about.”
Income-tax legislation is clear on the issue, allowing patients to access the credit for any medical treatment
offered by a doctor, nurse, dentist or other practitioner who is
licensed in their own jurisdiction, said Mr. Weissman. The fact that
jurisdiction is outside Canada “would not be relevant” in judging a
claim, the Canada Revenue Agency confirmed in a 2008 “interpretation” of
the law issued to another MS patient seeking stem-cell treatment
abroad. The agency said the bill for that procedure and related travel
costs would likely be eligible.
Travel expenses must be backed up by a letter from a Canadian doctor indicating the treatment is necessary
and could not be received here, said Mr. Weissman.
The revenue department has no way of collecting statistics on how many taxpayers
claim the credit for medical care they received in other countries, said
Philippe Brideau, a CRA spokesman. However, the total number of people
making allowable claims — the large majority undoubtedly for health care
they purchased in Canada — more than doubled to 3.8 million in 2008
from 10 years earlier, according to agency figures. They would have
received about $1.3 billion off their taxes.
George Jacob, an official with the MS Society of Alberta, said his office had received a
number of inquiries from patients about the tax issue and was told by a
CRA official that Liberation-treatment claims would likely be accepted.
“Many people are spending in excess of $20,000,” he said. “My sense is they
may be able to save in the range of four to five thousand dollars.”
National Post
tblackwell@nationalpost.com