More on Canadian Healthcare

A few people have been trying to get a lot of political mileage over the recent case of Newfoundland & Labrador’s Premier, Danny Williams, and his very publicized trip to Florida to get heart surgery.  Unsurprisingly, opponents of healthcare reform and insurance industry shills are pointing to this shocking revelation as proof of just how terrible Canada’s healthcare system really is, and citing it as a reason to maintain the USA’s terrible status quo.  They talk about “starting over”, rather than retaining status quo, because it’s more politically ambiguous – but it’s clear that these insurance company shills only want to keep delaying any reform.  It’s worth too much to them in lobbyist dollars to do anything else.

So, who’s Danny Williams, what’s Newfoundland & Labrador, and what really actually happened?

Danny Williams, who is often referred to by nicknames like “King Danny” and “Danny Millions”, is the often controversial, and apparently immensely popular Premier (Head of Government) of the Province of Newfoundland & Labrador.  His province is the newest in Confederation, having only joined Canada in 1949.  It is sparsely populated, home to about half a million.  Newfoundlanders are well known for their sense of humour, their unique accent and dialect, their hospitality, and so on.  Until the oil & gas industry took off, it was economically a very challenging place.  The collapse of the cod fishery in the 1990s, for example, was  disastrous for the province.  However, in later years, it has surged ahead, and has the second-highest GDP per capita of all Canadian provinces, behind oil & gas rich Alberta.

Danny Williams built his fortune first as a lawyer, then as a businessman, building up a cable television & telecommunications company into a huge success which he sold for a fortune.  He is a Rhodes Scholar, incidentally – a well-educated, well-spoken man.  That he wound up in politics is hardly a shock.

He became leader of the Progressive Conservative Party and a couple of years later became Premier, ending a long string of Liberal domination of Newfoundland’s House of Assembly.  He then set on a very contentious program of slashing government spending by ending some significant spending and shrinking the civil service dramatically.  They went on strike, he legislated them back to work.  This broke a significant campaign promise, but it seems that Mr. Williams was determined to accomplish what he saw as the vital business of reforms to improve the province’s fiscal position.

Williams’ masterwork, which made him so famous to all Canadians, was his bitter struggle with the federal government.  Canada has a system of fiscal equalization where “have not” provinces receive transfer payments from “have” provinces to try to increase the overall standard of living.  As Newfoundland’s oil and gas fields came online and started producing revenue, Williams fought hard to have the royalties excluded from the calculation of equalization.  A deal called the Atlantic Accord was supposed to guarantee this, but the Liberal Government in Ottawa tried to renege on their obligations.  Nova Scotia eventually joined in the fight as well, as it has developed some significant natural gas interests..  The fight got bitter, to the point that Williams ordered Canadian flags removed from government buildings in favour of just the Newfoundland provincial flag.  His popularity surged and eventually he won a settlement very favourable to the province.

During the 2008 Federal Election campaign, Williams, enjoying tremendous popularity, encouraged his province to vote “ABC” – Anything But Conservative.  Not a single CPC MP was elected in Newfoundland as a result, with the Liberal Party of Canada sweeping the polls.

Danny Williams’ heart surgery in the US was his next major controversy and the one I want to focus on.  Premier Williams was advised by his doctors that he need a mitral valve repair.  There are, from my understanding, three ways to accomplish the repair – a full sternotomy, a partial sternotomy, and a minimally invasive procedure.  Williams sought the advice of several doctors and decided that he wanted to get the minimally invasive procedure.  Given that he’s a pretty hard working guy, I don’t blame him, the quick recovery has a lot of appeal.

It’s hardly surprising that such a procedure wasn’t available in a province as sparsely populated as Newfoundland.  The reality of living in a country as sparsely populated as Canada in general is is that a lot of medical procedures require travel to centres of excellence.  That’s just a fact based on demographics.   Interestingly, most doctors Canadian media talked to about the options stated that the minimally invasive procedure is not something they commonly recommend because of the risks involved.  One stated she only offered it to young women who were seeking to avoid scars.

So Danny talked to a Newfoundlander cardiologist who suggested a doctor in Florida.  Given that he had a condo in Florida to recover at, it makes some sense that he’d see value in the idea.  Having to travel was inevitable, so why not go south to his place to get it done?

Ultimately, Williams has what most people don’t – the luxury of choice based on virtually infinite resources.  Most people don’t have that.  If the average American was in the position of needing mitral valve repair, the choice of what they’re getting wouldn’t be theirs likely.  It’d be their insurer’s.  One has to wonder what it would be…  Basing one’s assessment of comparative healthcare on the options open to someone with no budgetary concerns is a little ridiculous.

In Williams’ case, what would have happened had he not been so wealthy?  Would he have faced death and ruin?  No.  He’d have gotten the more conventional treatment without delay, wherever it could be done.  He would have received a surgery done by a cardiac surgeon who on average would do more procedures than his American counterpart, according to one news report I read.  What about waits?  Not an issue, there are no significant waits for cardiac surgery in Canada – it was one of the first areas targeted to be improved when we started reinvesting in healthcare.

What do I think of Danny’s choice?  Must be nice to be rich.  Hey,  actually, he almost did a Canadian a favour by selecting himself out of the queue, no matter how short.  I think he didn’t do the greatest job of handling the issue but have to agree with the statement he made – his heart, his health, his choice – because he had the ability to make that choice.  Does it serve as a damning indictment of Canada’s healthcare system though?  Not in my view.  Not in the least.

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3 comments so far

  1. Jeremy Hoover on

    Good post, Nick. This lays out the facts of the matter and points out that nothing Williams did betrayed Canadian health care. He made a personal medical choice that showed understanding of Canada’s health care and maturity on his part.

  2. Bill K on

    My take as an American, he did what I would have done. He chose what was best in his view. My father had his aorta rupture in Ca last year while on a job. He’s from PA, Ca doctors went in and operated and used the best of everything they could. The insurance co paid on par with it. The demonization of health ins is an easy target, but not always true

    • warriorbanker on

      It’s certainly not always true – there are plenty of good stories about what happens when insurance does fulfill their obligations. The problem is that there’s so many people who cannot obtain insurance, though that’s being fixed now by preventing pre-existing condition exclusions, which can be catastrophic in the case that one loses their benefits when they lose their jobs and can’t even afford their COBRA – or entrepreneurs who can’t set out on their ventures because they can’t risk the loss of insurance coverage, a phenomenon called job-lock – though one I’ve not read up a lot on yet.


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