WASHINGTON – Shona Holmes is the Harry and Louise of this year's health care debate, only unlike the fictional folks who memorably trashed the Clinton-era health plan in advocacy ads 15 years ago, Holmes is real.
But her story? It's not quite the slam-dunk indictment of socialized medicine that's been portrayed by Republican lawmakers and their allies.
Holmes, a Canadian living under that country's single-payer system, has said flatly that her brain tumor would have killed her if she'd accepted her fate in Canada — a wait of four months for one specialist and six months for another. Instead she went to the U.S. and had successful surgery.
But she never had cancer — a fact routinely omitted by the advocates who have seized on her case. Technically, she didn't have a tumor, either. She had a benign cyst that was apparently threatening her eyesight.
Holmes' decision to come to the U.S. exposed her both to the best of American health care and the worst: its capacity for prompt, advanced treatment for complicated conditions, and its staggering expense.
She and her husband took out a second mortgage on their Waterdown, Ontario, home and made other sacrifices to cover the nearly $100,000 in medical and travel bills from her visits to the Mayo Clinic in Scottsdale, Ariz.
In that respect, she was much like the 40 million or so Americans who have no health insurance and are only one hospital bill away from financial peril.
Had she waited, the surgery would have cost her nothing back home. She says that was a risk she couldn't take.
Holmes has pitched her case against government-run health care in advocacy group advertising, TV interviews and testimony to Congress, while holding back her medical records from scrutiny. She is back in Washington this week for a conservative forum. Republican Senate leader Mitch McConnell of Kentucky, among others, has showcased her story.
A look at rhetoric and reality in her case:
CLAIMS:
_"If I had relied on my government for health care, I'd be dead." Holmes, in an ad for Patients United Now, showing an image labeled as a brain tumor.
_"Shona's life was eventually saved because she came to the United States for the care she needed. ... Once the government is in control, politicians and bureaucrats will be the ones telling people what kind of care they can have." McConnell.
THE FACTS:
The Mayo Clinic diagnosed Holmes with Rathke's cleft cyst, which the clinic describes as a rare fluid-filled sac that grows near the pituitary gland near the base of the brain and can cause hormone and vision problems over time. The condition is not known to be fatal and the clinic, in trumpeting her treatment, makes no claim that her life was in danger.
It does, though, say she would have eventually lost her sight without surgery.
Holmes has declined to release medical records to Canadian news organizations checking her claims, citing her lawsuit seeking payment of her expenses by the Ontario provincial government.
Without them, the severity of her condition cannot be verified and it is impossible to know the circumstances that placed her on long waits in 2005 after she was referred by her family doctor to a neurologist and an endocrinologist.
Canada's system is not being emulated in the U.S. At most, some Democrats are pushing for a government-run plan to compete in the marketplace with private insurers, although even that idea is faltering.
Republicans contend that over time, a public insurance option could drive private insurers out of business, effectively giving the U.S. government-run care.
There's no question many Canadians wait for care they're anxious to get. A trade-off of guaranteeing coverage for all and paying medical bills mostly through taxes is that people often wait to be treated for conditions that may be serious but — rightly or wrongly — are not judged urgent.
Even so, across a range of diseases monitored in Canada, the average waiting time before seeing a specialist is typically measured in days or a few weeks, not the four to six months reported in Holmes' case.
Holmes was at first diagnosed in Arizona, then went back for the surgery after she failed to persuade health officials at home to speed up her treatment. She says her vision has been restored.
