Friday, August 21, 2009

Health Care Delayed is Health Care Denied

Do you know Shona White? She's from Waterdown; she had a brain tumour, and she had to go to the United States for treatment. We now find her in an ad against socialized health care in America.

In The Mark, Liberal MP Bob Rae objects to the use of Ms. White's non-treatment in Canada as part of an argument against health care reform in the U.S. The article, titled "Keep Canada Out of the U.S. Health-Care Debate", reads:
Watching the debate in the U.S. about health care has been a fascinating, if depressing, experience. In particular, the fact that a Canadian woman has played into the hands of the Republican lobby because of her understandable anxiety about her medical condition doesn't make me mad; it just makes me sad.


No one should demonize Shona Holmes. The health-care system we have in Canada has challenges – we all know people who are frustrated by delays. But that is hardly unique to Canada.

And the fact that she has weighed in with her story is not something we should fear or denigrate, though we are at a bit of a disadvantage, not knowing "the other side of the story" for privacy reasons.

Let's not forget the other stories we all know: the people who've been diagnosed and treated quickly and effectively without once being asked about their coverage or their income; the success we've had in dramatically reducing wait times for heart surgery and cardiac care.


Keep Canada out of the U.S. debate. We've never suggested exporting our system. We have our own debates and our own issues, and because of the moral choices we made 40 years ago they are different from the American paradigm.

We should be proud of what we have, but we need to keep the focus on how to improve it, how to combine access, excellence, and innovation. We shouldn't treat health care as some kind of taboo subject. We should keep what we have and make it better. And hope our friends in the U.S. will find their own answers to the questions that lie at the heart of health care everywhere.

I'm not a huge fan of this ad, either; arguing by anecdote is never terribly enlightening. However, I can't get on board with the rest of Mr. Rae's comments.

The idea that the U.S. should keep Canada out of their health care debate is ludicrous. Of course America should look to our system, just as they should look to European systems, just as we should look to their system, just as the Brits should look to us. Everyone’s health care system is kinda screwed up; it does no one any good to ignore the experiences of others when trying improve the lives of the citizenry.

Too many commentators that I've read get their backs up the moment anyone criticizes their country's health care system. There seems to be some sort of patriotic duty to bury your head in the sand and pretend that your country's health care system doesn't risk people's lives. But, obstinacy in the defense of pride is no virtue.

Mr. Rae writes:
Shona Holmes is a Canadian insured by the Ontario Health Insurance Plan. She says she was made to wait months to get a diagnosis for her benign tumour. Once diagnosed she wanted an operation right away, so she went to the States for the procedure. Now she wants OHIP to pay for the cost of her U.S. treatment, which she paid for out of her own pocket. She has a public insurer, and wants a refund on her private treatment, which she decided had to happen right away.
So, Mr. Rae thinks it's inappropriate for Ms. White, after purchasing treatment OHIP declined to cover, to seek re-imbursement. To an extent, this is a reasonable belief. Few insurers would pay out to a customer for something they had already told a customer wasn't covered. I'm a little surprised to hear, though, that Mr. Rae is defending OHIP by claiming it acts like any other insurer. Is that really an argument for socialized medicine?

Still, there's a whole lot of chutzpah here from Mr. Rae. The argument, apparently, is that because the insurer wouldn't cover it, Ms. White is out of luck - but things aren't that simple. In this situation, the insurer is the government, and they have not only made it difficult to access other treatment options, they have made it illegal. Ms. White had absolutely no recourse in this matter. She never had an option to purchase her own health insurance. She isn't even allowed to pay for the treatments herself. It has to go through OHIP, and OHIP refused to let that happen.

I've asked before, why is it that "health care is a right" means you don't have the right to get health care on your own? In our system, one's health care desires do not register as singularly important. They are but one factor in an intensely complex equation.

Notice the last two lines in the previous paragraph I cited:
Now she wants OHIP to pay for the cost of her U.S. treatment, which she paid for out of her own pocket. She has a public insurer, and wants a refund on her private treatment, which she decided had to happen right away.

Let's put aside the paternalistic scolding administered to Ms. White for her refusal to wait until someone else decided it was an appropriate time for treatment. Instead, note the description of the public insurer and the private treatment. It would seem to be the very nature of a public insurer to ignore the needs of the private individual when it suited the desires of the public entity, i.e., the state - at least that is what I am being taught by Ms. White's story and Mr. Rae's argument.

But let's not ignore the juxtaposition with private treatment. Apparently, by going to the U.S. and making her own arrangements, the treatment qualified as private. Had she waited in line, like a good little Canuck, her OHIP covered treatment would have qualified (at least according to Mr. Rae's analysis) as public. This is a more wretched thought than the idea of the public insurer.

The idea that our medical care - our health - is the domain of the government is ludicrous. It is an abhorrent violation of personal sovereignty and human dignity. It is not a mentality that aligns with classical liberal principles. We can decide that health care needs to be paid for by the state; we can decide that health care needs to administered by the state, but to appropriate ownership of the very treatments that we receive - potentially invasive measures - is one step too far if Canada is to retain any claims of liberalism and liberty.

According to Mr. Rae's analysis, anything that is covered by OHIP - every visit to your doctor, every surgery you require, the birth of every child you have - belongs to the state.

Tell me that's not horrifying.

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