For Whose Prosperity?

Lately I seem to keep getting spam emails from “Patients United Now,” brought to me by the Americans for Prosperity Foundation. The emails they send promote scare-tactic lobbying and advertising based on flimsy doomsday scenarios in which they foretell that even a modest attempt at healthcare reform will surely wreak havoc upon our great nation.

Their updates tout the fact that they’re spending nearly $2 million to buy cable advertising in all 50 states to run a TV spot featuring Canadian Shona Holmes, who was diagnosed with a “brain tumor” which was already impairing her sight and then informed by Canada’s state-run healthcare system that she would have to wait four to six months to get surgery. Panicking, Holmes “mortgaged her home to come to the U.S. for treatment,” and says in the ad, “I survived a brain tumor, but if I’d relied on my government for health care, I’d be dead.”

Now, all this sounds scary—when one receives such a diagnosis, of course, one wants to seek help as soon as possible. It’s a completely natural reaction. But let’s take a look at who’s paying for this advertising. In the 1990s and early 2000s, the AFPF was so concerned for our health that it vigorously defended (and was largely funded by) the tobacco industry during legislative battles over smoking bans in public places and the raising of cigarette taxes (raised largely to help cover the health care costs of the effects of tobacco). And in 2008 it launched its “Hot Air Tour” campaign, geared toward discrediting what it called “global warming alarmism,” and in which it claimed that the accumulating scientific arguments affirming the effects of human activity on climate change were “overblown.”

According to Sourcewatch, Americans for Prosperity (which also brought you the “tax day tea party” and the impetus for the accompanying teabag jokes) states on its website that it “gets its support from individuals and corporations which share its vision.” It does not, however, disclose which corporations fund its operations, which include million-dollar media-blitz ad campaigns like the one Holmes has become known for.

According to Sourcewatch, AFP has received substantial funding from the Koch Family Foundations and the Scaife Family Foundations, both of which contribute to conservative causes. In May, AFP launched Patients United Now, a website offering information for those opposed to a government takeover of the U.S. healthcare system. A series of television ads opposing healthcare reform appeared under the Patients United Now brand, including the spot featuring Holmes. Despite AFP’s clever and well-funded efforts at crafting a flag-waving populist charade that’s preyed largely on outdated, knee-jerk anti-socialist sentiments, I doubt that it’s our interests or prosperity they’re out to protect.

The Advocate located Holmes and asked her some questions.

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Valley Advocate: Healthcare reform is probably the number one hot-button issue these days in a country that’s one of the richest in the world, yet still leaves approximately 50 million people with no health insurance at all. Most Americans agree that something drastic must be done to control costs and make sure that everyone, especially every child, is covered. Your emergence as a public figure has a lot of folks scratching their heads and wondering if yours is really a legitimate story, or if you’ve been trotted out as an agent for the insurance, pharmaceutical and private health care lobbies in a last-ditch effort to preserve their profit margins in the face of overwhelming public opposition.

Shona Holmes: I am skeptical, as many, as to the actual number of 50 million people that are uninsured; this number has been debated to the nth degree, but I agree, like everyone involved in this debate, that indeed reform of some sort needs to be done. I just disagree with the type of reform that seems to be getting the most attention. I believe that Canada has been unable to control [the] costs of health care under our monopoly of services. I do not believe in polarizing any party, profession or people in order to make these points. We can’t simply blame one person in this debate with regard to costs. Everyone, including the government, insurance companies, pharma[ceutical] companies, doctors, nurses, lawyers, courts and patients all have a responsibility to reduce costs of healthcare. In Canada those attempts to reduce costs are simply by rationing services or increas[ing] taxes. Neither of these [actions] are working any more.

My “emergence” is not all that new. I have been involved in the debate of health care for four years now, from both sides of the border. It wasn’t until the latest burst of publicity that suddenly I seem new to some people. I can assure you I am not. I spoke at the National Press Club last June with regards to healthcare reform. I was available and did a lot of interviews in the states, in print, TV and radio. I also had been terribly active here in Canada as well, doing the same thing.

So, no, I have not been trotted out by any particular group for a last ditch effort. Lobbyist groups using me? It always surprises me when people don’t point a finger at the unions. I can tell by the tone of your question we obviously differ on the health care debate.

Was it your own idea to engage in this crusade, or were you persuaded recently to adopt the cause?

No one had to persuade me in any shape or form. From my point of view as a Canadian, I felt it was the neighborly thing to do. I had found myself in trouble in Canada, and I had no idea what my options were for treatment, as in Canada I had no options and no access to the tests and treatment that I needed. I had heard of more and more people going to the States for treatment, and after I had done it myself, I started to realize that there was a terrible language barrier between the two countries, even if we did indeed speak the same language; the perception of each other’s health care was very far off from the reality. There had been some Canadian public officials that came to the U.S. on behalf of the Obama administration and never told the truth about our situation; it was then I felt an even bigger obligation to talk directly to citizens of the United States about my experiences. I have been in the fortunate position of [receiving] care from both sides of the border.

As a Canadian, how do you feel about being suddenly thrust into the epicenter of an all-out battle over U.S. national health care policy?

I felt an obligation as well as grateful for the opportunity to testify before Congress with regards to my situation. I felt it would have been hypocritical of me not to. I used the American system when I was desperate, and I know a lot of Canadians do. In 2007 $101 million dollars was spent on pre-approval of sending people from my province alone to the States for treatment. This figure does not include those who have paid for it themselves or have yet to ask for reimbursement or [have been] denied reimbursement from our government.

The year I came to the U.S. for my surgery, 36 patients were sent in one month by the government due to shortages here, and six were sent in one day all for brain surgery. Our premature babies are being sent over the border due to lack of neo-natal space in our largest hospitals. Our newest members and sickest members, regardless of their economic status, are being sent out [of] the country for treatment.

When was the commercial you were in made?

I am thinking it was in April of this year but not sure, if my memory serves me correctly (it was April).

Has anyone from the Canadian health care establishment contacted you and asked you to stop bashing them?

Bashing them? I find that question quite offensive. I had an experience. I have never spoken out about any doctors, hospitals or any individuals. I spoke out about our government-run system that failed me and many others in our most vulnerable times. I have government-run insurance, without any option to opt out of [it]; they had an obligation to provide timely treatment. In fact, if I have had any responses from the health care establishment, it has been to thank me for having the courage to expose the weaknesses in our system, saying that I have spoken out to tell two nations the things that they have to tell their patients every day and are running out of excuses.

Obviously, since a large percentage of Americans support at least a partial reform of the health care system (which many feel should contain a government-run “public option”), people are skeptical of your motivations. Have you received any payment for your duties as a spokesperson, and if so, how much and from whom?

I am not convinced that is so obvious; I think that it is showing that the majority of Americans are satisfied with the health coverage they have now. Rarely is the number of the 250 million of insured ever spoken of. Yes, people agree there should be some reform; however the government option is what I see as the thing to avoid. Medicare/Medicaid [and] VA hospitals are prime examples of inefficiencies in government-run programs such as we have here in Canada. My motivations are pure in the sense that I just would like to see, after years of anti-American attitudes around the world, that someone pointed out, or at least said thank you for something good that America did for them. We would be, as a nation, in a terrible position if you were not our neighbors.

Your surgery was performed at the Mayo Clinic, and you’ve become at least casually affiliated with a political group known as the Americans for Prosperity Foundation. Have you received any non-monetary gifts, services or free health care from the Mayo Clinic or the AFPF?

None.

Is it true that the tumor you had removed was actually not cancerous, but a benign cyst that is considered by most medical professionals to be non-life-threatening?

I never once reported that I had a cancerous tumor; each time that was reported was due to poor reporting [see Fox News footnote] out of my control. I had been far too trusting with media, which I have had to harden up to. You will never find anything [in which] I or any of my representatives have ever referred to it as cancer. I have always been very clear about my condition. My case is complicated, and unfortunately, too many journalists tried to be neurosurgeons and endocrinologists after reading a fluff PR piece that I did for the Mayo Clinic that was done for the sole purpose of expressing my gratitude for the wonderful treatment I received.

Obviously, in such a short piece and [because of] my ongoing issues, it was decided to limit how much could or should be covered in the piece. My medical records actually refer to the tumor as with four possibilities; a lot could not be known until [the] actual surgery. It was the following: craniopharyngioma [also known as a Rathke’s Cleft Cyst, not technically a brain tumor].

Characteristics:

The complication for me was the rapid speed [with] which it was growing, the rapid loss of my vision, and the physical traits that were suddenly morphing my body, clearly stating there were issues. The concern was the damage this was causing to the Hypothalamus/Pituitary/Adrenal axis and [that it] was causing life-threatening conditions. I was then diagnosed with Cushing’s [disease, also known as pituitary adrenocorticotropic hormone hypersecretion], which is terribly serious when considering all that was happening. Without getting into too many details, I was suffering from dangerously high cortisol [a hormone produced by the adrenal cortex] levels and yet very little ACTH production, which was causing adrenal insufficiency. Life-threatening indeed. It isn’t the fall from the window that kills you but the sudden stop at the bottom. All of my conditions were putting me in danger from the brain tumor. One would have to review the stacks of medical records to fully understand the nature of this mass and the complications it caused.

Were you actually told by a Mayo Clinic doctor that you would have died if you hadn’t received the surgery when you did, as you state in the national television ad?

Yes. And when they told me that, it was in the context that I needed surgery immediately. We told them when our appointments were at home, and they said, clearly, I would be dead by then. I was always informed that my vision loss was so great that I would suffer irreversible tissue damage and from the onset of symptoms I had a window of four to six weeks to save my vision. They advised surgery immediately. When [I] asked for them to define immediately they said Monday, and this was Friday. At that time, the Mayo Clinic packed up my records and started to frantically contact people in Canada to see me. Two of my doctors were in fact Canadian doctors and did everything in their power for me to get treatment back in Canada, now that we had a confirmed diagnosis in hand.

Every expert, and there have been many that have reviewed my case, has confirmed that I should have been in surgery “within hours to days.” When that wasn’t going to happen—I had waited weeks with nothing happening in Canada, my vision getting worse—no one was more surprised than the Mayo clinic that I returned for treatment out of sheer desperation. Even experts who have been reporting without seeing my file have said, ”If she was that sick, she would have needed surgery immediately.”

Without question, it was a gamble that the government had no right to take on my behalf.

You sort of ducked the question about whether you’d been paid by anyone for your services as a spokesperson. Want to try again?

I have not been paid anything, by anyone for anything, either here [in Canada] or in the U.S. I also don’t consider it as duties as a spokesperson. I have no obligation or duties to anyone.

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To keep things in perspective, it is important that the following facts be considered:

• Holmes is suing the government of Ontario to recoup the costs of her U.S. operation ($97,000), and her legal fees are being funded by a right-wing political advocacy group called the Canadian Constitution Federation, a group that has “charitable status” and hence is funded by Canadian taxpayers because it is “non-partisan.” According to the Daily Kos, a staff member of the CCF edited a Wikipedia post concerning her prognosis, adding, “Shona Holmes was told she would lose her vision forever, unless surgeons immediately removed her growing brain tumour. But Ontario’s government monopoly health care system told Shona whe would have to wait for months just to see specialists and obtain treatment. Not willing to risk permanent blindness, Shona obtained surgery at the Mayo Clinic in Arizona. Within 10 days, her vision was completely restored.”

The post has since been deleted, but indicates that the story Holmes told to the CCF is not the story that she told to Americans in the television commercial, where she claimed to be facing death, not blindness.

• The Canadian Broadcasting Corporation interviewed neurosurgeons in Montreal and Toronto who described Holmes’ claims as exaggerated and stated that her condition was a benign cyst which was not a medical emergency.

• The original promotional interview with Shona Holmes was removed from the Mayo Clinic’s website.

• Fox News ran these screen captions during their interview with Shona Holmes: “Cancer Patient Says Canadian Health Care Nearly Killed Her” and “Shona Holmes: Came to America for Cancer Treatment.”

• The Mayo Clinic was contacted in an effort to confirm the diagnosis of Holmes’ condition and its likelihood of mortality with her physicians, but a spokesperson responded that, despite a large number of inquiries, they would not be commenting, citing issues of medical privacy.•