Wil­liams stirs medi­care de­bate

Cape Breton Post - - COMMENT -

N o one de­nies for a mo­ment that Danny Wil­liams is per­fectly within his rights to seek out med­i­cal care wher­ever he chooses, pay­ing for any ex­penses that aren’t cov­ered by Cana­dian medi­care and what­ever health in­sur­ance he car­ries. And if he was just Danny Mil­lions, self-made multi-mil­lion­aire and pri­vate ci­ti­zen, there wouldn’t be much of a hook for pub­lic com­ment about his se­cre­tive so­journ to the United States for some sort of spe­cial­ized car­diac surgery. All one could say is that rich peo­ple have more choices than oth­ers, which is hardly news.

But he’s not just Danny Mil­lions any­more; he’s the premier of New­found­land and Labrador, erst­while de­fender of Cana­dian medi­care and, po­lit­i­cally speak­ing, the man most re­spon­si­ble for the state of pub­lic health care in his prov­ince.

That doesn’t rob him of his free­dom as a pri­vate ci­ti­zen but it does at­tach to his de­ci­sion a pub­lic di­men­sion which even­tu­ally he should, and likely will, ad­dress. Nu­mer­ous com­men­ta­tors, rec­og­niz­ing that they might well do the same in his sit­u­a­tion if they could also af­ford the choice, have taken the slant that he should have ex­plained the sit­u­a­tion more fully be­fore he left or have au­tho­rized some­one to do so.

That might have con­tained the re­ac­tion to some de­gree and dulled the value of the story as an ob­ject les­son in what’s wrong with the Cana­dian sin­gle-payer medi­care sys­tem, as the hy­per­ven­ti­lat­ing blog­gers – es­pe­cially in the United States – are telling it. How­ever, the firestorm would likely have roared through in much the same way, ig­nor­ing the de­tails.

From ini­tial re­ports, the best clue to Wil­liams’s mo­ti­va­tion ap­peared to come from Vickie Kamin­ski, head of New­found­land’s largest health au­thor­ity, who spoke about “some very new tech­niques that come on the mar­ket” for pi­lot­ing and test­ing among “a small lo­cus of peo­ple across North Amer­ica.” So it seems this is not a ques­tion of wait time (that could be a secondary fac­tor, for all we know) but of the avail­abil­ity of some highly spe­cial­ized, cut­tingedge tech­nique that ap­plied to Wil­liams’s con­di­tion.

We can imag­ine Wil­liams say­ing some­thing like this: “I am con­fi­dent that I would have re­ceived ex­cel­lent treat­ment for my con­di­tion in Montreal (or Toronto or Cal­gary) but my doc­tors rec­om­mended this op­tion if I could af­ford it, and since I could I fol­lowed their ad­vice.”

New car­diac treat­ments are pi­o­neered in the United States, as oth­ers are in Canada. Richer-funded (and thus higher-cost) U.S. medicine may well be quicker to adopt new treat­ments and tech­niques, though of­ten only for those who can af­ford them and not al­ways on grounds of proven med­i­cal ef­fi­cacy. That does not make a com­pelling case against Cana­dian-style medi­care if one is will­ing to rec­og­nize the ad­van­tages it be­stows, such as uni­ver­sal ac­cess.

A U.S. In­ter­net com­men­ta­tor re­marked on the Wil­liams story: “It must be pretty bad when even some­one with his clout skips town for med­i­cal help.” Ac­tu­ally, there’s a lot to be said for a sys­tem where “clout” doesn’t help, even if it some­times does in prac­tice.

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