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Canadian Proof of US Health System

Terry Przybylski 30 March 2010 10 Comments

In hearing all the stories about the gigantic “health care reform” bill that the Democrats have rammed through Congress, which politicians’ names come to mind? Barack Obama, of course, and Nancy Pelosi, and Harry Reid. Maybe even the late Ted Kennedy, who spent his entire Senate career of nearly half a century promoting similar schemes.

Well, here’s the name of another politician: Danny Williams. Never heard of him, you say? Well, neither had I, until just a few weeks ago. He certainly isn’t well-known in America. In fact, he’s not even a U.S. citizen. But to me, Danny Williams illustrates the failure of state-run health care in a way that not even the most famous American politicians ever could.

Danny Williams is the premier of the Canadian province of Newfoundland, a mostly impoverished island of just over half a million people on the eastern edge of North America—still perhaps best-known as the place nearest to where the ship “Titanic” struck an iceberg and sank almost a century ago. The 60-year-old Williams, who as a premier is the rough equivalent of a U.S. governor, found out during a doctor’s appointment a year ago that one of his heart valves was failing to close properly, causing a leakage. Eight months later, in December, his doctors informed him that his problem had become “severe,” and they advised him to get it fixed right away, lest he suddenly slip into heart failure.

As I know from personal experience, that’s a road you don’t ever want to travel down. For I have undergone heart surgery three times in my life—twice as a baby, and once again in my early 40s, a decade ago. Shortly after I was born in Detroit, in the latter half of the 1950s, it was discovered that I had a birth defect known as “coarctation of the aorta.”

To make a long story short, the plumbing around the heart was scrambled, with the worst problem affecting the aortic valve. At the time, heart surgery on babies was entirely experimental, and was regarded by most doctors as not even worth the effort. But a bold young surgeon named Aran Johnson, who had worked at the Cleveland Clinic and had done test surgeries primarily on dogs, thought it could be done in a way that not only would save babies’ lives, but also enable them to live well into adulthood.

And Dr. Johnson was right. In two operations before I was 18 months old—one through my chest, the other through my back—the problem was repaired. Notwithstanding a scarred and underdeveloped upper body, and an often-noticeable nervous affliction, I was still able to attend school on a normal schedule, graduate from college with a journalism degree, work in the newspaper business for 15 years, and reach my 40th birthday with no need for further surgery of any kind.

But in 1998, my aortic valve, the part of my heart closest to where the original operation was done, suddenly became “stenotic”—hardened and narrowed—and in just a few short months, I slipped from apparent good health into a state of heart failure. That term is a bit misleading: it denotes not a cessation of heart function, but rather its inability to pump steadily and at full strength, usually caused by some “mechanical” glitch. It causes shortness of breath, dizziness, chest pains and edema—a buildup of fluid in the lungs (causing severe coughing spasms), abdomen, lower legs and feet.

It also drains your energy, and can make it almost impossible to walk more than a few steps at a time. And once a heart valve is deteriorated, nothing can restore it to its original condition; it must be removed and replaced, or else heart failure quickly becomes not just a death sentence, but an agonizingly painful one.

Using the medical insurance I had through my job, however, I was able to get treatment in a timely fashion just a few miles from my home in Chicago’s northwest suburbs, with my primary-care physician referring me to a cardiologist colleague. The cardiologist diagnosed heart failure and put me on a regimen to stabilize my condition, so that I could be reasonably sure of surviving surgery. Then, in 1999, I received an artificial heart valve in an operation done by a surgeon at a local hospital. It has worked flawlessly for over 10 years now.

Because I know exactly what it’s like to walk on that cliff, I totally sympathize with Premier Williams’ desire to get his heart problem fixed as quickly and efficiently as possible. And he did. But to do that, he of course had to leave Newfoundland—had to leave Canada entirely, in fact—and come to…guess where?

That’s right, the United States. Williams’ doctors in Canada had given him the option of getting either a full or partial “sternotomy,” an older surgical technique which necessitates breaking bones in the chest, followed by a long recovery period. So he consulted with a Newfoundland native who is a cardiac surgeon in New Jersey (notice he isn’t practicing in Canada?), and the surgeon advised him to get an operation at the Mount Sinai Medical Center in Miami from Dr. Joseph Lamelas, a surgeon who has done more than 8,000 heart operations. He repaired Williams’ heart in February, according to the Canadian Press, with a procedure that was “minimally invasive,” requiring only a simple incision under his left arm, and averting any need to break his sternum.

But there was an additional important reason why Williams decided to get his surgery done in Florida rather than Canada. Even to get a less advanced, more painful operation like a sternotomy, he would have had to either wait in line a long time—not something you want to do when you have a bad heart valve—or else find a way to jump ahead of someone else who was already waiting in line. As some of you may have heard, Canada has lots of lines when it comes to medical care; and the more specialized the care is, the longer the lines are. That’s the result of Canada having had a state-run, “single-payer” health care system for nearly half a century, in which the government pays the lions’ share of costs, and bureaucrats have the ultimate say on who gets what treatment, and when.

I was born and raised right next door to Canada, so I have better knowledge than most “Yanks” of what goes on there. For most of its history, Canada has been run by a leftist political and cultural establishment even more arrogant and obnoxious than ours is, if you can imagine that. And to them, socialized medicine, along with state-financed “multiculturalism,” gun control, and a small military devoted mostly to U.N. “peacekeeping” missions for over 40 years, is one of the things that make Canada a “more humane, more just, more caring” country than the crass, selfish, money-grubbing, gun-toting Yankee Republic.

A few years ago, CBC-TV polled its audience to determine the “Ten Greatest Canadians.” One of the ten was a truly great doctor, Frederick Banting of Toronto, who back in the 1920s discovered insulin, giving a new lease on life to untold millions of diabetics the world over. But he only ranked fourth. On top of the list was Tommy Douglas, a Scottish-born preacher-turned-socialist politician who spent over 20 years leading the drive for Canadian “Medicare,” which officially began in 1966.

Despite the fact that socialized medicine provides generally inferior service, and typically makes people wait longer to get it, it has become a political sacred cow in Canada that few if any politicians will criticize—even when they decide not to use it themselves. “The Canadian health system has a great reputation,” Williams said after his surgery in Miami. “We do whatever we can to provide the best possible health care that we can…I have the utmost confidence in our own health care system in Newfoundland, but we are just over half a million people.” He defended his operation as “a very specialized piece of surgery…and I went to somebody who’s doing this three or four times a day, five, six days a week.” He added that “I wanted to get in, get out and get back to work in a short period of time.”

In assessing Canadian health care, a couple of demographic facts must be kept in mind: Canada’s population is slightly less than that of California; and more than 80 percent of it lives within 100 miles of the border. And, always implicit in their socialized medicine system has been the understanding that if people couldn’t get the kind of care they needed within Canada, when they needed it, they could just hop across the border to use the system of the nasty, uncaring, inhumane United States as a backup—with much improved chances of getting just the right kind of care, and quickly. (Relatively few go all the way to Florida, of course; but plenty go to hospitals in Michigan and upstate New York.)

Williams didn’t publicly announce his trip to Florida beforehand—because, he said, he didn’t want to create a “media gong show” in Canada. He said he was aware that getting surgery in the U.S. would spark controversy back home; but he decided, sensibly enough in my view, that his health was more important than the criticism. He also noted that he paid for it out of his own pocket, without knowing whether he would be entitled to any reimbursements from the Canadian system. “This was my heart, my choice and my health,” he said, adding that “I did not sign away my right to get the best possible health care when I entered politics.”

As I said, I don’t begrudge Premier Williams doing what he had to do to save his life. But how many people in Canada have the options that he has? If some poor slob who works in a fish cannery in St. John’s, Newfoundland, needs a new heart valve, for instance, how much of a chance do you think he has to get an operation in Florida? Or how long would he have to wait even for a sternotomy in Toronto or Montreal, when even the premier of his province couldn’t get one without jumping ahead in a waiting line?

I’ve told Premier Williams’ story, and my own story, in some detail here because I want those of you who think President Obama’s “health care reform” sounds like a great idea to think about it some more. As someone who owes his entire life to having been able to be on the “cutting edge” of medical technology, surgical techniques and drugs, I am extremely worried on two counts—not so much for myself anymore as for other, mostly younger people who will require high-quality medical care for serious problems in the future.

First, as now proposed, the Obama plan would give our own bureaucrats the ultimate power to decide who gets what kind of medical care, and when. That means rationing, and ultimately, the power to decide who lives and who dies. Second, it would smother America’s advanced state of medical research and development. Over the past year, I don’t think I’ve yet heard one politician or major media person address the question: Where exactly does state-of-the-art medical technology come from? How are new surgical techniques, and ever-more-sophisticated drugs, and things like artificial heart valves developed in the first place?

Answer: They’re the product of medical R&D—and that’s something that’s possible only in a mostly market-driven, “capitalistic” system. Canada, Great Britain and every other country that now has socialized medicine produces virtually no medical R&D anymore; for this, most of the rest of the world is now almost totally reliant on the United States. And did you know that one of the items buried in the 2,000-page-plus health care bill would reduce the rate of return on medical technology by imposing a “fee”—in effect, a value-added tax—on medical device companies, according to their proportion of U.S. sales?

So what happens when the U.S. under “ObamaCare” ends up producing little or no new medical R&D because, in the judgment of the bureaucrats in charge, it’s “too expensive?” Or it’s “not a top priority?” Or because we’re so busy consuming all of our seed corn that we leave nothing to plant in R&D for the future? Even more to the point: if we can no longer get the care we need, when we need it, which border do we cross? Answer: There won’t be one—not for us, not for Canadians or Britons anymore, not for anyone. Unless you have lots of cash and/or political clout to jump over the waiting lines that will exist here, your chances of getting proper care for your problems will be about as good as that poor fish cannery worker’s.
And as to the cost of privately-run medical insurance, a bogeyman Obama cites endlessly: With Medicare and Medicaid already having run up trillions of dollars in unfunded liabilities in just a few decades, do any of you really think the federal government can be trusted to provide everyone with health insurance more cheaply and more efficiently than the insurance companies have done? If you do, I have an iceberg off the coast of Newfoundland I’d like to sell you.**

**

Terry Przybylski is a freelance writer in Chicago and its suburbs.

10 Comments »

  • Dan Kelley said:

    Some of the most insightful criticisms of government administered healthcare programs that I have listened to in the past few years have come from my acquaintances in Canada. Przybylski’s article effectively reiterates most if not all of the salient criticisms that I have been told about: patients resorting to “medical tourism” to obtain needed care abroad; a shortage of physicians and surgeons caused by recent medical school graduates choosing to relocate to other nations where they can repay their huge student loans and earn decent incomes, as a result severe shortages of doctors are commonplace throughout the dominion; cutting edge facilities and medical equipment are lacking in certain Canadian hospitals due to budgetary issues; rationed care is a reality. One Canadian bluntly put it to me “If socialized medicine cannot work efficiently for a population of thirty million in Canada, how do American politicians think that a similar system can be made to work for a population of over three hundred million persons .

    Of course, Obama, Pelosi and Reid need not fear the consequences of their costly and unpopular healthcare scheme since they are exempted from it.

  • Wellescent Health Forums said:

    It is important in mentioning along with the 10 times order of magnitude in population difference between Canada and the US that this affects the number of medical experts that you will have. If you have a condition that requires significant medical expertise, it is important to find the best expert that you can wherever they are. This would be the case regardless of the type of funding for the medical system.

    Secondly, the wait times in Canada are too often raised as an ominous specter without an adequate understanding of how they work. The wait times are not based on sequential processing, but rather on severity of the condition. If you need immediate care, you get it and others with less serious conditions will be delayed to accommodate.

    Lastly, there is some ideology in Canada regarding keeping the private sector out of health care and this is unfortunate because the private sector could offer value. However, this ideology is based, in part, at looking at the US system and how it discriminates against those with lesser financial means.

  • Elias Crim said:

    An excellent analysis–as usual, Przybylski does a great job making the personal illuminate the abstract!

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  • jeff said:

    Far from being the most ideal system in the world at least the Canadian health care system has ensured that all Canadians have health care for the past 40 yrs. Health is not a corporate enterprise in Canada as it has been run in America.

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  • Dan Kelley said:

    Jeff:

    Is it far from ideal for patients to become addicted to prescription pain pills while waiting to have necessary surgeries performed?

    It is not uncommon in Canada for these patients to end up in addiction recovery programs (paid for by the government health program) simply because their surgeries were repeatedly postponed due to medical rationing. Many of these operations were relatively routine matters, but the bureaucracy and budgetary concerns caused delays. Ultimately, in addition to the costs of the operations, the socialized medical system ended up footing the bill for trying to treat these same people for drug addiction. How is that economical or efficient? Is this a system that any sane person would want in the United States of America.

    But, hey, as you said, everyone in Canada is insured.

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