Guest Column:

A Canadian’s Journey South

And a Warning to Americans

Karen Selick
Oct. 8, 2009

Imagine this. You’ve been noticing for a couple of months that your vision is deteriorating. You’ve been having headaches and unexplained vomiting. You feel tired all the time.

You know your doctor is busy so you don't trouble her for an appointment immediately, hoping you’ll get better. When you finally do go, she’s alarmed by your vision loss and your skyrocketing blood pressure. She orders an MRI scan. Five weeks later you get the report: There’s a lesion on your pituitary gland, just below your brain. The doctors aren’t sure what to call it. It could be a meningioma, a pituitary adenoma, a craniopharyngioma, an epidermoid adenoma, or a Rathke’s cleft cyst, they say.

You ask what these are. Several are types of brain tumor, one possibly malignant. Uh-oh. Your doctor refers you to two specialists. The earliest appointment you can get with a neurologist is more than seven weeks away. The earliest appointment with the endocrinologist is 16 weeks away.

But this thing is growing in your head. Your optometrist’s tests confirm you are getting progressively closer to blindness. What to do?

Shona Holmes, the woman who has been criticized in some quarters recently for jumping into the U.S. debate on health-care reform, faced exactly this situation. She decided to take matters into her own hands. If Canada's health-care system didn’t care enough about her to alleviate the unbearable anxiety that anyone would feel under such circumstances, there were other places in the world that would.

Shona travelled to the world-famous Mayo Clinic in Arizona, where she was seen by three specialists within seven days. She was fortunate: Her growth turned out to be non-malignant. But it still had to be removed or she would surely go blind. As well, it seemed to be the source of hormonal problems that had been plaguing her. Left unattended, she was warned, her symptoms could worsen dramatically and over the long run, could be fatal. The U.S. doctors were clear: Urgent surgery was needed.

Shona returned to Canada thinking that with such a clear diagnosis and treatment plan, she would have no trouble getting urgent surgery. Wrong again. Faced with more consultations and more waits of indefinite duration, she returned to the U.S. and had immediate surgery that restored her vision completely within 10 days.

Would you have done anything different? I wouldn’t. Canadian politicians and celebrities frequently don’t wait either, using private Ottawa clinics or U.S. hospitals for speedier care.

Nor should Canadians have to wait, according to the Supreme Court of Canada. In 2005, the court struck down Quebec’s health insurance monopoly, thereby permitting Quebecers to purchase private health insurance. “Access to a waiting list is not access to health care,” wrote Chief Justice Beverley McLachlin. The court accepted evidence that Canadians sometimes die on waiting lists for the public health-care system. Many others undergo physical and psychological suffering that saps not only their enjoyment of life, but also their ability to contribute to society as productive members of the workforce.

Four years have passed since then, but Ontario’s laws have not changed.

That’s why Shona Holmes, supported by the Canadian Constitution Foundation, is bringing a similar constitutional challenge to Ontario’s health insurance monopoly. Canada’s Charter of Rights and Freedoms guarantees citizens’ rights to life, liberty and security of the person. No one should have to experience the agony Shona endured because of a legal bar on spending your own money to buy something essential for your health.

Some fear ending the health-insurance monopoly would also spell the end of Ontario’s public health care system. The experience of other countries has demonstrated this is not the case. Public and private plans coexist in many countries, including Austria, Germany, the Netherlands, Australia, Great Britain and Sweden, providing care to all citizens, regardless of income, but without long waiting lists. These countries have care outcomes as good as, or better than, Ontario’s.

Ironically, two of the doctors who treated Shona in Arizona were Canadians who had gone south. Permitting privately funded medicine in Canada could end the brain drain and might even encourage some of the talent we have been exporting for decades to return.

Karen Selick is an attorney who is litigation director for the Canadian Constitution Foundation. This article appeared in the Calgary Herald Aug. 13, 2009 and appears here by permission. Emphasis was added.

An American Looks North

Before Our Health Care Goes South

David C. Stolinsky, MD
Oct. 8, 2009

The Canadian health-care system could have been a very good system, but those in charge valued “fairness,” not quality of care. And to achieve “fairness,” they chose to lower the ceiling, not raise the floor. In Ontario, they chose to forbid Canadians from paying for care that the government does not provide: “If we don’t give it, you can’t get it.”

To achieve “fairness” of health care, one need not uproot the entire system. One need only go to prison. There everyone gets guaranteed health care − as well as guaranteed food, clothing, shelter and work. No, they don’t get good health care, good food, good clothing, good shelter or good work. But they do get “fairness.”

“Access to a waiting list is not access to health care.” The Canadian Supreme Court can grasp this simple thought. Yet it seems to be beyond the capacity of Democrats in the U.S. Congress, so they tell us to emulate the Canadian system. From a distance, almost anything may look attractive. But up close, the flaws become painfully obvious. The key is to look carefully before we get too close.

Calling the proposed government takeover of health care a “reform” does not make it any less of a takeover. Those who are pleased with the Postal Service or the Department of Motor Vehicles will have no problem with this. The rest of us may have a different view. “Take a number” may be tolerable when we are renewing our driver’s license, but not when we are in pain or losing our eyesight.

America is responsible for the majority of advances in health care and for over 60% of the Nobel Prizes in Medicine. We just won another. America has the best survival rates for most forms of cancer. Under a proposed Democratic plan, there will be more money for general practice, but less for cardiology and oncology.

Our two biggest killers are heart disease and cancer, but the plan is to reduce expensive treatments for these diseases. Is our goal to reach the low survival rates of the British National Health Service? If “fairness” merely means equality, we can say that a cemetery is “fair.”

Handing out white coats for a photo-op at the White House is not a substitute for providing needed care. President Obama lectures on tonsillectomy and on amputations in diabetes, but he is not a doctor − he just plays one on TV.

Bureaucrats cannot care for patients; they can only deny care. The Democratic plans do not provide one penny to train more doctors and nurses. Who will care for all the new patients? This inevitably will lead to rationing − that is, to government control over the lives of everyone. This may be the goal of those who push ObamaCare.

Yes, there are horror stories from American health care. I’ve heard some. But there is a difference. If an insurance company denies coverage, you can complain to your state insurance commissioner. You can go to a public hospital, like the one where I worked for 25 years. You can go to any emergency room. You can apply to a charitable organization. You have some flexibility.

But if you have a “single payer,” you wait. You wait for your vision to fail. You wait for your cancer to grow. You wait for your hip to be replaced − or not. You wait to get a pacemaker − or not. You wait for unelected, unaccountable, faceless bureaucrats to decide whether you will live out your days blind, or in pain, or not at all.

Why does “pro-choice” refer only to abortion, but not to health care, or schools, or gun ownership, or what car (if any) you can drive, or even what light bulbs and toilets you can use? Choice? What choice? Whether to live in pain or kill yourself?

Are we independent citizens who care for ourselves and our loved ones, but who sometimes need the government’s help? Or are we infantilized subjects, totally dependent on a parentified government to care for us, usurp the responsibility for our families, and make important decisions for us? This, rather than what health-care system we choose, is the key question.

Dr. Stolinsky writes on political and social issues. He can be contacted at dstol@prodigy.net.

www.stolinsky.com