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Canadian official has heart surgery -- in the U.S.


Newfoundland and Labrador Premier Danny Williams (AP)

What to make of reports that Canadian official Danny Williams opted to have his heart surgery in the U.S. instead of in his homeland?

Williams, premier of Newfoundland and Labrador, apparently needed surgery on a leaky heart valve, a problem discovered when doctors detected a heart murmur. According to news accounts, he chose to have the surgery done in Florida, where he could take advantage of a minimally invasive through-the-armpit procedure that promised to leave no scar on his chest and would allow for a speedier recovery than the traditional sternum-cracking open-heart approach.

Many have viewed his choice as an indictment of Canada's government-run health-care system and a sign that America's health-care system remains superior.

Others say they're puzzled by Williams's choice, noting that the procedure he underwent is available in Canada.

Allowing his words to speak as loudly as his actions, Williams, who is said to be recovering in Miami from his surgery (which according to this story took longer than expected), had explained his decision simply: "This was my heart, my choice and my health."

"I did not sign away my right to get the best possible health care for myself when I entered politics," Williams said.

That's not much of an endorsement for Canada's vaunted public health system. I hope that President Obama and Congress, on the eve of their health-care summit, are paying attention. And I hope that we in the U.S. won't end up trashing our excellent, though imperfect, health-care system in our rush to "reform" it.

But that's just my opinion. What's yours? Share your views in the comments section, and take a moment to vote in today's poll.

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By Jennifer LaRue Huget  |  February 25, 2010; 7:00 AM ET
Categories:  Cardiovascular Health , Health Policy  
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Comments

I went with the 'hard to tell' choice because of lack of enough information to make a cogent decision... Having said that, let me point out that if I need heart surgery I will NOT be running across the Windsor tunnel to get it in Canada...

dr. o

Posted by: ad4hk2004 | February 25, 2010 7:53 AM | Report abuse

Its looks to me like he simply wanted a Florida vacation paid for by the healthcare system.

Posted by: aahpat | February 25, 2010 7:56 AM | Report abuse

Seems like an endorsement of the Canadian system, he could come to the US if he wanted. Try geting your US health insurance to pay for treatment at a better facility in a ofreign country.

Posted by: crete | February 25, 2010 8:04 AM | Report abuse

"None of the above" should be an option. Canadian papers have made it clear what happened - Willams wanted the minimally-invasive procedure and he wanted the most-experienced physician; the guy who does this five times a day, three days a week, and has been doing so for a while. That's the doctor in Miami. The procedure is available in Canada - at the Ottawa Heart Institute - but it's rare there, among other reasons because the medical staff there don't regard it as being useful. (The chief cardiac surgeon in Ottawa gave an interview in which he said he'd only recommend the minimally-invasive procedure for young women who didn't want four-inch scars on their chests; all others should have the sternotomy because it's easier for the doctor.)

Williams, known as "Danny Millions" because he got extremely wealthy before entering politics, wanted the minimally invasive procedure because it heals faster (no broken bones to heal), is less painful (no broken bones to heal, less thoracic damage overall) and has a lower chance of infection (not as much of the body cavity exposed). Since he can afford to pay for it himself, he got what he wanted - this procedure, from a physician experienced with it.

The only thing this says about the Canadian health system is this: it was set up to ensure that money doesn't let you "jump the queue;" everybody gets the same care regardless of wealth, but that's not realistic because people with enough money CAN ALWAYS get better care. (Belinda Stronach, former Cabinet member and one of the wealthiest people in Canada because her father founded the Magna empire, came to the US for breast cancer surgery a few years back.)

Posted by: ArmyBrat1 | February 25, 2010 8:06 AM | Report abuse

to crete: "Seems like an endorsement of the Canadian system, he could come to the US if he wanted. "

The Canadian system didn't pay for it; he paid for it out of pocket. I worked for a Toronto-based company for three years, and it wasn't at all unusual for Canadians with enough money to run across the border to Buffalo or Rochester for treatment. A co-worker injured his knee skiing; he was told he needed minor outpatient surgery and was put in the queue. He was told it would be 6-9 months before he came up for the procedure. He went to Buffalo on a Friday for the exam; went back on Monday for the surgery and was at work Tuesday morning. (He kept his place in the OHIP queue because he might hurt the knee again. :-) Yes, he also paid out of pocket, but since he could afford it, that was okay.

Posted by: ArmyBrat1 | February 25, 2010 8:09 AM | Report abuse

The problem is that Williams would have had to wait a considerable time for the procedure if he'd stayed in Canada. With better-qualified and available surgeons in the U.S., and with his Canadian doctor saying that this surgery was urgent, Williams opted for the U.S. Canadians may have a good system in some respects, but it also involves waiting for procedures. Those who don't want to wait or can't wait are either out of luck or else come to the U.S.

One has to wonder, if the U.S. system becomes more like Canada's, will Canadians still like their system as much, without the U.S. as a convenient second option if Canada can't take care of them right away as well as they'd like?

Posted by: blert | February 25, 2010 8:23 AM | Report abuse

At least the Canadian system covers everyone, without any out-of-network or co-pay nonsense. And it also covers preventive care, which catches problems early, helping keep costs down. Not to mention no advertising and marketing costs. I worked in Vancouver for a few years and the system was fantastic- pick a doctor you like, walk in, show id, get treated. Simple. Pay your taxes, get health coverage. No greedy middlemen between you and the doc. The ReThugs are desperate to keep America from trying it. Like Medicare, once tried the country would never give it up.

Posted by: hairguy01 | February 25, 2010 8:28 AM | Report abuse

hairguy: "At least the Canadian system covers everyone, without any out-of-network or co-pay nonsense. "

True, but irrelevant. This doesn't apply to the Williams case at all because he paid 100% of the costs out of his own pocket.

Even if the US system were to copy the Canadian system exactly (single payer, no private health care allowed by law) this situation would still exist, because there are other places in the world that would pick up the slack. See http://www.bumrungrad.com/

"ReThugs", "DemoCraps", doesn't matter - the reality is that people with enough money will ALWAYS get better medical care (and better other stuff, too.)

Posted by: ArmyBrat1 | February 25, 2010 8:46 AM | Report abuse

"I did not sign away my right to get the best possible health care for myself when I entered politics," Williams said.

The above is the patients statement. The only conclusion one can reach is from what we know from the patient, Mr. Williams. Therefore the only option on the poll is the one statement,

"At least one Canadian leader thinks American health care trumps Canada's system."

I hope that Congress does not fix that which is NOT broken.

Posted by: jnrentz@aol.com | February 25, 2010 8:50 AM | Report abuse

Mr. Williams is a very wealthy man. He's also very high profile. It's possible that he wanted to get his surgery performed and recuperate in a place where he would be unknown and left alone. It's a shame that some people who wish to deny their fellow Americans health care have chosen this case to trash Canada's health universal health care system. The facts do not support their statements.

Posted by: lemoip | February 25, 2010 8:56 AM | Report abuse

crete said :
"Try geting your US health insurance to pay for treatment at a better facility in a ofreign country."
I did, just last year.

Posted by: observer31 | February 25, 2010 8:58 AM | Report abuse

That poll was ridiculous. Some countries have superior facilities for certain ailments, and it is quite certain that America is where anyone sensible would go for heart surgery. We are world renowned for it.

Of course, practice makes perfect, and our preventative health in America leads to a need for much more heart surgery to be performed here than in Canada or elsewhere. And furthermore, were I recovering from heart surgery performed in the winter, I think I might be likely to choose Florida as the venue for it simply because recovery is likely to be more pleasant in its warm climate and flat terrain.

Of course, the national medical care systems in most nations pay for your procedures wherever you may have them performed. The choices for us Americans, whose medical care decisions are made by insurance company clerks whose job depends on denying claims and cutting "medical losses" are generally more limited.

Posted by: FergusonFoont | February 25, 2010 9:03 AM | Report abuse

ArmyBrat1, thanks for providing details that the bloggers themselves didn't produce.

The season before last, two players from DC United (Marcelo Gallardo and Gonzalo Peralta) went to Germany to get hernia surgery, because a world expert works there . . . I hope that Jennifer and Rob are paying attention. Do you think that proves that Germany's health system is better than ours? Oh, you don't? Because two examples like that are not sufficient? Hmmm.

Posted by: fallschurch1 | February 25, 2010 9:14 AM | Report abuse

fallschurch1 - thanks. (I still read the Toronto Star online - hope that doesn't get me banned from the Post. :-)

Look, folks who can afford to will get care from the best in the world. In terms of sports injuries - knees, etc. - the best surgeon in the world is reputed to be Dr. Richard Steadman, of Vail, CO and Dallas. He treats million-dollar legs from all over the world - many, many European soccer players go to him for treatment. They (or their employer) can afford it, and it's that important to have the "best."

It's unfair generalization to say that the US system is best because it produced the best orthopedic surgeon, or the best cardiac surgeon or... Or that the Canadian system is best because of some other great doctor. That's like saying that Kalamazoo Central High School has the best baseball program because it produced Derek Jeter (or Aberdeen High because it produced Cal Ripken, Jr., or ...)

That's why the correct answer to this poll is "none of the above." It's not necessarily true that "Danny Millions" thinks the US medical system is superior to the Canadian system (or that Belinda Stronach thinks that, or...) It IS true that "Danny Millions" thinks that the best doctor for the treatment he wanted is in the US, PERIOD.

Posted by: ArmyBrat1 | February 25, 2010 9:33 AM | Report abuse

This means absolutely nothing vis a vis public policy. The rich people will always and forever have the best health care. Excellent private doctors will always be available. Public policy cannot be driven by the acts of one or 1000 rich people.

Think about about the many Americans who cannot get their children with ear infections to a doctor -- except for the emergency room. This sort of waste is what needs to be fixed -- we are all paying for it now -- it needs to be handled in a more reasonable way.

Grow a heart.

Posted by: Virginiatransplant | February 25, 2010 9:46 AM | Report abuse

This is another example of how the rich get better health care than average. If I had some serious ailment and the best doctor in the world were in Canada, I would fly to Canada and get the surgery. That sounds like what this guy did. The best person for the job was in Florida; he has the money; he went to Florida. If the average Joe Canadian had this ailment, he would have no other choice but to get his surgery done by the inexperienced, yet competent, surgeons in Canada. Universal public health wouldn't change the situation.

Posted by: philmphile | February 25, 2010 10:10 AM | Report abuse

His decision makes perfect sense to me, it's a hell of a lot warmer in Florida than it is in Canada... Maybe he's a Disney fan?

Posted by: SUMB44 | February 25, 2010 10:36 AM | Report abuse

Danny Williams may want to stay in Florida for a long long time, as his reception at home could test the strength of his heart surgery. He has lost all credibility to talk on health care matters. This is not a comparison of health care in North America; just a very wealthy man jumping the queue for non-life threatening surgery in another country, like many other wealthy people. The founder of universal health care coverage, Tommy Douglas (Kiefer Sutherland's grandfather) must be rolling in his grave.

Posted by: gorton | February 25, 2010 10:47 AM | Report abuse

It doesn't mean one darn thing, as you perfectly well know.

This is one person, doing something very personal (and probably with lots of emotional baggage -- as with any serious surgery) and with the $ to do as he pleases. People choose surgeons, hospitals, and locations for many, many reasons, both rational and irrational. I have had several major surgeries myself, and as a non-physician my choices have to be somewhat guided by what I am told by physicians whose judgment I consider trustworthy, and in addition I can assure you that there is also a non-rational emotional component involved as well.

Our health care system is totally irrational, and is a national disaster. I speak as a retired Fed, with excellent, government-provided (oh, horrors to speak the word) insurance. My son, self employed and with health issues, cannot get health insurance at any price he can possibly afford. And as for Canada, I have spent time in Canada -- including Newfoundland & Labrador) and made numerous friends and acquaintances. Not one would prefer the US (non)"system". Of course, none is a wealthy and well-connected as Mr. Williams, whom I do not know.

The people who hate the "Canadian system" most are not the Canadians who use it (and pay taxes for it): they are US doctors and, above all, insurance companies.

Posted by: icyone | February 25, 2010 11:23 AM | Report abuse

Hey, I'd take February in Miami over February in any city in Canada, too!!

Posted by: howkim | February 25, 2010 2:39 PM | Report abuse

The fact that we have some exceptionally skilled doctors and highly rated hospitals and medical centers, which attract folks from around the globe who have the money to pay out of pocket for their care, does NOT mean that we have the best healthcare system in the world. We don't, as the statistics about longevity and infant mortality, among others, point out. It is also pathetic how many people in this country suffer and die on a daily basis because they are uninsured or dropped by their insurance companies or lose their coverage because they've lost their jobs or had to move from one state to another where they can't obtain similar policies.

The U.S. is the ONLY advanced country that doesn't make some kind of basic health coverage available to all its citizens. Everybody screams about how those countries are "socialist" to some degree or another and going broke. Well, some of them may be a little more "socialist" than we are, though all of them are fully capitalist systems, and I don't know that they're all more broke than we are. Healthcare costs are going to bankrupt us in just a few years.

I've been sitting here watching the healthcare summit on C-Span all day, and the Republicans are still digging in their heels and saying no, no, no. There are NO Democrats who are recommending we change to a Canadian system. Nobody wants that, so quit talking as if that's what's been proposed! People who live where I do keep writing letters to the editor about how they think members of Congress wouldn't choose the coverage that is in the Democratic bills. Folks, what is being proposed IS the kind of coverage that Federal employees enjoy, including members of Congress -- a system of exchanges in which both young and old, healthy and unhealthy, Americans can choose the coverage they want, at lower costs because the pooling holds them down, and with subsidies available for the poorest people.

There is no excuse for not getting together to solve this mess.

Posted by: sally1860 | February 25, 2010 4:50 PM | Report abuse

The premier's logic is sound. He went to the specialist who could give him the service he wanted, and he can recover in Florida where he already owns a condo. It's a lot easier to recover in a sunny, warm place than in Newfoundland in February. No big deal - just a personal health decision.

Posted by: panamint | February 25, 2010 6:17 PM | Report abuse

Such procedures are best done in a place where lots of them are done, and I doubt that St. John's NL (or anywhere else in NL) would fit that description.

It sounds like the Canadian health system will pay for his operation. If so, those Canadians really do have a good system!

Posted by: jimk8mr | February 26, 2010 5:03 PM | Report abuse

Mr. Williams is indeed a wealthy man so he chose to pay for his care himself. He also owns a condo in Florida which made the choice of hospitals easier.

The care that he needed was not available in his home of Newfoundland and Labrador, combined population of about 526,000.

It is indeed correct that he could have had the more invasive procedure had he desired to wait in line as his was not an emergency yet. He elected to do neither.

Some newspapers in Canada have been carrying a debate over the ethical correctness of Mr. Williams's leaving the queue in Canada to push an American out of line in Florida.

Canada has a health care system that reaches everyone and those who don't want to wait their turn or are looking for a procedure that isn't covered do as they have always done. They go elsewhere.

Mr. Williams's action is no more a vote for the American health care system than it is a vote against the Canadian health care system.

Posted by: steelchaser | February 27, 2010 12:38 AM | Report abuse

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