Canadian Premier Comes to U.S. for Surgery

[Ought Six]

Fd:

"What a fantasy world you live in. You better be a CERTIFIED indigent patient and part of a program (which can take years to qualify) to get more than minimum critical care at many, or most, facilities in this country anymore."

"Fantasy world"? In your state, Medi-Cal covers over seven million people and offers them just such care. And if it was so impossible to qualify for, then how the hell did seven million people get onto Medi-Cal roles? That is getting close to one-fifth of the population of the entire state covered. Must be just a 'fantasy', hmm, Dave?

[Feather]

I have no medical insurance so I go to our county hospital. All I have to do to requalify every 6 months is show how much I am making. I pick up papers from unemployement and bring in my paystubs for the temp service I work for and they take all of the info and let me know how much if anything I have to pay for services and meds. At this time I pay $4 for meds but no more then $20 a day, and I have all of my meds due the same day, and $0 for medical services. My property taxes help pay for this service but you don't have to be a property owner to qualify. They turn no one away no matter if you can afford to pay or not and you do not have to be certified as indigent to pay $0 for all services.

[Potemkin]

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

"All animals are equal, but some animals are more equal than others."
Animal Farm



http://www.google.com/hostednews/can...Yz_6_b-gsGGDxA

'My heart, my choice,' Williams says, defending decision for U.S. heart surgery

By Tara Brautigam (CP) – 1 day ago

An unapologetic Danny Williams says he was aware his trip to the United States for heart surgery earlier this month would spark outcry, but he concluded his personal health trumped any public fallout over the controversial decision.

In an interview with The Canadian Press, Williams said he went to Miami to have a "minimally invasive" surgery for an ailment first detected nearly a year ago, based on the advice of his doctors.

"This was my heart, my choice and my health," Williams said late Monday from his condominium in Sarasota, Fla.

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

The 60-year-old Williams said doctors detected a heart murmur last spring and told him that one of his heart valves wasn't closing properly, creating a leakage.

He said he was told at the time that the problem was "moderate" and that he should come back for a checkup in six months.

Eight months later, in December, his doctors told him the problem had become severe and urged him to get his valve repaired immediately or risk heart failure, he said.

His doctors in Canada presented him with two options - a full or partial sternotomy, both of which would've required breaking bones, he said.

He said he spoke with and provided his medical information to a leading cardiac surgeon in New Jersey who is also from Newfoundland and Labrador. He advised him to seek treatment at the Mount Sinai Medical Center in Miami.

That's where he was treated by Dr. Joseph Lamelas, a cardiac surgeon who has performed more than 8,000 open-heart surgeries.

Williams said Lamelas made an incision under his arm that didn't require any bone breakage.

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

Williams said he didn't announce his departure south of the border because he didn't want to create "a media gong show," but added that criticism would've followed him had he chose to have surgery in Canada.

"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," he said.

"(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."

Williams said his decision to go to the U.S. did not reflect any lack of faith in his own province's health care system.

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

"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."

He quipped that he had "a heart of a 40-year-old, so that gives me 20 years new life," and said he intends to run in the next provincial election in 2011.

"I'm probably going to be around for a long time, hopefully, if God willing," he said.

"God forbid for the Canadian public I won't be around longer than ever."

Williams also said he paid for the treatment, but added he would seek any refunds he would be eligible for in Canada.

"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.

"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."

He is expected back at work in early March.

[dharma]

"I have the utmost confidence in our own health care system"

Finish the sentence, sir: "for everyone else".

[rb.]

Ok, earlier reports said he was having a procedure that IS done in Canada, so were those reports wrong? Or do they equate cracking bone with an incision in the arm? I'd go with the incision, too, if I had the money. I don't though, so I'd be stuck with the bone cracker. How is this different than US care?

[Potemkin]

Originally Posted by rb.

Ok, earlier reports said he was having a procedure that IS done in Canada, so were those reports wrong? Or do they equate cracking bone with an incision in the arm? I'd go with the incision, too, if I had the money. I don't though, so I'd be stuck with the bone cracker. How is this different than US care?

They didn't have someone to do this procedure in his province.

I find it hard to believe they didn't have someone in Toronto (2.5Mil pop.) or Montreal (1.6Mil pop.) who could do this procedure.

Heck, they even had someone in my hometown (130k pop.) who did it on my father. (And it was a valve replacement not a repair.)

[rb.]

Yeah, there's an awful lot they can't have done in his province, Pot, due to the population. I'm just wondering if there IS the opportunity to have it done inside Canada. I would think so, since the really touchy surgery my cousin was to have was offered to him in LA (he's close...Vancouver) or Ottawa. It is kind of uncommon to have this surgery, as many don't survive long enough to have it. Anyway, he chose Ottawa, as his parents were a few hours away, so he'd be closer to the specialist/for recuperation time. The article mentioned that the premier was at his place in Sarasota, so I wonder if that factored in to his decision...he had a place "kind of" close to Miami to recuperate on his own dime. In his own home.

[CanadaSue]

He could have had it done in another province but would have been on a loooooong waiting list & expected to be ready at a moment's notice when a spot came up. A bit tough for a sitting premier.

[Sarrah]

I found this story
So the question is. Is it propaganda by the US? Or propaganda by Canada? Or is it propaganda by the Premier of NFL? Or is it just a story with many sides to the same picture.

CTV.ca

Benefit of Williams's surgery is cosmetic: expert

The Canadian Press

Updated: Tue. Feb. 23 2010 6:34 PM ET

An international expert on heart repair says he would rarely recommend the type of heart surgery Newfoundland and Labrador Premier Danny Williams received earlier this month at a Miami hospital because its only long-term benefit is cosmetic.

Dr. Thierry Mesana, chief of cardiac surgery at the University of Ottawa Heart Institute, said Tuesday he would only consider offering the "minimally invasive" procedure to young women hoping to avoid a chest scar.

The mitral valve repair Williams received Feb. 4 at Mount Sinai Medical Center involves surgeons making a five-centimetre incision on the side of the chest, near the armpit. Slender surgical tools are then inserted between the ribs to reconstruct the valve.

The traditional method requires a 10-centimetre incision in the middle of the chest and cutting through the breast bone, or sternum.

A damaged mitral valve can cause blood to leak backwards in the heart, causing heart infections, an enlarged heart and heart failure.

Mesana issued a statement saying a survey published last month by the Society of Thoracic Surgeons expressed "caution" about the less invasive procedure because the rate of complications -- strokes in particular -- is higher.

"Many world-renowned experts do not advocate it," the statement said.

"It is done in Canada, but again, with caution. I propose it only for cosmetic reasons in a young woman who dislikes the idea of having a scar visible in summer."

However, the doctor confirmed there are short-term advantages, including a more rapid recovery, less need for blood transfusions and less likelihood of an irregular heartbeat after surgery.

Marlene Orton, a spokeswoman for the Heart Institute, stressed that Mesana was not commenting specifically on Williams's case or his choice of treatment.

Mesana is considered one of the world's top authorities on mitral valve repair, having recently co-authored an expert guide for the New England Journal of Medicine.

Hugues Jeanmart, a cardiac surgeon at the Montreal Heart Institute and nearby Sacre Coeur Hospital, disagreed with Mesana, saying the less invasive surgery is as safe and effective as traditional methods, with fewer complications.

As well, he said the advantages of the procedure, which has been around since the 1990s, are more pronounced than Mesana suggests, particularly when it comes to recovery.

"(Patients) have less pain, they have less chance of bleeding (and) the risk of having a chest infection is very, very low," Jeanmart said in an interview from Montreal.

"The patient can leave the hospital and, as soon as they're home, they can do what they want."

Recovery from the larger chest incisions, known as sternotomies, typically takes about six to eight weeks because more time is needed for bones to heal.

Williams has said his doctors told him he would only be offered full or partial sternotomies.

"The big priority for me, to be quite honest with you, was get something done that would get me back to work as soon as possible, given the importance of the spring in any fiscal calendar for any government," he said Monday.

"It was indicated to me that I would've had to get the partial sternotomy in Canada ... I then chose to go to the Miami route on the basis that I could get minimally invasive, get in and out quick, get it repaired quick."

Jeanmart said he was surprised to hear that advice.

"I guess that it's somebody who didn't have any contact with the (Canadian) surgeons who are doing these procedures," he said. "We are among the leaders in many fields of surgery, especially in cardiac surgery."

Jeanmart said he wasn't aware of the details of Williams's case, but he said he couldn't see an obvious reason why the premier couldn't have the surgery at his hospital, where the procedure has been offered since 2006.

"Most patients who present with mitral valve leakage ... are candidates for minimally invasive approach," he said, adding that the two centres in Montreal are typically completing two or three surgeries every week.

"We can repair all kinds of valves through the minimally invasive approach."

Blair O'Neill, incoming president of the Canadian Cardiovascular Society, described the type of surgery Williams received as "a work in progress," having yet to undergo a full, scientific comparison with more traditional types of open-heart surgery.

"When it's first coming into common practice, there's only going to be a few places that offer it," said O'Neill, a practising cardiologist at the Mazankowski Alberta Heart Institute in Edmonton.

Of the 30 heart centres in Canada, no more than four offer the procedure.

"I believe (Mesana) takes the right approach in saying we should be cautious whenever we're introducing new procedures," O'Neill said.

But O'Neill said it would be a mistake to assume Williams received better care in the United States where, on average, cardiac surgeons do fewer operations per year than their Canadian counterparts.

As well, he stressed that wait time problems in Canada have been solved when it comes to cardiac surgery, with most serious cases requiring only two or three weeks in the queue.

© 2010 CTVglobemedia All Rights Reserved.
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http://www.ctv.ca/servlet/ArticleNew...223?hub=Health

[rb.]

Huh. Two to three week wait for a non-emergency situation. So either his doc needs to buy a clue, the premier is lying, or he didn't want to wait. I can buy the doc needing a clue, if it wasn't a heart specialist, but you would think it WAS a cardiologist, and he/she SHOULD have known the surgery was available here, relatively quickly. Interesting.