Another country

by Andrew Coyne on Thursday, February 4, 2010 6:17pm - 231 Comments

Ever since Danny Williams was revealed to have been seeking treatment for a heart ailment across the border, the media have been observing a strange and uncomfortable silence about the matter.

On one hand, this reticence is commendable. Williams’s preference in health care is nobody’s business, and should remain, as far as possible, a private matter between him and his God. Though some claim this is a lifestyle choice, it’s far more likely that it is a result of something beyond his control. As such, it is not a fit matter for public commentary.

But once the story has, by one means or another, entered the public domain, that puts a different colour on it. At that point, the media are not just declining to report on something: they are actively colluding in a fiction. The issue is no longer Williams’s medical inclination. It’s the media’s refusal to acknowledge reality.

It’s not as if this were twenty or thirty years ago, when the mere knowledge that someone had a preference for American health care might have been enough to end his political career, or to bring social censure and humiliation upon him. In this more enlightened age, most people are more likely to react with a yawn. It is no longer unusual to see people who openly “go south,” from captains of industry to sports stars. Many Canadians have discovered they know someone like that — perhaps even a member of their own family. All that we are accomplishing by suppressing discussion of Williams’s case is to suggest that there is something embarrassing or shameful about it. Far from erasing a stigma, we are reinforcing it.

I’m not suggesting we should go around unmasking politicians who use American health care, but who prefer not to discuss it. But this taboo on reporting things that are already public knowledge is contrary to our natural urges as a profession, and as such strikes me as unhealthy.

SIGH: For readers who are puzzled by the first paragraph, Rob Silver’s comment below is well worth reading.

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  • Ritchie Simpson

    Coyne, sometimes you are just the biggest disappointment, If one chooses to enter the public arena especially as a Politician then surely your choices, when they are made in light of major Public Policies(and is anything more MAJOR in Canada than Health Care) are on the table and open for debate and comment. Politicians are not like you and me they are elected to lead and that includes by example Williams deserves to be roasted and roundly so for this adventure. For me it highlights clearly just how superior he feels and I cannot understand why he isn't being openly pilloried for it; I find it hard to believe that either Harper or Ignatieff would be treated so gently.

    • Gary

      " I cannot understand why he isn't being openly pilloried for it"

      Let me help you understand……Danny is a ally when it comes to our lamestream media. He attacks Harper at every turn, so fights the good fight. That is ALL you need to know!

  • http://intensedebate.com/people/PolJunkie PolJunkie

    What I don't understand is that it is a well known fact in the medical community that we have some of the best cardiology facilities in the world. In fact, the Institut de Cardiologie de Montreal ranked rather high in Forbes' world ranking list.

    I'm sure that Williams had his reasons but if he was under the impression that Canada couldn't offer him the care that he needed, that's just plain ignorance on his part.

  • Rob Silver

    Would it blow all of your minds if I told you that Andrew's post had absolutely nothing to do with Danny Williams?

    • Lord Kitchener's Own

      Turn out the lights, put on "Dark Side of the Moon" and read this blog post.

      THAT will blow your mind.

    • http://intensedebate.com/people/Inkless Inkless

      I'm pretty sure nobody would even notice at this point. I'd have been entirely oblivious if I didn't have Twitter.

      • http://intensedebate.com/people/s_c_f s_c_f

        I think you're saying that Williams should not need a license to do this? I certainly agree with that.

    • http://intensedebate.com/people/jolyon jolyon

      I first read this post last night and I had impression Coyne was trying to tell us something without being explicit what his point was. We were supposed to read through lines.

      Silver – you wrote earlier "What makes the "Danny Williams" story particularly interesting is that it was someone from his own team that let the info of his affinity for American healthcare slip, and then it was quickly ignored by the media (as opposed to an opposition member of parliament or a reporter playing gotcha)."

      So you and Coyne are saying msm knew about this earlier and did not report on it?

    • http://intensedebate.com/people/Inkless Inkless

      To some extent I think it's unfair for a guy to use subtle humour when he so often fails to laugh at my jokes.

      • http://intensedebate.com/people/andrewcoyne Andrew Coyne

        I would, but you usually beat me to it.

        • Stephen Meurice

          This is giving me a headache. But really, Andrew, do you think we should be outing "Danny," now that it's out there? To what end?

          • Stephen Meurice

            And if you DO think we should, why didn't YOU?

          • http://intensedebate.com/people/andrewcoyne Andrew Coyne

            I just think it's creepy for the whole media to be collectively pretending something is not public knowledge when it is. It made sense twenty years ago, and I certainly wouldn't go out of my way to report it, but neither does it make much sense to take such elaborate pains to avoid mentioning it. It struck me that the best way to point out how strange this omerta is was to abide by it.

          • Stephen Meurice

            I know you're no coward — it takes a brave man to wear some of those skinny ties I've seen you in on TV — but that seems like a bit of a weaselly way to break code, ie by not breaking it. Anyway, what kind of "elaborate pains" have we taken to avoid talking about it? we never write about whom MPs are dating — um, I mean, what kind of health care premiers prefer — unless they date celebrities or bring them to cabinet swearings-in (sorry, I can't figure out a Danny Williams analogy for that last bit). so why should it come up now?

  • Loraine Lamontagne

    The reality that Andrew Coyne should address here is that when you are wealthy you can make choices that you would not be able to make if you were poor. In healthcare. In the type of car you drive. In the home you live in. On your vacation destination, etc…

  • wsam

    Why is this being framed as a ‘preference’ for American health care?

    From what I understand the surgery he needs isn't available in Newfoundland. If so, it’s not a preference, his choice to go out-of-province is a necessity. (Though, why he chose to go to Boston rather than Halifax or Montreal would be an interesting question).

    Newfoundland has 500,000 people. Canada has 30 million. The US has more than 300 mil. As well, the US economy is the world’s biggest economy (outside of the EU – though comparing the two is apples to oranges). Even if we turned our health care system into the libertarian paradise some demand, people would still be traveling to the US for Health Care.

    The different provincial health plans do occasionally send people out-of-province, including to the US. There are always going to be procedures and treatments that are more readily available there.

    I also don't understand why the Canadian system is considered to have failed because rich people cannot jump the queue here.

  • http://intensedebate.com/people/madeyoulook madeyoulook

    If only Canada was a mature enough country to have a sensible discussion about enabling a second tier of medical care within our own borders. Since it will not, that second tier will remain outside our borders.

    • DPT

      Having that discussion is the political equivalent of throwing yourself in front of a bus. Williams deserves the best care he can afford, wherever he can afford it. That said, he still pays lip service to medicare and invokes Tommy Douglas when it's politically convenient. The hypocrisy should be the story, not that fact he was having surgery in the US.

      • http://intensedebate.com/people/madeyoulook madeyoulook

        Like I said, if only Canada was a mature enough country…

      • http://intensedebate.com/people/s_c_f s_c_f

        Well said.

    • Lord Kitchener's Own

      Baby steps myl. Let's get past the private provision of services within a single payer system first (I know that's happening now of course, in many contexts, but I mean let's get to the point where it is widely understood and excepted, and not confined to a relatively few very specific examples). Then we can move on to a debate about tiers (which I think is legitimately a much more complicated debate).

      • http://intensedebate.com/people/madeyoulook madeyoulook

        Right, then, so a portion of our economic output will continue to support the health care industry in the USA. Sort of like a reverse (perverse) form of protectionism. No! You are prohibited by law from consuming private health care here. Go do it over there instead. Brilliant.

        • http://intensedebate.com/people/s_c_f s_c_f

          Yes, exactly. You can jump the queue, but only with a plane flight. So you can only jump it from 10 000 feet. But then, it's prefectly OK. My head spins that people seem to think this is a good way to be doing things.

          • http://intensedebate.com/people/madeyoulook madeyoulook

            Good news, scf. A substantial number of Canadians live within an hour's drive of the border. So the second tier is only slightly less inaccessible than you suggest.

            Assuming we are permitted to discuss the Canadian health care system in a Coyne post that mentions the Canadian health care system when it actually isn't about the Canadian health care system.

          • Lord Kitchener's Own

            Assuming we are permitted to discuss the Canadian health care system in a Coyne post that mentions the Canadian health care system when it actually isn't about the Canadian health care system.

            I'd say that horse is WAAAAY out of the barn. (Or is it a jacket out of the closet?)

          • http://intensedebate.com/people/s_c_f s_c_f

            LOL, I've just been barging on and talking about the health system, despite the fact we are so off-topic :-)

          • Lord Kitchener's Own

            My own point s_c_f is simply that you should be careful what you wish for when attempting to convince the nation to rectify the silly little bit of cognitive dissonance that you quite rightly point out.

            When you write "You can jump the queue, but only with a plane flight. So you can only jump it from 10 000 feet and you must land on the other side of the border. But if you do that, it's perfectly OK." I understand the problem you're trying to address, but I simply fear that if you try to get the country to address it in one move, the argument that may win is "s_c_f's right! It shouldn't be 'OK' for rich people to jump the queue by using their money to fly outside of our borders. We need to find a way to make that illegal!!!"

          • http://intensedebate.com/people/s_c_f s_c_f

            I agree, and you are correct that there are two ways to approach that problem, one of them being the method employed by the former Communist bloc.
            I would hope that people who impose an ideology on others would eventually relinquish their zeal when exposed to the cognitive dissonance, rather then doubling down.

          • Lord Kitchener's Own

            I do think we need to acknowledge that people who are uncomfortable with tiers have a legitimate point as well. It's not just a concern about the second tier being better, it's about the diversion of resources from one tier to another possibly making the first tier much, much worse.

            There are people on the extremes of course, but those of us in the mushy middle probably don't have much of a problem at all with rich people being able to get absolutely the best world-beating treatment that money can buy, the concern is that this unfettered ability could have the unintended consequence of poor people receiving ENTIRELY INADEQUATE healthcare, and dying as a result. We'd all love to have a system that can provide the broad spectrum of world class care that's available in the U.S. if you can afford it, but there's a dark side to the U.S. system as well that needs to be acknowledged, and I don't think it's unreasonable for us to have a debate which attempts to find a balance between people being able to get absolutely the best care they can afford, and people having to declare bankruptcy in order to get the care that they need.

          • http://intensedebate.com/people/s_c_f s_c_f

            I don't like the diversion of resources argument. We have no shortage of dentists, nor a shortage of veterinarians. Yet we have a shortage of doctors.

            And in fact it does take just a day for a dog to get an MRI, while a human must wait months.

            The single tier single payer system is what actually creates the lack of resources. This has been the case time and time again in all socialist systems everywhere.

            Also, replicating the US system is not the argument I would make. However, there is something to be said for the one system in the world that attracts those who wish to get the best care in the world. When it comes to innovation and quality, the US has no peer. However, there are many health systems in the OECD that are clearly superior to ours. Ours is the only system in the world that prevents individuals from paying for services. I've heard good things about the system in France, the system in Japan. The fact that people refuse to acknowledge this is detrimental, and is simply a blind adherence to ideology and nationalism.

          • JGNS

            You don't like the argument? Tough – it's entirely valid. The old canard about "two-tiered" systems in Europe would be more relevant if public funding were not even higher there. Only about 70% of health care spending in Canada comes from the public purse, at least 10% lower than most countries in Western Europe. While the US has many fine hospitals, there is nothing about the "system" that attracts anyone. Few Americans have access to the Cleveland Clinic.

          • JGNS

            You don't like the argument? Tough – it's entirely valid. The old canard about "two-tiered" systems in Europe would be more relevant if public funding were not even higher there. Only about 70% of health care spending in Canada comes from the public purse, at least 10% lower than most countries in Western Europe. While the US has many fine hospitals, there is nothing about the "system" that attracts anyone. Few Americans have access to the Cleveland Clinic.

        • Lord Kitchener's Own

          For the record, I don't necessarily disagree with your point, and it's CERTAINLY a debate we need to have, I just mean to point out that, for Pete's sake, the private provision of healthcare WITHIN A SINGLE PAYER SYSTEM is still controversial, and would appear to still not have majority support (mostly because people don't understand the issue, I suspect). My point is simply that, as frustrating as it may be, I don't think you're ever going to get the country where you want us to be by trying to get the country to just jump right to where you want us to be.

          Frankly, as silly as it is, you're more likely to get people arguing "Yeah, myl's right! We need to figure out a way to make it illegal for rich people to leave the country and pay to skip the queue by scurrying outside of our borders!!!"

          • http://intensedebate.com/people/madeyoulook madeyoulook

            You have a dimmer of view of this country's population than I do. You really think we would have an easier time pushing us even CLOSER to Cuba and North Korea than we already are, healthcare-system-wise? Shudder…

    • wsam

      I don;t get this mature country thing? Name me one country capable of having a mature national discussion about anything.

      Britain? In the middle of the worst recession since electricity, the UK is busying itself by humiliating Tony Blair at an apparently endless series of public hearings.

      The United States? In the summer guys were showing up armed to town hall meetings on health care, I guess to demonstrate their willingness to die for the right to be charged 800$ for an ambulance ride.

      France hasn't had a mature disscussion about anything since Louis IX declared himself King of the sun.

      China is arguably the most mature country of all and it has outlawed all discussion, mature or not.

  • wsam

    Why bother working hard and getting rich if you cannot lord it over people. It’s natural that rich children should receive better health care than poor children. The Canadian system represents a perversion of nature.

    If your parents work hard enough to send you to private schools and teach you how to appreciate the finer things like which utensil to use during desert, then you deserve preferential treatment. Rich children should be much, much healthier than poor children. If poor people want fancy medical treatment for their sickly, undernourished children, they should get rich.

    People are poor for a reason. It’s a lifestyle choice.

    The rich should not have to use the same services as poor people.

    Why should a rich guy’s kid who, for example, has blown his knee out skiing, have to queue up beside, for example, the son of a taxi driver? They should never even come into contact with each other.

    Poor people are disgusting.

    • DPT

      now that , is snide.

      • Richard

        This post obfuscates, rather than clarifies the issue. Couldn't you (Coyne) just come out and say that it's weird no one reported that Baird is gay instead of dancing around the issue like a fairy? Just kidding with the "like a fairy" part — that was gratuitous.

      • Gary

        And quite accurate!

  • http://intensedebate.com/people/Gaunilon Gaunilon

    oy. I'm dying here.

  • RDB

    I’m slowly catching on. This is entirely too subtle, though.

  • Anon

    Everyone leave. The pundits want to talk to each other, privately.

    *rolls eyes*

  • Stephen B

    Thanks, I live in Ottawa and this was the first I've heard about Baird's "outing".

  • http://intensedebate.com/people/Jack_Mitchell Jack Mitchell

    Lord, I'm slow. Rob Silver is not. And, in fairness, this point about Danny Williams hasn't exactly been all over the news.

    On the other hand, was Danny's preference a secret? How much of a revelation can it be? As Mr. Coyne says, it's not of much interest in itself, though I suppose it must affect his public stance on healthcare issues and serve to moderate his party's attitude. Frankly I hope he embraces it: there are still a good number of people out there who don't think big, loud, obnoxious, aggressive men can be in favour of outsourcing healthcare, and a glance at Danny will serve to correct their prejudice in that regard.

    • http://intensedebate.com/people/Crit_Reasoning Crit_Reasoning

      Danny's affinity for American health care wasn't really a revelation to most people in the political bubble, I should think. He himself has been quite open about his American-style preference for years now, and he regularly consults with like-minded individuals at various parties and events. I always thought it was pretty cool that the media never tried to ambush him about his views on health care.

      • http://intensedebate.com/people/Jack_Mitchell Jack Mitchell

        Yeah, I hope this doesn't serve to define him in any way. If there's one man who works overtime to define himself in ways that have nothing to do with health care, it's Danny Williams.

        • Lord Kitchener's Own

          Good Lord people (lol), while I've finally caught on myself (thank you Chris Selley) can we at least put Danny Williams in quotation marks when our comments are using him as a stand-in for the topic about which this post actually pertains? As everyone HAS heard of the Williams story, and many people (myself included) had NOT heard of the story the post is actually about, these two comments just add to their poor ignorant confusion (and I hasten to add, OF COURSE I knew about the substance of the story everyone's talking about without talking about it – EVERYBODY knows that, even if it's not always acknowledged – I hadn't heard of the latest episode to make that substance more public, which is why the parallel established by the post flew right over my head).

          I feel relieved that I'm not as obtuse as I was beginning to think I might be! I don't think I can be expected to understand that a blog post ostensibly about story X is really about story Y if I haven't heard about story Y.

          • http://intensedebate.com/people/s_c_f s_c_f

            I'm also with you. I heard about John, considered the news completely uninteresting, and forgot about it, and frankly, I think there are things about the Danny story that reporters have avoided, and I also think there is almost nothing to report about John, so I don't consider myself obtuse for missing the "joke".

          • http://intensedebate.com/people/Crit_Reasoning Crit_Reasoning

            I'm with you, LKO. I hadn't even heard of Story Y (the radio "outing") when I read Coyne's piece the first time. Subtle insider humour – but very funny, once you're in on the joke.

  • http://intensedebate.com/people/Mader David Mader

    I understand the basic point, AC – Danny's choice shouldn't be a big deal. But by dressing him up in borrowed clothes, aren't you really acknowledging that – for better or worse – it is? Or at least that it's ultimately up to Danny to decide how big a deal it is, and what to do about it? And yet if you recognize that much, why dress him up in such a way that at least some folks – most folks, as it turned out – wouldn't recognize him, leading other folks to undress him entirely? With the result that you've made his choice for him, no?

  • MikeB

    I just figured this one out. Heck of a wink-wink-nudge-nudge, and it's brilliant. I've oft wondered about this cone of silence. Who was maintaining it, "Danny Williams", orders from a higher (political) power or the media? As was pointed out, quite correctly, he's doesn't go to very great pains to hide it.

  • wsam

    Hmmm …. The best way to rebel against stifling conformity is to conform?

    That's just crazy enough to work!

    Someone should have told the hippies, though. We would have been spared the drum circles and organic food.

  • wsam

    I don't think it's weird at all.

    Has anyone reported that Stephen Harper spits when he eats? Because he does. If you sit across the table from him you have to wear a facemask.

    Also: his hair isn't real, that's a wig he's wearing.

    Where are the stories on that?

    • Gerda

      And word has it, Harper goes commando, unless it's Friday when"Danny" is delivering the Whiskas.

      • wsam

        The public needs to know.

    • Lord Kitchener's Own

      Has anyone reported that Stephen Harper spits when he eats? Because he does. If you sit across the table from him you have to wear a facemask.

      I tend to agree with the broader point you're making, but I know that there are people out there who will argue (in some ways correctly I think) that the difference is that Stephen Harper's government doesn't simultaneously take the policy position that people who spit when they eat shouldn't have the same rights as people who don't.

  • http://intensedebate.com/people/s_c_f s_c_f

    Well, you and Coyne should hook up and head to the bars and lauch your arses off all day long.

  • Kory Teneycke

    A very clever piece, Andrew. It is a debate worth having. Too bad it is so in-the-closet that most people reading your post will have no idea what you are referring to. I would point out that this is a question that affects a number of politicians from a number of different political parties — not just the one you are referring to.

    • Lord Kitchener's Own

      For my part, I was ENTIRELY aware of the substance of what the post (it turns out) is about (and everyone I know knows this, and I didn't even think it was really a matter people discussed, not because it shouldn't be discussed, but because EVERYBODY ALREADY KNOWS it) but I too had no idea what Mr. Coyne was talking about because I hadn't heard the story about the CBC radio incident (and I do follow politics pretty closely, as everyone here does).

      I do agree that most people reading the post had no idea what the post was referring to (including several journalists and pundits apparently – Chris Sulley referred to it as "quite possibly the most inscrutable blog post in the history of the Canadian media") but not because people are unaware of the substance of the story that's the actual basis for the post, but simply because they hadn't heard about what happened on CBC radio (due to the media not really talking about it), and so why on EARTH would their minds connect the Danny Williams story to that story if they hadn't heard the other story?

      • http://intensedebate.com/people/Gaunilon Gaunilon

        It's ok LKO. Really, we don't think you're slow just because you missed this one for a while.

  • Aldyen

    About a year ago, my husband subscribed to a private clinic here in Vancouver. The clinic bills the provincial medical services plan the same rate for services that all doctors in BC are allowed to bill. But subscribers pay an annual membership fee on top of the rates billed under the public health insurance scheme.

    The quality of the care that my husband receives from the private clinic is much, much superior to that which he received from his GP and the system before he joined the clinic.

    A doctor at his clinic tells me that every Liberal and Conservative MP and MLA that lives in Vancouver is a subscriber to one of the two major private clinics in town. I do not have direct access to the facts and I would guess that the word "every" might be an exaggeration. But I would also guess that the word "most" might not.

    By definition, fedearl and provincial elected officials are among the top 10% of Canadian income-earners.

    So we clearly already have two-tier medicine in Canada. Those who can pay get better service. Elected officials are in the "can and do pay" category.

    • wsam

      Not in Ontario.

      Extra-billing (what the Vancouver clinics are doing) is illegal here.

    • JGNS

      Extra-billing is also illegal in BC and it's debatable whether such clinics will be allowed to operate under that scheme for much longer (in short, it is illegal to charge specifically for access).

  • Kevin

    Are all of you completely dense? You're clearly not getting all the hints in this article and on the comment pages, so why don't I spell it out for you:

    'Danny Williams' is a euphenism for John Baird. This article is about John Baird being outed on CBC by PC Candidate Pam Taylor, and how the media has been silent on the matter.

    Jesus.

    • wsam

      You're a homophobe for mentioning it.

    • Dave

      Why do you hate our troops?

      • http://intensedebate.com/people/s_c_f s_c_f

        Now that's funny.

      • http://intensedebate.com/people/Gaunilon Gaunilon

        That has to be the best comment on the thread.

  • Loraine Lamontagne

    Are we talking about Pierre Pettigrew and his chauffeur?

    Are we talking about Stephen Harper and his stylist?

  • http://intensedebate.com/people/DerekPearce DerekPearce

    Duh, I'm very slow as well. And I remember blagging about this, accidentally helping to set off a s*** storm on Coyne's old blog back when the Tories were first elected in '06! So, it seems the media will retain a cone of silence as long as said MP(s) don't vote in a "hypocritical" way, and it seems so far that no MP(s) did, when it came to SSM for instance. Someone like Florida Gov. Charlie Crist however is fair game.

  • http://www.lastminute-pauschalreisen.eu Günstige Reisen

    Every man try too get comfort according to his own choice,same is the case with Williams,he should choose US treatment for quick health.

  • jarrid

    That's been my experience as well, which no doubt is mirrored across the country. You have to wait, and wait but the care is top notch, once you get it.

  • PeteTong

    In Ontario OHIP policies favour sending patients out of country (rather than to another Canadian province) when a service is not available or not available in a timely manner.

  • http://intensedebate.com/people/Gaunilon Gaunilon

    Mine too. But I still think there's something to be said for the US system, where you don't have to wait and then still get the best treatment.

  • http://intensedebate.com/people/s_c_f s_c_f

    "in a timely manner": more than 10 years away. 9 years is OK.

  • http://intensedebate.com/people/PeteTong PeteTong

    Now that I've realised what Andrew is talking about I realise that my comment is totally lame and would give myself a thumbsdown if it were possible.

    Anyways, John Baird, old news. He's not the only out of the closet yet unreported gay man in the House either… If this were the U.S. it would have been picked up years ago as a headline story.

  • http://intensedebate.com/people/YYZ YYZ

    My doc told me it was about 2-3 months for a non-serious MRI — but if you do a little work (calling to get put on cancellation lists etc) it would be within a week or so.

    However, I agree 2-3 months is unacceptably long.

  • http://intensedebate.com/people/s_c_f s_c_f

    It depends on the area. The wait times in Nanaimo exceed a year: http://www2.canada.com/nanaimodailynews/news/stor…

    or a year in the some hospitals and regions of Ontario…
    http://www.canada.com/ottawacitizen/story.html?id…

    But, if you happen to walk on four legs, the wait can be a day: http://www.youtube.com/watch?v=SXkB64Ss5Xk

    And yes, if you call and get lucky, you can take advantage of a cancellation, but of course, if there are more people calling than there are people cancelling (which is likely always the case), then you need to be very lucky to avoid the long wait.

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