The number of Canadians who use the US as "safety value for those in need of urgent, critical or innovative care and therapies" is vanishingly low, quite possibly zero. How many Americans can afford to get medical care in America without the aid of their healthplan? How can Canadians, with their lower average salaries, be doing that?

The whole question was very exhaustively researched in "Phantoms In The Snow: Canadians' Use Of Health Care Services In The United States", by Steven J. Katz, Karen Cardiff, Marina Pascali, Morris L. Barer and Robert G. Evans, in Health Affairs, May/June 2002. They surveyed medical institutions in Buffalo, Seattle, and Detroit, across the border from large Canadian population centers, for procedures which were reported to be in short supply or waitlisted in Canada like CAT scans, cataract surgery, MRIs, etc., and found a few hundred Canadians max per year, as opposed to tens or hundreds of thousands of Canadians having the same procedure in each Canadian province. They checked with mental health organizations (clinics for depression, rehab, drug abuse, etc.) and found all but one having seen fewer than ten Canadians, and one fewer than 25. In New York State, out of over 100,000 patients treated for alcoholism and drug abuse, only 246 were from outside the US at all. Over five years of hospital admissions, Canadians admitted to US hospitals in the three cities represented 0.23% of the total Canadians admitted to hospitals across the border from the three US cities. And, 80% of those 0.23% were emergencies and childbirths. They surveyed 11 of "America's Best Hospitals", (according to US News and World Reports), and found that 6 had seen fewer than 15 Canadians and 4 had seen 20-60 Canadians. The last had seen 600 Canadians, 90% of whom were outpatients being sent there by their provincial plan for proton beam therapy for cancer. When asked directly, which would presumably give Canadians forced to leave the country for medical care a chance to complain, "Only 90 of 18,000 respondents to the 1996 Canadian NPHS National Population Health Survey] indicated that they had received health care in the United States during the previous twelve months, and only twenty indicated that they had gone to the United States expressly for the purpose of getting that care."

Meanwhile, of course, the US has in fact come up with an innovative form of lower cost medical care; medical tourism, with Americans leaving the US to get high quality low cost care anywhere else on the planet, including Canada.

http://www.foot.com/articles/?p=656

That's aside from the folks going to Canada to steal services with bogus membership cards for the Canadian health plans, which are now having to shift to picture IDs. (Obviously, there's no demand among Canadians for bogus Canadian healthcare IDs.) Alberta Health plan reports "several thousand residents of northern Montana, Idaho, and Washington State have Alberta health care cards and come to Lethbridge or Calgary for all their health care needs" illegally. And of course, crossing over to Mexico for cheap healthcare of questionable quality has been popular in the Southern border states for quite a while, but only among poorer folks, so it doesn't rate a lot of headlines like "real" Americans going to get care in Thailand.

http://abcnews.go.com/Business/IndustryInfo/story?id=2320839&page=1

http://www.medicalnomad.com/inthenewslist.do?view=procedure&startIndex=20&procedureID=null

And now, that's an official strategy/service of healthcare insurers:

"WellPoint Introduces International Medical Tourism Pilot Program

WellPoint announced a new international medical tourism pilot product that will allow members to access benefits for certain common elective procedures at designated facilities in India. Beginning in January 2009, WellPoint's affiliated health plan in Wisconsin will pilot the program with Serigraph, Inc., a Wisconsin-based global provider of printed decorating solutions. The pilot program includes coverage of certain common nonemergency procedures such as major joint replacement, upper and lower back fusion, and other procedures that have significant cost differences between domestic and international providers."

made by frank rich in the times, yesterday:

1) "The piece is not the work of a partisan but the Texan journalist Robert Draper, author of “Dead Certain,” the 2007 Bush biography that had the blessing (and cooperation) of the former president and his top brass."

2) Those Biblical quotations studding Rumsfeld's documents are particularly troubling, as Rumsfeld himself is not particularly pious; he was cynically trying to manipulate our born-again president. And, "If these official daily collages of Crusade-like messaging and war imagery had been leaked, they would have reinforced the Muslim world’s apocalyptic fear that America was waging a religious war. As one alarmed Pentagon hand told Draper, the fallout “would be as bad as Abu Ghraib.”

those with long memories for useless things may remember that jessica simpson started out as a christian singer; but when she started to develop upper frontally, the christian music industry began to cast aspersions on her morals, despite no evidence of her ever being anything other than a squeaky-clean preacher's daughter, so she jumped ship.