http://www.nationalpost.com/news/story.html?id=2514581Danny Williams could have stayed in Canada for top cardiac care, doctors say
Tom Blackwell, National Post Published: Tuesday, February 02, 2010
N.L. Premier Williams set to have heart surgery in U.S.
Newfoundland Premier Danny Williams has caused controversy by seeking cardiac treatment in the United States. Rhonda Hayward/St. John's Telegram Newfoundland Premier Danny Williams has caused controversy by seeking cardiac treatment in the United States.
Danny Williams' decision to seek out heart surgery in the United States may seem like an embarrassing blow to Canadian health care, but cardiac specialists say the Newfoundland Premier could have obtained virtually any heart treatment in his own country, carried out by top-notch doctors.
Long wait times for cardiac surgery were a problem 15 years ago but are generally "a thing of the past" in most parts of Canada, physicians insist. Where queues develop for elective operations, patients are routinely sent to other provinces for speedy care, with their own government's medicare plan picking up the tab, they say.
"Virtually all forms of cardiac surgery are looked after in Canada, and I would say extremely well," said Dr. Chris Feindel, a cardiac surgeon at Toronto's University Health Network. "Personally ... I would have my cardiac surgery done in Canada, no matter what resources I had at my disposal."
In fact, he said, patients from the United States and other countries come to the UHN's Peter Munk Cardiac Centre for valve repairs, a procedure developed by Toronto surgeons. Meanwhile, the death rate after bypass surgery in Ontario is among the lowest in North America, reports the province's Cardiac Care Network.
Kathy Dunderdale, Newfoundland and Labrador's deputy premier, confirmed yesterday the popular Premier, pictured, left for the United States on Monday to undergo heart surgery.
However, Ms. Dunderdale declined to detail his condition or the nature of the treatment he was receiving.
She said the operation is not available in Newfoundland and the decision to go south of the border was made after weeks of consultation with his doctors. Mr. Williams, 60, is expected to make a full recovery, said Ms. Dunderdale.
The spectacle of a prominent Canadian politician seeking out important health care in the U.S. is already being seized upon by opponents of health reform in the States, who tend to portray the proposed changes there as a move toward Canadian-style care.
"What a Newfie Joke!" blared David Horowitz's Newsreal, a conservative blog site. "[Mr. Williams] has so much confidence in his country's compassionate, socially just health care system he's come to the U.S. for heart surgery."
In fact, Newfoundland is able to provide bypasses and other common heart operations at home, but routinely ships patients to Montreal, Toronto and Ottawa for rarer procedures, such as transplants and treatment of congenital heart defects, said Dr. Eric Stone, a St. John's cardiologist.
There are simply not enough cases of that sort for surgeons in Newfoundland to develop the requisite expertise, he said. In 28 years, though, Dr. Stone said he has never had to refer a patient to the U.S.
"What is wrong is to create the impression the Canadian health care system can't take care of things," he said. "To get excited about that makes no sense to me."
Dr. Feindel said he is aware of only a single non-experimental heart operation not available in Canada: one to repair a rare aneurysm in the part of the aorta descending through the chest. While about 11,000 heart surgeries are carried out in Ontario every year, only one or two patients are sent to Baylor University Hospital in Texas to undergo the complex aorta operation, he said.
A half-dozen or so other Ontario patients are sent to the States yearly for emergency heart surgery that is closer at hand in the States because the patient lives near the border, said Kori Kingsbury, CEO of the Cardiac Care Network.
This country's heart care is otherwise on a par with the States, agreed Dr. Blair O'Neill, vice president-elect of the Canadian Cardiovascular Society. "I would say the expertise in Canadian centres is quite high and the type of procedures they do are definitely leading edge," said the Edmonton cardiologist.
The one problem area is in treatment of some heart-rhythm problems. The waits for so-called "ablations" to fix atrial fibrillation -- an abnormal rhythm in the heart's upper chamber -- can stretch to over a year in some parts of the country, said Dr. O'Neill, though the condition is generally not life threatening.
In fact, 99% of people with the problem can be treated easily with inexpensive drugs, and the ablation procedure itself has never been proven effective in a randomized controlled trial, said Dr. Colin Rose, a Montreal cardiologist.
All that being said, heart doctors say there have always been Canadians who, like Mr. Williams, are rich enough that they can choose to get care in the United States at their own expense.
"Having sophisticated, wealthy patients pick the places they want to go is not a new thing," said Dr. Stone. "Someone who has enough money can get on a plane and go anywhere they want for health care."
http://www.nationmaster.com/graph/hea_hea_dis_dea-health-heart-disease-deathsHeart disease related deaths per country
# 1 Slovakia: 216 per 100,000 people
# 2 Hungary: 192.1 per 100,000 people
# 3 Ireland: 152.6 per 100,000 people
# 4 Czech Republic: 148.6 per 100,000 people
# 5 Finland: 143.8 per 100,000 people
# 6 New Zealand: 127.3 per 100,000 people
# 7 United Kingdom: 122 per 100,000 people
# 8 Iceland: 115.4 per 100,000 people
# 9 Norway: 112.5 per 100,000 people
# 10 Australia: 110.9 per 100,000 people
# 11 Sweden: 110.1 per 100,000 people
# 12 Austria: 109.3 per 100,000 people
# 13 United States: 106.5 per 100,000 people # 14 Germany: 106.1 per 100,000 people
# 15 Denmark: 105.4 per 100,000 people
# 16 Canada: 94.9 per 100,000 people
