Every year thousands of Canadian have no choice but to seek medical care outside of the country’s single-payer health care system, according a report from a Canadian free-market think tank.

In 2013, nearly 42,000 Canucks left their homeland to avoid long wait times and inferior care that plagues their centralized health system.

The report from the free-market Fraser Institute found that 41,838 Canadians became “medical tourists” in 2013 and sought care outside of their hockey-loving country. While there were slightly fewer people fleeing the Canadian health system in 2013 than the previous year, the number leaving still amounts to nearly one percent of medical patients in Canada.

“Canadians may leave for a number of reasons including a lack of available resources or appropriate technology, a desire to return more quickly to their lives, to seek out superior quality care, or perhaps to save their own lives or avoid the risk of disability,” Nadeem Ismail, director of health policy studies at the Fraser Institute, told The Daily Caller News Foundation.

“That a considerable number of Canadians traveled and paid to escape the well-known failings of the Canadian health care system speaks volumes about how well the system is working for them,” Ismail added.

Each year the Fraser Institute surveys physicians across 12 major medical specialties about how many of their patients received non-emergency care abroad in the past year. The Institute then combines these numbers with data from the Canadian Institute for Health Information.

In 2013, 41,838 Canadians went outside the country to get medical treatment, down from 42,173 people leaving the country in 2012. This is interesting since wait times for patients who had consulted with a specialist till the time they got actual treatment increased from 9.3 weeks in 2012 to 9.6 weeks in 2013.

According to the report, there are many reasons why someone would leave Canada to seek treatment. Including “because of a lack of available resources or the fact that some procedures or equipment are not provided in their home jurisdiction” as well as “concerns about quality, seeking out more advanced healthcare facilities, higher tech medicine, or better outcomes.”

A major problem with the Canadian health system is that people may have fled because of “the consequences of waiting for care such as worsening of their condition, poorer outcomes following treatment, disability or death. And some may have done so simply to avoid delay and to make a quicker return to their life.”

U.S. conservatives have often criticized the Canadian health system as being subpar compared to the American health system. But liberals point to the relatively low-cost, fair alternative to market-driven health care.

In fact, failed Green Party presidential candidate Ralph Nader recently argued that the Canadian system was an even better system than Obamacare.

“Costly complexity is baked into Obamacare. No health insurance system is without problems but Canadian-style single-payer full medicare for all is simple, affordable, comprehensive and universal,” Nader wrote.

Canadians, however, may not always be getting adequate care. Patients have had to suffer through long wait times and lack of specialized medical equipment, according to the Fraser Institute.

“That a considerable number of Canadians traveled and paid to escape the well-known failings of the Canadian health-care system speaks volumes about how well the system is working for them,” the Fraser Institute says. “It leaves open the question of just how many more Canadians might choose medical tourism outside Canada if given the opportunity.”

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