Danny Williams: The hypocrisy of Canada's Left

[msj]

It might be wrong to attack Mr. Williams, but then, he isn't doing himself any favours with the arrogance of his explanations....or his lack of explanations to start.

Oh, go ahead and attack Danny but do it like you are doing - with substance. The OP had very little substance to it. Not even a link for further thought.

And yes, it seems it wasn't an emergency, but it was urgent, meaning the wait would be short. As one doctor from the Peter Munk Centre for Cardiac Science said, their average elective heart surgery wait time is about 2 weeks...and not too many people want to rush into a surgery any faster than that if they don't have to.

Which brings me back to timing.

Maybe the advice he received was imperfect (or maybe he got things mixed up) with respect to the procedure being with the bone crack or not and/or when the procedure would be available.

As such, he made his decision based on his schedule and, perhaps, the US provided a better time frame for him (whether real or perceived).

Or, maybe he just likes dropping a bunch of money and creating a controversy for nothing.

[msj]

Interesting to note, Williams doesn't keep his salary, but rather donates all of it to charity.

I forgot he did that.

Back to the tax return:

Okay, say he only puts $150,000 on his tax return (T1).

Say he donates the net amount to charity (~$99,000).

His tax bill would be: $7,300 (donations get a generous tax credit but it is not a 1:1 ratio to tax being paid.).

Okay, so now lets add $80,000 for medical expenses and we get:

Taxes owing of $2,500.

In fairness, I have never done a NFLD tax return so there could be special credits that I'm not including here.

But it does give a good idea of the amount of money we're talking about - diddly squat when compared to money Danny saved the taxpayer by not getting the procedure done in Canada in the first place.

[Guest American Woman]

Well, he should get the tax break since that's how the rules work.

If that procedure cost him $80,000 then he would save ~$18,000 in taxes on his Newfoundland tax return (in BC, it would only be about $15,600 because BC has lower tax rates - for those who may remember my posting on this issue yesterday). ...........

The nerve of him to apply the tax laws properly! I mean, Canada is getting such a raw deal on this.

Since he refers to "reimbursement" later on in the article I linked to, it would appear as if that's what he is referring to, not a tax refund.

[msj]

Since he refers to "reimbursement" later on in the article I linked to, it would appear as if that's what he is referring to, not a tax refund.

Well, unless he has a medical plan that will reimburse him for such things, which is possible - he is a politician after all - then I doubt it is a true reimbursement.

Perhaps one of his companies has a private health services plan and maybe he can write it off through that (saving closer to $32,000 in corporate taxes, I would estimate but this depends on the residency of the corporation and its tax rate).

Even if this is the case, he is still paying the full amount. He just gets some tax savings by not pulling dividends/wages from the company (and not paying income taxes on that) and by his company saving some corporate taxes.

Once again - perfectly legal and still considerably cheaper to the Canadian taxpayer than had he got the surgery within Canada for "free."

[Guest American Woman]

Interesting to note, Williams doesn't keep his salary, but rather donates all of it to charity.

A multi-millionaire donating $140,000 to charity isn't really all that remarkable, but it's interesting the way he in effect 'markets' it by saying he's giving up his paycheck. If he were to merely donate $140,000 to charity, without reference to his salary, I doubt whether anyone would think anything of it.

[Smallc]

Or, maybe he just likes dropping a bunch of money and creating a controversy for nothing.

Actually, I was thinking he'd just rather recover in the condo that he owns in Florida.

Edited February 25, 2010 by Smallc

[Smallc]

Well, unless he has a medical plan that will reimburse him for such things, which is possible - he is a politician after all - then I doubt it is a true reimbursement.

In many cases, provincial health plans will reimburse for procedures done outside of country. If you are referred by your doctor to a facility out of province, your provincial health plan will generally pick up all of the entire bill without you ever seeing it. If you are sent outside of country, the provincial health plan generally picks up the procedure to the amount that it would cost in Canada. They may pay their share before you get the bill, or they may reimburse you after for covered costs. Often, the provincial board governing the covered procedures under the health plan will decide to pick up up most if not all of the medical costs related to the procedure. There is generally a procedure though.

First, can the procedure be done in your nearest facility? If yes, good, if no, can the procedure be done within your health region? If yes, good, if no, can the procedure be done in your province (note that in Alberta, PEI and [i think] the territories, the health region and the province are the same thing)? If yes, good, if no, can it be done within Canada? If yes, good, if no, can it be done somewhere else? Now, generally, you can't just go off and get things done in another country without a referral. There is a recent case in Winnipeg of a man with back pain that could not be treated adequately in the Manitoba Pain Clinic. He heard about a procedure in Florida using lasers, so he went and got it done, and it worked. He did this without getting a referral for his doctor (he didn't bother to ask). Because of that, Manitoba Health refused to pay the bill that was over $10K. I'd have to know more about the specifics of how the Newfoundland and Labrador health plan works, as well as more specifics of the situation to know what will happen here.

Edited February 25, 2010 by Smallc

[msj]

In many cases, provincial health plans will reimburse for procedures done outside of country. If you are referred by your doctor to a facility out of province, your provincial health plan will generally pick up all of the entire bill without you ever seeing it. If you are sent outside of country, the provincial health plan generally picks up the procedure to the amount that it would cost in Canada. They may pay their share before you get the bill, or they may reimburse you after for covered costs. Often, the provincial board governing the covered procedures under the health plan will decide to pick up up most if not all of the medical costs related to the procedure. There is generally a procedure though.

First, can the procedure be done in your nearest facility? If yes, good, if no, can the procedure be done without your health region? If yes, good, if no, can the procedure be done in your province (note that in Alberta, PEI and [i think] the territories, the health region and the province are the same thing)? If yes, good, if no, can it be done within Canada? If yes, good, if no, can it be done somewhere else? Now, generally, you can't just go off and get things done in another country without a referral. There is a recent case in Winnipeg of a man with back pain that could not be treated adequately in the Manitoba Pain Clinic. He heard about a procedure in Florida using lasers, so he went and got it done, and it worked. He did this without getting a referral for his doctor (he didn't bother to ask). Because of that, Manitoba Health refused to pay the bill that was over $10K. I'd have to know more about the specifics of how the Newfoundland and Labrador health plan works, as well as more specifics of the situation to know what will happen here.

Good points.

I have seen many bills paid for by clients who have paid for medical services in the US (and even Mexico, which I find a bit scary).

Perhaps these people never get a referral and just get 'r done (wouldn't surprise me at all, really).

I assumed this to be the case here, too, but maybe Danny's got enough brains to get the referral properly documented and will be able to get some of it back.

If he does, then I think he really is blowing it (politically speaking).

You can't say it's your money if you get reimbursed for it.

Perhaps we'll find out, in time, what the real facts are/were.

[Guest American Woman]

Well, unless he has a medical plan that will reimburse him for such things, which is possible - he is a politician after all - then I doubt it is a true reimbursement.

Perhaps one of his companies has a private health services plan and maybe he can write it off through that (saving closer to $32,000 in corporate taxes, I would estimate but this depends on the residency of the corporation and its tax rate).

I read it to mean that he is referring to reimbursement by the government/health care system. If he has a private health plan, seems to me his insurance company would have been billed. But he said he paid it, and if he's entitled to reimbursement, he'll take it. If that is the case, tax money that could have gone to a medical facility in Canada went to the U.S. instead. That's hardly a good thing for Canada; it's taking your tax dollars out of Canada and into the U.S.

Bottom line. If I were a surgeon in Canada doing this type of surgery, I would be offended by William's claim that he went where he would get the best health care, and I would think he's lost a lot of credibility in regards to his claims of how good Canada's health care is.

Edited to add: From my link: "If I'm entitled to any reimbursement from any Canadian health care system or any provincial health care system, then obviously I will apply for that as anybody else would," he said.

Edited February 25, 2010 by American Woman

[msj]

I read it to mean that he is referring to reimbursement by the government/health care system. If he has a private health plan, seems to me his insurance company would have been billed. But he said he paid it, and if he's entitled to reimbursement, he'll take it.

I think it to be more likely that he would have a private health services plan than insurance coverage that would cover this type of thing, given that provincial plans normally cover this type of thing (within Canada, anyway).

I doubt he is paying extend medical premiums to the extent that this would be covered. But as Premier, maybe he gets some special coverage? I don't know.

If that is the case, tax money that could have gone to a medical facility in Canada went to the U.S. instead. That's hardly a good thing for Canada; it's taking your tax dollars out of Canada and into the U.S.

Good point. Should have been made in that other thread.

Bottom line. If I were a surgeon in Canada doing this type of surgery, I would be offended by William's claim that he went where he would get the best health care, and I would think he's lost a lot of credibility in regards to his claims of how good Canada's health care is.

I don't know to what extent he claims Canada to have great health care or not and don't place much value on his words as he tries to defend himself from some rabid critics.

I prefer to wait and see how he performs when things have calmed down.

I still wonder the extent that this was done due to the timing of the procedure (and perhaps without the bone crack) and perhaps some misunderstanding on the timing within Canada. An expensive error politically and perhaps financially.

Edited to add: From my link: "If I'm entitled to any reimbursement from any Canadian health care system or any provincial health care system, then obviously I will apply for that as anybody else would," he said.

Good to see that he would do it just like any other Canadian (who could afford to do it this way).

As I stated elsewhere, I think the OP criticism is based on jealousy - unlike many of us, Danny can afford to do this and it rubs people the wrong way.

Thankfully, people like you, smallc and Picard (in that link provided by smallc) can offer up some substance based criticism to counteract the deficiencies of the OP.

[Guest American Woman]

I still wonder the extent that this was done due to the timing of the procedure (and perhaps without the bone crack) and perhaps some misunderstanding on the timing within Canada. An expensive error politically and perhaps financially.

CTV News consulted four heart specialists to get to the bottom of the whole "claim-game". They all echoed the same details that "the minimally invasive procedure is not available in Newfoundland, but is widely offered in other provinces". link

He's actually doing Canada a great disservice by giving the impression that he couldn't have had this surgery in Canada.

Furthermore, Dr. Alan Menkis, a Winnipeg cardiac surgeon, was a pioneer in using the technology. link

Furthermore still: ....a news release from Dec. 3, 2009, announcing[ed] that the prestigious New England Journal of Medicine had just published a feature article on the latest techniques for reconstructing the valve, which separates the heart’s two chambers so blood flows during a normal beat.

The authors? Dr. Thierry Mesana of the University of Ottawa Heart Institute and Dr. Subodh Verma of St. Michael’s Hospital at University of Toronto.

Apparently Ottawa and Toronto have somehow managed to emerge as leading centres for both the theory and practice of heart surgery—in particular, it seems, the operation Williams needed... link

As for his case being "urgent:" There is a wait-list in Montreal of up to three months, but urgent cases can get the surgery right away... link

I find it convenient that the doctor who was recommended to him happened to coincide with where he has a condo.

Will it be an expensive mistake politically? Only time will tell, but I don't doubt that he set back people's opinion of Canada's health care.

Good to see that he would do it just like any other Canadian (who could afford to do it this way).

That's the catch, isn't it? You have to be able to "afford" doing it that way, which means the rich can go ahead of the not-as-rich treatment wise. If he chooses to leave the country when he doesn't have to, he should be responsible for the bill, otherwise he is queue-jumping at the expense of the Canadian people.

Do you honestly believe "any other Canadian" could chose to get treated in the U.S. over Canada and then seek reimbursement? Do you have that option with your health care needs-- to choose between being treated in Canada or elsewhere?

It remains to be seen if he will be reimbursed, but the fact that he feels he's entitled to Canadians paying for services that he chose to have in the U.S. rather than Canada would irk me if I were a Canadian.

[Argus]

I didn't know that PC's were leftists... wow.

You don't know much,do you?

Why do you think conservatives abandoned them?

[dizzy]

You don't know much,do you?

Why do you think conservatives abandoned them?

They're not connected. The federal PC party fell apart in the lead up to the 93 election, largely do to a populist swing against Mulroney. The PC party is still the conservative choice in most provinces.

[dizzy]

He's actually doing Canada a great disservice by giving the impression that he couldn't have had this surgery in Canada.

As for his case being "urgent:" There is a wait-list in Montreal of up to three months, but urgent cases can get the surgery right away... link

This has definitely provided for a lot of negative coverage about the canadian health care system and given fodder to reformists in canada and anti-reformists in the US. For my part, I think any attention is good attention on the Canadian front, as some is needed to put healthcare reform back onto the public agenda.

Still, people should feel encouraged with the response from heart specialists, who have made clear that this service is available at no cost and within a reasonable time only a short drive from most Canadian's homes.

I find it convenient that the doctor who was recommended to him happened to coincide with where he has a condo.

I suspect this is the real issue at play. The Miami option gave him a chance to get the service done at a reputable clinic, away from the cameras and near to his secondary home. In the florida sun, no less.

It remains to be seen if he will be reimbursed, but the fact that he feels he's entitled to Canadians paying for services that he chose to have in the U.S. rather than Canada would irk me if I were a Canadian.

...

Do you have that option with your health care needs-- to choose between being treated in Canada or elsewhere?

Only when a doctor is concerned that the required service cannot be provided in-province within a reasonable time AND the provincial insurer has consented to travel abroad to an approved facility (the latter usually done on standing offer). I wonder if Danny's ducks are lined up on this one. If they're not and he wants to go 'Shona Holmes' on the system, I'll watch with an open mind and a bowl of (low sodium) popcorn.

[Smallc]

This has definitely provided for a lot of negative coverage about the canadian health care system

Certainly not here. It may have where you live though, because Quebec has the biggest problems at its healthcare touch points, such as the ER.

[dizzy]

Certainly not here. It may have where you live though, because Quebec has the biggest problems at its healthcare touch points, such as the ER.

The negative reaction I was referring to is with respect to media attention - in canada towards Danny and in the US toward the Canadian model.

I live about 30 mins from Ottawa and I have a well equipped rural hospital (probably because there are four ski hills within 20 minutes). But you're absolutely right, if my little guy needs emergency care, I'll cross the border for CHEO.

[ToadBrother]

It might be wrong to attack Mr. Williams, but then, he isn't doing himself any favours with the arrogance of his explanations....or his lack of explanations to start. And yes, it seems it wasn't an emergency, but it was urgent, meaning the wait would be short. As one doctor from the Peter Munk Centre for Cardiac Science said, their average elective heart surgery wait time is about 2 weeks...and not too many people want to rush into a surgery any faster than that if they don't have to.

What I enjoy is how successfully Williams has managed to put up the smokescreen of "it's none of your business!!!"

The guy clearly doesn't trust Canadian cardiac specialists, has the money to go elsewhere, but somehow still wants it to appear as if it shouldn't raise any particular questions of any kind.

I know for a fact (my wife had surgery for a tumor on her carotid artery... very serious...) within weeks of the diagnosis. Yes, the system crawls over some things, but believe me, if they figure out you've got something life threatening, they don't screw around.

[Argus]

Let me explain the issue here more clearly than perhaps has yet been done. The issue is not that Danny Williams, millionaire, went south to get immediate health care. Any millionaire would have done the same.

The issue is that Danny Williams, one of the liberal elites in charge of our health care system, one of those constantly telling us to stop complaining, one of those constantly defending the cuban style system we have which FORBIDS the rest of us from obtaining private medical care at our own expense - jaunted off to do the opposite himself.

There can be a one year wait for CT scans in Ottawa. Why can't I decide to pay a thousand bucks to get one done privately? Because Danny Williams says that would be unfair. Danny Williams and the rest of the political elites have decided that those with more money ought to not be able to purchase better, more immediate medical care than the rest of the population.

Except of course, that he doesn't include himself in that prohibition.

If some cardiac surgeons wanted to set up a state of the art, for-fee cardiac centre in Newfoundland, Danny Williams' government would shut them down - because they believe that people should not have the right to purchase medical services. The liberal elites, of which he is a member, have been near unanimous on this score.

And yet, when it comes to him, he gives the citizenry the finger, brays contempt at them, and then gets on his jet and flies south to avoid the very restrictions he enforces.

Danny Williams is a lying, hypocritical blowhard.

But then, we already knew that.

Edited February 26, 2010 by Argus

[Smallc]

Yes, the problem with waits comes during diagnosis for some things, usually cancer or strange conditions. That however will improve with the opening of new facilities in Alberta, Manitoba, and other places that use an integrated theoretical and clinical approach based on Mayo and Cleveland.

[Smallc]

There can be a one year wait for CT scans in Ottawa.

That's not what the wait time site says. There is only one hospital reporting that has a long wait.

Why can't I decide to pay a thousand bucks to get one done privately?

Just cross the provincial border.

Edited February 26, 2010 by Smallc

[ToadBrother]

Yes, the problem with waits comes during diagnosis for some things, usually cancer or strange conditions. That however will improve with the opening of new facilities in Alberta, Manitoba, and other places that use an integrated theoretical and clinical approach based on Mayo and Cleveland.

The largest wait my wife had was because at first they had misdiagnosed it as a salivary gland problem. I'd wager that's just as likely to happen in the US as it is here. Once the diagnosis had been made of a carotid body tumor, around the beginning of March, she was on an operating table 5 weeks later. The big delay at that point was that the surgeon wanted to get another MRI and CT scan. Because this is an extraordinarily delicate surgery surrounding one of the major arteries feeding the brain (they literally have to scrape the tumor from around the artery without compromising it), he wanted as complete a picture of what he was doing as possible.

In the end, of course, that was a misdiagnosis as well. It turned out to be thyroid cancer, and she had a total thyroidectomy in June of that year. It's no fault of the doctors, of course. The neck is an absolutely horrible place to have anything go wrong, and until you can get in there, it's sometimes nearly impossible to tell what the issue is (she had had plenty of bloodwork with no indication there of thyroid issues).

Edited February 26, 2010 by ToadBrother

[Oleg Bach]

There was a time in CANADA when even lowly me could have top notch private health care..I in the past have had the best private and most talented doctors..one was an Irishman..Dr. Devlin now deceased--and Paisely the PHd with great intelligence and personal charm along with great natural healing abilities---NOW I have no private health care-- the last doctor I mentioned has gone into a closed practice with a company....IF you find a bright doctor it will be a brief and fleeting situation--these doctors know they are special and very valuable----It is impossible to get a long standing family physican...unless you are ready to settle for Mr..high production I wanna be a billionare from Borneo..there are very few high level doctors left in Canada..They are like good looking smart woman- either gone or off to marry a rich ugly AMERICAN.

[msj]

CTV News consulted four heart specialists to get to the bottom of the whole "claim-game". They all echoed the same details that "the minimally invasive procedure is not available in Newfoundland, but is widely offered in other provinces". link

He's actually doing Canada a great disservice by giving the impression that he couldn't have had this surgery in Canada.

If you focus on just his quotes (rather than the media filler between them) then you would wonder, like I do, if he did it for convenience sake (i.e. the timing was better to get the procedure done at this point in time without the bone crack) rather than wait the week or two to get it done elsewhere in Canada.

Furthermore, Dr. Alan Menkis, a Winnipeg cardiac surgeon, was a pioneer in using the technology. link

Furthermore still: ....a news release from Dec. 3, 2009, announcing[ed] that the prestigious New England Journal of Medicine had just published a feature article on the latest techniques for reconstructing the valve, which separates the heart’s two chambers so blood flows during a normal beat.

The authors? Dr. Thierry Mesana of the University of Ottawa Heart Institute and Dr. Subodh Verma of St. Michael’s Hospital at University of Toronto.

Apparently Ottawa and Toronto have somehow managed to emerge as leading centres for both the theory and practice of heart surgery—in particular, it seems, the operation Williams needed... link

Once again, read only the quotes attributed to Danny and ignore the fluff in-between.

I don't expect a Premier to read the New England Journal of Medicine and to know where a procedure is or isn't.

But according to Danny Williams we have this on the record:

"This was my heart, my choice and my health"

"I did not sign away my right to get the best possible health care for myself when I entered politics."

"I wanted to get in, get out fast, get back to work in a short period of time."

"I would've been criticized if I had stayed in Canada and had been perceived as jumping a line or a wait list. ... I accept that. That's public life,"

"(But) this is not a unique phenomenon to me. This is something that happens with lots of families throughout this country, so I make no apologies for that."

"I have the utmost confidence in our own health care system in Newfoundland and Labrador, but we are just over half a million people,"

"We do whatever we can to provide the best possible health care that we can in Newfoundland and Labrador. The Canadian health care system has a great reputation, but this is a very specialized piece of surgery that had to be done and I went to somebody who's doing this three or four times a day, five, six days a week."

Based soley on what is quoted to him I think this nonsense about him insulting Canadian doctors and the Canadian system is overblown, if not outright spun to absurd conclusions by the media.

As for his case being "urgent:" There is a wait-list in Montreal of up to three months, but urgent cases can get the surgery right away... link

I have stated on several occasions that this case does not appear to have been medically urgent.

The timing of getting the procedure is important to any individual and very well could have been the primary motive for doing it this way (well, besides getting a personal referral from a doctor in New Jersey, that he knew well, to go to that doctor in Miami).

I find it convenient that the doctor who was recommended to him happened to coincide with where he has a condo.

Could be convenient and could be co-incident. Either way, could also be another reason for doing it this way. Big deal.

Will it be an expensive mistake politically? Only time will tell, but I don't doubt that he set back people's opinion of Canada's health care.

Sure, people who rely on the fluff filler from the media while ignoring what he actually stated.

That's the catch, isn't it? You have to be able to "afford" doing it that way, which means the rich can go ahead of the not-as-rich treatment wise. If he chooses to leave the country when he doesn't have to, he should be responsible for the bill, otherwise he is queue-jumping at the expense of the Canadian people.

There are rules in place to deal with this as smallc showed in a post above. Should he get a full reimbursement, then I agree those rules should be changed.

If he gets little to no reimbursement under the rules then I have no problem with this.

If it was medically urgent and he couldn't get it done in Canada, then of course the taxpayers should pay for it.

This case appears to be for convenience sake (whether the timing or the condo) so it is fair to not reimburse him, imo.

Do you honestly believe "any other Canadian" could chose to get treated in the U.S. over Canada and then seek reimbursement? Do you have that option with your health care needs-- to choose between being treated in Canada or elsewhere?

I believe that I could do it. I tend to leave some spare cash around just in case and I have a private health services plan set up from my own company so I could even arrange to use that method to get a deduction should the BC government not reimburse me per the rules mentioned by smallc in a post above.

I'm not particularly wealthy, but I could do it so I have to think that 20-30% of Canadians could find a way to do it too.

If the circumstances are right (which they appear not to be in Danny's case) then, with proper referrals and procedures, yes, I think Canadians can and do get reimbursement for medical procedures done in the US.

It depends on the details, though.

It remains to be seen if he will be reimbursed, but the fact that he feels he's entitled to Canadians paying for services that he chose to have in the U.S. rather than Canada would irk me if I were a Canadian.

Danny Williams has stated:

"If I'm entitled to any reimbursement from any Canadian health care system or any provincial health care system, then obviously I will apply for that as anybody else would[.]"

"But I wrote out the cheque myself and paid for it myself and to this point, I haven't even looked into the possibility of any reimbursement. I don't know what I'm entitled to, if anything, and if it's nothing, then so be it."

So I'm okay with that and he seems to be okay with it too.

[Argus]

That's not what the wait time site says. There is only one hospital reporting that has a long wait.

I misspoke. It is MRI's that have the long wait, not CTs

Just cross the provincial border.

You're missing the point. The privately operated clinics on the Quebec side are against the law. The QC government simply isn't enforcing it.

[Smallc]

I misspoke. It is MRI's that have the long wait, not CTs

Yes, that I will agree with. We should really be looking to see how they do it in the UK. They have fewer machines than us and yet shorter waits.