Danny Williams is unlikely to be — if he ever was — included on Barack Obama’s Christmas card list this year.

The U.S. president’s health-care plan, which was already showing symptoms of a severe malady, received another dose of poison when Newfoundland and Labrador’s bombastic premier flew south of the border in late January for heart surgery. Danny became an overnight sensation for U.S. Republicans, who happily elevated him to poster-boy status for everything that’s supposedly right about private health care and, conversely, the evils of universal public health care.

Undoubtedly, this was not Williams’ intent, and his legions of adoring fans in this province have stridently defended their hero’s right to obtain health care wherever he chooses. The few critics and journalists who dared to ask publicly why the province’s guardian of health care found it necessary to travel to the U.S. have found themselves shouted down on radio call-in programs.

What the government is unable to deny effectively, however, is how badly it handled the issue of Williams’ health. While the premier may have the right to seek surgery anywhere he wants, critics point out that the health of a senior politician lies within the realm of public interest. In addition, Williams could have quashed speculation about his confidence in Canada’s health-care system by explaining in advance his reasons for obtaining surgery in the U.S.

But Williams may have inadvertently opened a debate about some larger issues pertaining to public and private health care, issues that Canadians may be compelled to address. The fact is that for those with money, the often lengthy wait times for health care endured by many people in this country can be avoided by paying at the gurney in a U.S. hospital. Should Canadians have the right to avoid lineups (not to mention weeks or months of discomfort) by paying for health care in their own country if they have the financial resources?

In 2005, the Supreme Court of Canada struck down a Quebec law that prohibited the use of private health insurance to pay for procedures offered by the public system when wait times are unreasonably long. This ruling pertains solely to Quebec, and few doctors in this country offer private health care. That’s due to long-standing restrictions imposed by provincial governments that forbid physicians from accepting payments from the public system if they go this route.

But the proverbial Pandora’s box may have been opened. Last summer, Quebec’s Charest government expanded the role of private health care by increasing the number of surgical procedures that can be contracted out to hospitals and clinics, to 56 from three. These include hip and knee replacements, cataract surgery, mastectomies, hysterectomies and bariatric surgery. Quebec has also loosened restrictions on the ability of surgeons to practice simultaneously in both the public and private sectors.

Canadians also have to ask whether universal health care really exists when hundreds of thousands of people cannot find a family doctor. Rather than ask governments to spend more public money on recruiting and paying additional physicians, should general practitioners be permitted to work in the public system while also offering private services for patients who can afford it?

And what’s so universal about a health-care system that does not provide drug and dental coverage for those without private insurance? The civil servants and politicians who rely on their workplace benefits to cover these costs do not appear terribly concerned about their fellow citizens who must pay for drugs. As “boomers” like Williams reach retirement age in even greater numbers, the big question is whether they will put up with unacceptable wait times for health care.

The post-Second World War demographic segment that altered Canada so much in its youth may not be finished yet. IE