TORONTO, Canada - Near the end of the Winter Olympics, the premier of the small province of Newfoundland made a much-anticipated appearance at the Vancouver Games.
Danny Williams arrived straight from Florida, where he had gone in early February for heart surgery. It was his first public appearance since igniting a national debate about the quality of Canada's health care by opting for surgery south of the border. He looked healthy and tanned.
"If I collapse up here, please drag me to Seattle, because the Canadian Medical Association won't have anything to do with me," he reportedly joked after taking the podium at a reception in honor of his province.
For many Canadians, Williams' decision to have surgery in the United States was no laughing matter. Williams has long been a staunch defender of Canada's non-profit, government-insured health care, which covers all residents. But when it came to his own health, he went south of the border, where private care rules.
He might as well have publicly rooted for the U.S. to win hockey gold.
Not surprisingly, Williams became a poster boy for Americans opposed to President Barack Obama's health care reforms, even though those changes look nothing like Canada's system of public insurance, known as medicare, which covers medically necessary procedures (an explanation of Canada's system).
At Obama's bipartisan health care summit last week, Republican Sen. John Barrasso cited Williams as an example of why Americans should fear Canadian-style health care.
"That's why the premier of one of the Canadian provinces came here just last week to have his heart operated on," Barrasso told Obama. "He said, 'It's my heart, it's my life, I want to go where it's the best.' And he came to the United States."
Williams, a 60-year-old populist who has been running Newfoundland since 2003, did indeed put it that way.
"This was my heart, my choice and my health," he told the Canadian Press from his condominium in Sarasota, Fla., where he was recovering from surgery. "I did not sign away my right to get the best possible health care for myself when I entered politics."
Williams was suffering from a leaky heart valve. He did not want a sternotomy, which would have required breaking bones to access the valve. For a less invasive procedure with a quicker recovery time, Williams sought out Dr. Joseph Lamelas at the Mount Sinai Medical Center in Miami.
Williams says Lamelas accessed his heart valve through an incision under his arm, a procedure known as the "Miami method." The procedure is available in Canada, which has its share of world-renowned heart surgeons. But no one has done it anywhere near as often as Lamelas.
According to a spokesperson for Mount Sinai in Miami, quoted in the Globe and Mail newspaper, Lamelas has performed 2,000 minimally invasive heart operations. His mortality rate is far below the U.S. national average. And, he has trained more than 300 physicians from around the world in the procedure.
In short, for the procedure he preferred, Williams went to the most established doctor in North America.
"This is not a unique phenomenon to me," he said, referring to Canadians going south for health care. "This is something that happens with lots of families throughout this country, so I make no apologies for that."
To be more precise: To the extent that it happens, it happens with affluent Canadians.
Williams is rich. Before entering politics, he sold his cable company for hundreds of millions of dollars. His trip for medical services to the U.S. follows in the footsteps of Belinda Stronach, heiress to an auto parts empire, who went to California for breast cancer surgery in 2007 while an elected Member of Parliament. Before her, the late Quebec Premier, Robert Bourassa, went south for skin cancer treatment.
These are the public figures whose purchase of U.S. care made news. The number of wealthy private citizens who have done so is anybody's guess.
Canadians are rightfully proud of their publicly funded health coverage. Except for the taxes they pay, the health care they receive is free. Canada spends less of its GDP on health care than the U.S., yet Canadians, on average, live longer than Americans. In the U.S., health care is a commodity to be bought and sold for profit; in Canada, it's considered a human right.
No G7 country - including those like France and Germany, with public insurance systems at least as generous as Canada's - restricts private care or private health insurance as much as Canada. For this, too, Canadians are proud. It's a matter of fairness and equality: When it comes to health care, rich and poor get the same treatment.
But this national pride hides a dirty little secret: The rich, like Danny Williams, go south.
