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Konrad Yakabuski (Fernando Morales/The Globe and Mail)

Konrad Yakabuski

(Fernando Morales/The Globe and Mail)

KONRAD YAKABUSKI

Don’t cross Canada’s health-care ayatollahs Add to ...

The ayatollahs of Canada’s single-payer health-care system are at it again. This time, they want Ontario Premier Kathleen Wynne to shut down a pilot project at Toronto’s Sunnybrook Hospital that aims to treat fewer than 10 foreign patients a year in order to bring in new revenue.

“Ontario risks stepping onto a slippery slope toward a two-tier system of health care, where a parallel for-profit system provides care to those who can afford to pay,” opponents of the Sunnybrook plan, including a group called Canadian Doctors for Medicare, told the Premier in a letter this month.

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When the ayatollahs say jump, the politicians say, How high? Ms. Wynne’s Health Minister, Deb Matthews, responded by ordering a review of this reverse medical tourism. (Normally, it’s Canadians leaving the country for timely care, rather than foreigners coming here.) Officially, the review is to ensure not a single public penny gets diverted or a single second added to wait times for Ontarians. But that’s just an excuse.

No doubt, Ms. Matthews’s review will extend beyond the next provincial election, expected any time now, to avoid difficult questions on the campaign trail. Ideology still trumps evidence in Canada’s health-care debate and we remain incapable of having an adult conversation about how to extend the lifespan of a public system that is not aging well.

The self-righteous defenders of socialized medicine brook no dissent as they steamroll over any attempts to improve our system that might involve private money or choice. They express a certainty as to the superiority of our system that is so all-encompassing they never consider for a second that ideas like Sunnybrook’s could actually strengthen public health care. What hospital couldn’t use a bit of extra cash?

The ayatollahs are a perfect foil for the American fundamentalists on the other side of the health-care divide, which is why the founder of Canadian Doctors for Medicare, Danielle Martin, was such a hit back home when she appeared last month before a U.S. Senate subcommittee.

“On average, how many Canadian patients on a waiting list die each year, do you know?” North Carolina Republican Senator Richard Burr asked Dr. Martin.

“I don’t sir, but I know there are 45,000 in America who die waiting because they don’t have insurance at all,” she shot back.

The CBC loved it. But what Dr. Martin “knows” is actually a matter of much debate south of the border. Her reference to 45,000 deaths comes from a 2009 Harvard Medical School study released by Physicians for a National Health Program, a group that lobbies for a “universal, comprehensive single-payer” system.

The truth is that Americans without health insurance often have access to better and more timely “free” health-care than Canadians with government-provided coverage. I witnessed this while covering the bitter debate over U.S. President Barack Obama’s 2010 health-care legislation, which made health insurance mandatory for all Americans, when I visited emergency rooms and Community Health Centers that treat the uninsured.

Community Health Centers provide preventive and ongoing care for 22 million patients a year, including illegal immigrants. They operate with federal, state and charitable grants, as well as donations from ordinary citizens. They depend on heroic doctors committed to caring for the poor, rather than getting rich.

I was inspired, but also envious. I returned to Canada more than a year ago and still haven’t found a family doctor. Twice, I went to walk-in clinics only to be told there was no way a doctor could see me before closing time, hours away. I would get much faster service at a CHC.

The fact is, there are lots of reasons why some Americans go without insurance – and why millions will continue do so, despite Obamacare. Inability to pay is just one of them. Canadians should think twice before throwing stones.

Obamacare’s stated goal is to insure the uninsured, but its unstated goal may be more important. By making insurance more expensive for average Americans, they’ll consume less health care. Instead of gold-plated plans, they’ll buy silver- or bronze-plated ones that ration care by limiting doctor and hospital choice.

That’s essentially the way we do it here. We could eliminate wait times in a heartbeat if we were willing to pay higher taxes. But we know that, globally, the costs would probably outweigh the benefits.

Heaven forbid, however, that anyone suggest using idle operating rooms to bring in extra money by treating foreigners now and then. The health-care ayatollahs will try to silence you in a heartbeat.

Follow on Twitter: @konradyakabuski

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