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Thursday, July 30, 2009

Barack Obama feels the repercussions of the Chaoulli decision

There's one Canadian who should scare Barack Obama more than any other these days, and it isn't Guantanamo Bay prisoner Omar Khadr.

It's Shona Holmes, the Ontario woman who is among the first Canadians to put the Supreme Court's 2005 Chaoulli decision to the test outside of Quebec.

The court's decision in the Chaoulli case, which pitted the crusading Montreal physician Jacques Chaoulli and a Quebec patient against the Quebec government, established that bans on private health insurance violate the Charter of Rights and Freedoms when wait times to access medical care are so long as to endanger patients' health. (Read the decision here.) That principle hasn't been extended beyond Quebec's borders, but several cases -- including the one Ms Holmes is involved in -- are trying to change that, as I reported nearly two years ago.

So what does Barack Obama have to fear from Ms Holmes? Well, Ms Holmes claims that she had to flee Canada to the United States to get a brain tumour treated before it would kill her. And although that claim has not been proven in court (the Ontario government only just finally filed its defence in her case earlier this month) she has become the poster child of late for the US Republican Party's campaign to make the Washington, DC healthcare-reform battle Obama's "Waterloo," as one representative put it.

Ms Holmes has appeared in a sharply partisan anti-"nationalization" advertisement that's been broadcast across the US:

And she was recently featured at a Republican Party news conference, where she described her plight at the hands of the Canadian healthcare system.

The net result of this has been twofold, and both aspects have been sadly predictable: firstly, the demonization of the Canadian healthcare system; and, consequentially, a serious political problem for the Obama administration and the Democratic Party, which is attempting to draft major health-insurance-reform legislation. Despite the fact the Republicans' reliance on the Canada-is-socialist-and-bad narrative is misleading, the party's influence and the reach of its advertising and the advertising produced by associated political groups all but ensure Canada looks awful, and thereby represent a serious threat to the American reform project.

Shona Holmes, and other Canadians like her who have either entered the US political scene of their own accord or have been pulled into it by lobby groups, are very much at the centre of that regrettable mess.

Photo: President Barack Obama listens to comments while meeting with healthcare stakeholders in the Roosevelt Room at White House May 11, 2009. At right is Health and Human Services Secretary Kathleen Sebelius. Pete Souza, US Government


  1. RE: Shona

    It would be hard to challenge the danger of her medical condition without the input of the expert ( versus the non-expert).
    Therefore it is somewhat foolish for Shona to speak ( and for others to listen) as she denigrates how Canadian "medical" professionals treated her and the impact of her tumour type on her HPA Axis.
    to elevate this complaint to a "systems" level is to overturn the valuable impact she could have as her argument against a "system" is based on an " issue".

    RE: Obama

    His most significant sentence in U.S. health reform has been a declaration of how " point of access" will be treated and insured.
    We live in a time where the scarcity of individual physicians ( in terms of physical and capabilty to manage an appropriate caseload number ) now requires a different " first-stop" for the patient than what the physician can presently provide.
    These nurse-managed clinics in the U.S have long existed funded by "foundations" of good repute.
    My guess is the funding burden of foundations for these care structures will be the first level of government financial support in "primary" care.,,,as the GP moves up into a "referral" role.

    This also frees foundations to fund "integration" models versus" practice centers.... and the coordination dollarts related to that are beyond your imagination.
    Time for mezzanine financing for new "model"...not new staffing plans.

    Obama gets the role of " front man" ( musch better role than "shill")

    RE: Canada

    'Breathes there a man ( or woman) with soul so dead who never to himself hath said... this is my home... my native land'?

    Seriously, Shona........ you could have "shone a" better light on the excellence within the Canadian system if you looked beyond your own interpretations.

    RE: new insurance plans/schemes for health care delivery

    If you can get a company who will let you control "the percentages within the policy" of where monies are placed ( before penalty) then you can face medical emergencies.
    In canada prior to OHIP there was no shortage of privated medical plans and patients cashed in on doctors visits by having one plan pay the doctor...and the other pay them.( yup,yup,yup, it actually happened!)

    Gosh.... how hard would this be to trace... and who would care as long as premiums flowed?

    RE: Chaouli ... lest we forget....

    'No one is sure just how long Jean-Jacques Sauvageau sat in the clinic's waiting room, dead.'

    Good thing Shona did not seek reform under his wing :)

    Read up on the HPA Axis..... and the nature of related tumours............fascinating!!!!!

  2. hello... hapi blogging... have a nice day! just visiting here....

  3. I must be getting senile...I thought that I read that the brain tumour that Ms Holmes had was a type of BENIGN cyst,was not spreading and could be removed at any convenient time.Ms Holmes didn't trust the opinion of her Canadian doctors(after all they weren't costing her a dime)so she panicked and fled to the States for emergency treatment,all at a high cost financially to Ms. Holmes.Now the Republicans are using her as an example of how terrible our Canadian system is and are using her paranoia to thwart any changes to the American health care system...

  4. Dr Carolyn Bennett, the Liberal Party's health critic, has weighed in on Shona Holmes's lobbying:

    Watching the debate in the US about health care has been a fascinating, if depressing experience. And the fact that a Canadian woman has played into the hands of the Republican lobby because of her understandable anxiety about her medical condition doesn't make me mad, if just makes me sad...

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