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Welcome home to Canadian health care, Premier Danny Williams; Now come clean about that visit to the US

Danny Williams, the premier of Newfoundland and Labrador, should soon be back home.

In case West Coast Canadians haven’t heard, Mr. Williams went to the United States for heart surgery. Why? According to his spokesperson, because his doctors told him to. For what operation? The spokesperson and the Newfoundland government refused to say. To which hospital? The Mayo Clinic? The Massachusetts General? Sorry, we’re not allowed to know.

The right-wing pundits in the United States and Canada immediately seized on this as evidence of failure of universal health care. The Fraser Institute in Vancouver said Williams is one of tens of thousands of Canadians who cross the border for treatment each year. In their efforts to pummel faltering health-care reform legislation, US conservatives suggested that if Canadians have to come to the States, the Canadian system must be broken, the US is the best, and so the status quo south of the border is fine. Never mind the 47 million people without health insurance.

Newfoundland is small; it has only a half million inhabitants. A cardiologist in St. John’s told the National Post that bypass surgery is available in Newfoundland, but patients who need more complex procedures are sent to Montreal or Toronto. He never had to refer a patient to the United States. Various media outlets quoted specialists in Ontario and elsewhere who said that virtually all types of heart surgery are available in Canada. Patients with urgent needs get operations quickly, and Canadian surgeons have standards as high as U.S. surgeons.

Of course, Mr. Williams is wealthy and can pay for whatever treatment he chooses, but was his illness so exceptional that he had to go to another country? He owes the citizens of Newfoundland and Labrador a full explanation, which he’s promised to provide once he’s recovered. Although his health matters are his own concern, he and his cabinet are responsible for health care in the province. Their mysterious pronouncements have undermined confidence in the Canadian health care system simply by creating space for doubt. And critics of universal, publicly funded health care are always ready to pounce.

Whatever the inadequacy of the Canadian system, the Fraser Institute has the same response: Canada needs commercial health-care insurance and for-profit clinics and hospitals. Their solution for any problem is privatization, so this is no surprise. The Fraserites fail, however, to take account of some important findings in health care research.

Investor-owned insurance and hospital chains make lots of money for stock holders, executives, and certain medical specialists, but research shows that for-profit care costs more and often delivers lower quality. For instance, people with kidney failure who are treated at for-profit clinics in the Unites States are less likely to be referred for transplant surgery and more likely to die than people treated at not-for-profit clinics.

Although the efficiencies of the market are supposed to work wonders, the market-driven US health system is the most complex and inefficient in the world. With myriad insurers, marketing consultants, and competing clinics and hospitals, the number of paper pushers and bean counters per patient is much higher than in Canada. And all these actors add little to no value to patient care; they just shuffle money and skim some off the top. Leading economists such as Paul Krugman emphasize the rationality of a single-payer system, which exists in every Canadian province.

Some Canadians have experienced unfortunate medical outcomes, prolonged waits for specialist appointments, and unattractive facilities. But so have many Americans, and plenty of them have been turned away for lack of insurance. It’s true that some US hospitals are renowned for their expertise, personal care, and cutting-edge technology. The wealthy few in North America, or from any other country, can pay for “the best medical care in the world” at this handful of US hospitals, most of which, by the way, are not-for-profit.

The great majority of Canadian and US citizens can’t afford to travel for brand-name surgery. And in Canada, they don’t need to worry about it because they can get very good care at home. If the money and energy used by ideologues to promote parallel commercialized health care were invested in the existing system, perhaps all Canadians could have the best medical care in the world, from St. John’s to Vancouver.


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