Or if you're trying to find that perfect sunshine getaway to seek shelter from winter's chill, you go to a travel agent to plan how you are going to get there.

But if your body is not just right and you want the comfort of putting it back in order in a timely manner outside of the regular health care system who do you turn to?

For the past two years Richmond's OneWorld Medicare Inc. (www.oneworldmedicare.com) has been specializing in lining up surgical procedures for clients in U.S. hospitals that in some cases can reduce their wait time for treatment in Canada from two years to just two months south of the border.

"Overall, the Canadian health care system works very well for those who require immediate (lifesaving) care. But if you fall into that grey area where you require treatment considered elective, you can spend a long time on the wait list," said Michael Starko, OneWorld's managing director. "That's the unfortunate part of the system.

Starko pointed to the wait some patients endure in Canada for bilateral knee surgery-one of the more popular procedures-that can have patients wait two years to complete since the surgery is done one knee at a time with a lengthy wait between procedures.

"You can wait up to nine months to have the first surgery. Then, after recovering you have to go back on the wait list for the next surgery, which can take another nine months," Starko said.

The cost for this type of service through OneWorld is $25,000. And that covers all of the medical procedures, including an initial "meet and greet" with the surgeon at the hospital in advance of the surgery, the operation, and then a follow up visit to judge the healing process.

While the price may not be prohibitive to some clients, their current medical condition might rule them out of taking advantage of the service since OneWorld, along with the medical facility across the border performing the surgery, screens out those who they deem might pose a high complication risk as a result of the surgery.

So, how do Canadians used to having national medicare programs pay for their surgeries react to having to foot the bill out of their own pockets?

What OneWorld gets from the transaction is a portion of the savings the clients receive thanks to the "corporate" rate the company is granted based on the volume of patients they send south.

"We want to help people who are frustrated and fed up with waiting for their surgery and simply want to get on with their lives," Starko said. "The only change is that people are paying for it themselves no rather than their insurance company.

"Everyone's situation is different," Starko added. "If someone believes that having surgery outside the Canadian health care system can affect their way of life, then it maybe a viable option."

Vancouver Coastal Health Authority spokesperson Viviana Zanocco said her organization would never counsel patients to seek health care outside the Canadian system. The health authority believes the province is providing adequate levels of service and new methods are being introduced to shorten wait times.

For example, the health authority recently announced wait times for hip and knee reconstruction surgeries for patients waiting longer than 24 weeks had decreased 63 per cent thanks to a pilot project procedure at Richmond Hospital.

Zanocco said surgical teams are making better use of operating room time, enabling them to complete six cases a day when they used to manage three.

As a result, surgeons at Richmond Hospital are on track to carry out 650 procedures this year, an increase of 136 per cent over what the hospital handled before the project was launched in the fall of 2004.

"Our joint replacement surgical teams have gotten so good at what they do, we've been able to lower the median wait time for completed hip and knee joint surgery in Richmond from 19 months to seven months," said Dr. Ken Hughes, orthopedic surgeon and co-lead of the Hip & Knee Reconstructive Project in a press release. "Thanks to the things we've learned as a result of this pilot project, we've been able to provide patients with better access to service and improved outcomes."

According to the website during the week of Oct. 31, the median wait time at Richmond Hospital for knee replacement surgery-on a single knee-ranged from 6.3 weeks to 37.7 weeks. Zanocco said knee surgery in B.C. is performed on one joint at a time to allow the patient to retain some mobility following the procedure.

Starko said OneWorld bases its service on providing the best care quickly and doesn't rule out sending them within Canada for treatment, if possible.

"We're more than happy to send our clients to a facility in Canada as well as the U.S. Whatever is best for the patient is what we do," he added. "And that's different than a business that just sends customers across the border to the same hospital in Bellingham for a procedure just to beat the wait list. We find the best facility for your surgery, and at the best price."

And since OneWorld's parent firm, Travel Underwriters, has been insuring travellers for more than 40 years, Starko said his service is well placed to ensure the best care at a competitive price.

"We've insured millions of Canadians over the years for medical coverage when they visit the U.S., so we already have the infrastructure in place to offer this service," he said. "We have core management people who ensure that our clients get the proper treatment because in the U.S., which is a very litigious country, their medical system tends to overtreat patients by ordering some unneeded tests and procedures. We ensure you get the treatment you need."

In addition to finding the right hospital for the right surgery, OneWorld offers some customization by tailoring treatment to a client's circumstances.

"If you have family in Palm Springs and want to spend part of your recuperation with them, or if you want to spend it in the sun by the pool in Phoenix, we can also arrange that," Starko said.

Currently, OneWorld has yet to go big with marketing its services. B.C. has been the main focus as things got off the ground. But plans to branch out to Ontario are in the works, and a corporate benefits package version is being worked on where subscribers have the service provided through their employer.

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