Here’s a television ad currently being aired in parts of the United States, as private interests, including physicians and health insurers, wage their war against President Barack Obama’s push to reform health care. It features Shona Holmes of Waterdown, Ont.
Holmes, 45, has become the latest poster child for Americans hoping to stave off Canadian-style “socialized medicine.” She has appeared at press conferences on Capitol Hill and been interviewed on CNN and Fox News. She has repeatedly told the story of how she was diagnosed with a brain tumour and eventually had surgery at the Mayo Clinic in Phoenix, Ariz., when it became apparent that the wait for treatment in Canada would take months. She remortgaged her home to pay the clinic’s $97,000 bill and is suing the Ontario Health Insurance Plan (OHIP) to recoup the costs.
(Holmes certainly isn’t the first media darling to be featured on U.S. networks on the issue of Canadian health care. British Columbia businessman Don Neufeldt, who went public earlier this year about lack of timely access to a cardiologist in Canada, forcing him to seek treatment in Oklahoma City, Okla., is another).
As one might expect, Holmes’s case is slightly more nuanced than powerful lobbies or ratings-driven newscasts care to reveal. In today’s Globe and Mail, columnist André Picard offers a piece that provides some background, balance and clarity. Holmes’s tumour was not malignant; it was a benign cyst that, yes, was impairing her vision, but was not life-threatening. Frightening as vision loss would be for any patient, Canadian doctors believed it to be temporary and reversible. They were doing what, in the Canadian and British systems, doctors must do: prioritize patient care.
Meanwhile, Holmes has come under personal attack by defenders of the Canadian system, including bloggers and Facebook users, who are giving the family mediator a little more grief than she’s accustomed to.
Having lived and worked under both systems, I don’t understand the overheated rhetoric deployed by both sides of the health-care debate. Each system has strengths and weaknesses. In the U.S., thanks to competition among hospitals and an abundant supply of health-care professionals, care is often more immediate, especially when specialists are involved. For those with health insurance, most trips to the doctor or operating room carry a cost in the form of a deductible or co-payment. For those without, the quality of care is less robust or comprehensive. Depending on the condition, it may even be absent. Long-term catastrophic illness, for either the insured or uninsured, can spell financial disaster.
In Canada, taxes are substantially higher to bear the massive burden of a national health-care system, but illness is seldom financially catastrophic. Everyone working in the system — from nurses to doctors to specialists — must ration and prioritize care, and that can mean long waits. (See CBC News correspondent Neil Macdonald’s open letter to Americans in the wake of the Neufeldt story.) The system is imperfect at best. Sometimes, wait times can get so long that they threaten Canadians’ right to personal security, as specified in the Canadian Charter of Rights and Freedoms. Remember the case of Chaoulli v. Quebec (Attorney General  in the Supreme Court of Canada? “Delays in the public system are widespread and have serious, sometimes grave, consequences,” wrote Chief Justice Beverley McLachlin and Justice John Major, as part of a split decision. “Inevitably where patients have life-threatening conditions, some will die because of undue delay in awaiting surgery.”
Picard’s final observation is a salient one, brimming with irony: Given her medical past, Holmes is now in a position where she would find it nearly impossible to buy medical insurance in the U.S. In Canada, she will continue to be covered and will get the same access to the system as any other Canadian.