Editor's note. The following is an update of entry that appeared yesterday on the invaluable blog, http://powellcenterformedicalethics.blogspot.com

Multiple sources have confirmed that Newfoundland and Labrador Premier Danny Williams is in the United States for heart surgery that is unavailable in the provinces which he governs. His decision has set off a firestorm in Canada.

Newfoundland and Labrador Premier Danny Williams

The Canadian Press, similar to the U.S.-based Associated Press, reported, "His decision to go to the U.S. for health care has triggered a heated debate online, particularly in a province that has tried to restore public confidence in its health care services after a major scandal involving botched breast cancer tests."

According to the Associated Press, "Kathy Dunderdale, the province's deputy premier who is taking over in his absence, said Tuesday that Williams decided to go to the U.S. for surgery after weeks of consultation with his doctors. She did not say where in the U.S. he would seek care. Dunderdale says having the surgery done in the province was never an option. But she wouldn't comment on whether the type of surgery Williams was having was available elsewhere in Canada."

Williams' recovery is expected to take from three to 12 weeks. Canada, a single payer system, is often held up by lawmakers as a model worth emulating (in whole or part) in the U.S. However, the system has also been plagued by claims of waiting lines, inadequate care, and poor survival rates.

In 2007, one of the problems--wait times-- had gotten so bad that the Prime Minister, Stephen Harper, announced:

"During the last federal election campaign, I and my party made a clear and unequivocal commitment to Canadians. We promised to sit down with the provinces to develop Patient Wait Times Guarantees, and today, I'm proud to announce, we're delivering."

With the promise of delivering a solution by 2010, many Canadians remain skeptical. For more of the problems associated with Canada's health care system go to www.nrlc.org/news/2009/NRL05/UniversalHealthCare.html.

NRLC has long argued that the cost of health care does not require rationing lifesaving treatment. For a full explanation go to www.nrlc.org/MedEthics/AmericaCanAfford.html.

As Congress contemplates how to move forward to pass health care reform intended to have universal coverage, it is essential that any health plan include a means of sustainable, adequate funding so as to lessen the real danger of rationing.

This high profile story from Canada is one among countless examples of what can go wrong in the rationed health care systems elsewhere that rely on general fund revenues.

Please send your thoughts and comments to daveandrusko@gmail.com.

Part Two