The Munk Debates

by Rudyard Griffiths

  The U.S. system is in need of reform. We made a huge step towards the Canadian ideal of universality earlier this year. But a single-payer, totally funded public system will never be adopted by Americans. Americans by their very nature are much more individualistic, less taken with the European construct of solidarity, more inspired by high — sometimes too high — expectations that for your daughter or your wife, there is going to be the very best care available with medical advances and modern technology, and that they’ll have it when it’s needed.

  In the U.S., in our pluralistic system, we don’t see this centralized control which ultimately does create longer wait times. It does force our opponents to make the argument that less technology is good, that in regard to medical advances we should go slowly.

  We don’t have those upstream limits on physician supply and specialization. We don’t have those limits on technology or on capital expenditures. We’re not afraid of the private marketplace. We will go there to access capital if it comes down to improving the care of your daughter.

  Yes, America has a lot to do to transform its system to a value-based one rather than one based on volume. Individual consumer and employer mandates are a huge advantage for us.

  Canadians get good value, but maybe too little is spent. In the United States, when it comes to cancer, if you have prostate cancer or breast cancer the outcomes are better. And if you have cancer you are more likely to have earlier screening and survival if you are in the United States. If you have diabetes diagnosed, you are twice as likely to have begun treatment within six months of having the diagnosis.

  Wait times matter. If you need the most modern technology to make a more thorough and a more rapid diagnosis, you would rather be in the United States. So don’t get sick. But if you do get sick — and if you get really sick — come and see us in America.

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  SUMMARY: At evening’s start, the pre-debate vote was 23 percent in favour of the resolution and 70 percent against, and 7 percent were undecided. The final vote showed a shift and a disappearance of the undecided voters, with 23 percent in favour of the resolution and 77 percent against.

  ABOUT THE DEBATERS

  DR. ROBERT BELL is President and CEO of University Health Network (UHN). He is an internationally recognized orthopaedic surgeon, health care executive, clinician-scientist, and educator. Dr. Bell was Vice President, Chief Operating Officer of Princess Margaret Hospital and was a Chair of the Clinical Council for Cancer Care Ontario (CCO), as well as a Regional Vice President (Toronto) for CCO from 2003 to 2005. He earned a Doctor of Medicine from McGill University and a Masters of Science from the University of Toronto, and he completed a Fellowship in Orthopaedic Oncology at Massachusetts General Hospital and Harvard University. Dr. Bell is a Fellow of the Royal College of Physicians and Surgeons of Canada, the American College of Surgeons, and the Royal College of Surgeons of Edinburgh.

  JOHN BOLTON is a diplomat and lawyer. From June 2001 to May 2005, he served as Under Secretary of State for Arms Control and International Security. In this role, a key area of his responsibility was the prevention of proliferation of Weapons of Mass Destruction. From 2005 to 2006, he served as the United States Permanent Representative to the UN. He has also held positions as Assistant Secretary for International Organization Affairs at the Department of State; Assistant Attorney General, Department of Justice; Assistant Administrator for Program and Policy Coordination, U.S. Agency for International Development; GeneralCounsel, U.S. Agency for International Development; and he currently serves as a Senior Fellow at the American Enterprise Institute for Public Policy Research.

  PAUL COLLIER is the author of the award-winning book The Bottom Billion: Why the Poorest Countries Are Failing and What Can Be Done About It. He is a Professor of Economics at the University of Oxford, Director for the Centre for the Study of African Economics at the University of Oxford, and a Professorial Fellow at St. Anthony’s College. He has also served as Senior Adviser to Tony Blair’s Commission for Africa, and was Director of the Development Research Group at the World Bank from 1998 to 2003. His most recent book, The Plundered Planet: Why We Must, and How We Can, Manage Nature for Global Prosperity, was published in 2010.

  DR. HOWARD DEAN is a former Democratic National Committee Chairman, presidential candidate, six-term governor, and physician. He graduated from Yale University with a B.A. in political science, and received his medical degree from the Albert Einstein College of Medicine in New York City in 1978. After completing his residency at the Medical Center Hospital of Vermont, he went on to practise internal medicine in Shelburne, Vermont. Dean began his career in public service in 1982, when he transitioned from a full-time practising physician to an elected representative in Vermont. He served as Governor of Vermont for twelve years — the second longest serving in the state. Dr. Howard Dean is a CNBC contributor and is the founder of Democracy for America.

  HERNANDO DE SOTO is an economist and the international best-selling author of The Mystery of Capital: Why Capitalism Triumphs in the West and Fails Everywhere Else. He is President of the Institute for Liberty and Democracy (ILD), and he has served as an economist for the General Agreement on Tariffs and Trade (GATT), as President of the Executive Committee of the Copper Exporting Countries Organization (CIPEC), as CEO of Universal Engineering Corporation, and as a governor of Peru’s Central Reserve Bank. He was named as one of the five leading Latin American innovators of the twentieth century by TIME magazine.

  GARETH EVANS is President and Chief Executive of the International Crisis Group (ICG). He served as a member of the Australian Parliament for twenty-one years, and he is one of Australia’s longest serving Foreign Ministers. He was co-chair of the International Commission on Intervention and State Sovereignty (ICISS) in 2000–1, which published its report, The Responsibility to Protect, in December 2001. He was a member of the UN Secretary-General’s Advisory Committee on the Prevention of Genocide, and he is currently Co-Chair of the International Advisory Board of the Global Centre for the Responsibility to Protect. He is the award-winning author of several books, including The Responsibility to Protect: Ending Mass Atrocity Crimes Once and For All, and he was made an Officer of the Order of Australia in 2001.

  MIA FARROW is an award-winning actress and advocate. She has appeared in more than forty films, including Hannah and Her Sisters, The Purple Rose of Cairo, Crimes and Misdemeanors, and Husbands and Wives. As an advocate she raises awareness for children’s rights in conflict-affected regions, predominantly in Africa. She is a UNICEF Goodwill Ambassador, and has worked extensively to draw attention to the fight to eradicate polio, which she survived as a child. She has visited Darfur and neighbouring countries six times since 2004, and led the effort to focus public attention on China’s support for the government of Sudan in the lead-up to the 2008 Olympic Games in Beijing. In 2008, she was named one of the most influential people in the world by Time magazine.

  NIALL FERGUSON, considered one of the world’s leading historians, is the author of several internationally acclaimed works, including The Pity of War, The Cash Nexus: Money and Power in the Modern World, and The War of the World: Twentieth-Century Conflict and the Descent of the West. He is the Laurence A. Tisch Professor of History at Harvard University and William Ziegler Professor of Business Administration at Harvard Business School. He is also a Senior Research Fellow at Jesus College, Oxford University, and a Senior Fellow of the Hoover Institution, Stanford University. He is a prolific commentator on contemporary politics and economics, and he is a contributing editor for the Financial Times and a regular contributor to Newsweek. In 2004, TIME magazine named him one of the world’s hundred most influential people.

  DR. WILLIAM FRIST is a renowned heart and lung transplant surgeon, and a former U.S. Senate Majority Leader. He is Professor of Business and Medicine at Vanderbilt University. He was the Founder and Director of the Vanderbilt Transplant Center, and he has performed more than 150 heart and lung transplants and authored more
than 400 newspaper articles. He is the author of seven books on topics such as bioterrorism, transplantation, and leadership. He is Chair of Save the Children’s “Survive to Five Campaign” and Hope Through Healing Hands. Dr. Frist represented Tennessee in the U.S. Senate for twelve years and served on both the Health and Finance committees, which were responsible for writing health legislation. He is considered one of the most influential leaders in American health care.

  DR. DAVID GRATZER is a physician and a senior fellow at the Manhattan Institute. He is the author of four books, including Code Blue: Reviving Canada’s Health Care System, which was awarded the Donner Prize for best Canadian public policy book. His writing has appeared in several publications, including the Wall Street Journal, the Washington Post, the Los Angeles Times, and the Weekly Standard. Dr. Gratzer has recently been cited in the New England Journal of Medicine and Health Affairs, as well as by major media outlets across the United States and Canada. He has delivered keynote addresses at several major industry conferences, including the World Health Congress and the [U.S.] National Consumer Driven Health Care Conference. He also testified before Congress on the Health Care Choice Act, and was the keynote speaker at the Long Island Health Care Summit.

  RICK HILLIER is the former Chief of the Defence Staff for Canadian Forces and a military advocate. He has served throughout Canada, notably commanding the two-brigade commitment to the Red River floodings and the CF commitment to the Quebec Ice Storm. In 1998 General Hillier was appointed as the Canadian Deputy Commanding General of III Armoured Corps, U.S. Army in Fort Hood, Texas. In 2000, he took command of the Multinational Division (Southwest) in Bosnia-Herzegovina. He assumed the duties of Assistant Chief of the Land Staff, and the duties of Chief of the Land Staff. In 2003, General Hillier was selected as the next commander of the NATO-led International Security Assistance Force (ISAF) in Kabul, Afghanistan, leading 6,000 allied soldiers. He retired from the Canadian Forces in July 2008.

  RICHARD HOLBROOKE is a diplomat best known as the chief architect of the 1995 Dayton Peace Agreement that ended the war in Bosnia. He is the U.S. Special Representative for Afghanistan and Pakistan, and he served as the U.S. Ambassador to the UN, where he was also a member of President Bill Clinton’s cabinet. He was the Secretary of State for Europe, the U.S. Ambassador to Germany, and the Assistant Secretary of State for East Asian and Pacific Affairs. He is the recipient of numerous awards, and he has received several Nobel Peace Prize nominations for his work on negotiation. Holbrooke has written numerous articles and two books, including To End a War, which was a New York Times best book. He previously wrote a monthly column for the Washington Post.

  CHARLES KRAUTHAMMER is a Pulitzer Prize–winning author and commentator, and was named by the Financial Times as the most influential commentator in America. He earned degrees at McGill University, Oxford University, and Harvard University, and he served as a resident and chief resident in psychiatry at Massachusetts General Hospital. In 1978, he left the medical practice to direct planning in psychiatric research during the Carter administration. Krauthammer currently writes a syndicated column for the Washington Post, and he is a contributing editor to the Weekly Standard and the New Republic. He is also a weekly panelist on Inside Washington and a contributor to FOX News.

  LORD NIGEL LAWSON, Baron Lawson of Blaby, is a former president of the British Institute of Energy Economics. He is currently Chairman of Oxford Investment Partners and of Central Europe Trust, an advisory and private equity firm. Lawson had a distinguished career as a journalist before entering the Cabinet in the British Parliament in 1981 as Energy Secretary. In 1983, he began a six-year term as Chancellor of the Exchequer, where he was a key proponent of the Thatcher government’s privatization policy. He is the author of several best-selling nonfiction works, including The View from No.11: Memoirs of a Tory Radical and An Appeal to Reason: A Cool Look at Global Warming.

  STEPHEN LEWIS is Chair of the Board of the Stephen Lewis Foundation in Canada and Co-Director of AIDS-Free World in the United States. He was the UN Secretary-General’s Special Envoy for HIV/AIDS in Africa from 2001 until 2006. His previous roles also include Canadian Ambassador to the UN and Deputy Executive Director of UNICEF. He was an elected member of the Ontario Legislative Assembly, and in 1970 he became leader of the Ontario New Democratic Party. He is the best-selling author of Race Against Time, which won the Canadian Booksellers Association’s Libris Award for nonfiction book of the year. He is a Companion of the Order of Canada, Canada’s highest honour for lifetime achievement, and was awarded the Pearson Peace Medal in 2004 by the United Nations Association in Canada.

  BJØRN LOMBORG is Adjunct Professor at the Copenhagen Business School and the best-selling author of The Skeptical Environmentalist and Cool It: The Skeptical Environmentalist’s Guide to Climate Change. TIME magazine named Lomborg one of the world’s 100 most influential people; he was also named one of the 50 people who could save the planet by the Guardian. Lomborg’s commentaries have appeared regularly in prestigious publications such as the New York Times, the Wall Street Journal, the Globe and Mail, the Guardian, the Sunday Telegraph, The Times, The Economist, the Los Angeles Times, and the Boston Globe. He has appeared on television shows such as Politically Incorrect, 60 Minutes, Larry King Live, 20/20, and BBC Newsnight among others.

  ELIZABETH MAY is Leader of the Green Party of Canada, and an environmentalist, author, and lawyer. Before winning the leadership in 2006, she was the Executive Director of the Sierra Club of Canada. She is the author of seven books, including At the Cutting Edge: The Crisis in Canada’s Forests, co-authored with Maude Barlow; Global Warming for Dummies, co-authored with Zoe Caron; and most recently Losing Confidence: Power, Politics and the Crisis in Canadian Democracy. She is the recipient of many awards, including the United Nations Global 500 Award. She was named one of the world’s leading women environmentalists by the United Nations, and was made an Officer of the Order of Canada in 2005.

  GEORGE MONBIOT is the author of several best-selling books, including Heat: How to Stop the Planet Burning; The Age of Consent: A Manifesto for a New World Order, and Captive State: The Corporate Takeover of Britain. He has held visiting fellowships or professorships at the universities of Oxford, Bristol (philosophy), Keele, East London (environmental science). In 1995, Nelson Mandela presented him with a United Nations Global 500 Award for outstanding environmental achievement. He has also won the Lloyds National Screenwriting Prize for his screenplay The Norwegian, a Sony Award for radio production, the Sir Peter Kent Award, and the OneWorld National Press Award. He currently writes a weekly column for the Guardian.

  DAMBISA MOYO was born and raised in Lusaka, Zambia. She holds a Doctorate in Economics from Oxford University and a Masters from Harvard University’s Kennedy School of Government. She also has an MBA in Finance and a Bachelor of Science (Chemistry) from American University in Washington, D.C. She has held positions as a consultant for the World Bank and at Goldman Sachs. Moyo is a Patron for Absolute Return for Kids (ARK), a children’s charity, and serves on the boards of the Lundin Charitable Foundation and Room to Read, a non-profit organization that provides educational opportunities to local communities in the developing world. In 2009, TIME magazine named her as one of the world’s 100 most influential people.

  SAMANTHA POWER is a Pulitzer Prize–winning author, professor, and human rights activist. She was a former foreign policy adviser to Barack Obama, and she is currently the Anna Lindh Professor of Practice of Global Leadership and Public Policy at Harvard’s John F. Kennedy School of Government. Her book, A Problem from Hell: America and the Age of Genocide, was awarded the Pulitzer Prize, the National Book Critics Circle Award, and the Council on Foreign Relations’ Arthur Ross Prize for the best book in U.S. foreign policy. Her New Yorker article on the horrors in Darfur, Sudan, won the 2005 National Magazine Award for best reporting. From 1993 to 1996, she covered the wars in the former Yugoslavia as a reporter for the US News and World Report, the Boston Globe,
and The Economist.

  ABOUT THE MODERATORS

  LYSE DOUCET is an award-winning Canadian journalist. She is a regular presenter and foreign correspondent for BBC World Service Radio and BBC World News TV. Doucet joined the BBC in 1983, and she has reported from West Africa, Pakistan, Afghanistan, Iran, and the Middle East. She has covered world events, including the funeral of Yasser Arafat in 2004; the aftermath of the tsunami from Tamil Nadu, India, in 2004; and the war in Iraq in 2003. She was awarded an honorary doctorate in Civil Law from the University of King’s College, an honorary Doctor of Laws degree from University College at the University of Toronto, and an honorary Doctor of Letters degree from the University of New Brunswick. She recently won gold for Best News Journalist at the Sony Radio Academy Awards.

  RUDYARD GRIFFITHS is a co-host of the Business News Network television show SqueezePlay and a columnist for the National Post. He is the co-director of the Munk Debates and the Salon Speakers Series. He is a co-founder of the Historica-Dominion Institute, Canada’s largest history and civics NGO. In 2006, he was named one of Canada’s “Top 40 under 40” by the Globe and Mail. He is the editor of twelve books on history, politics, and international affairs, and the author of Who We Are: A Citizen’s Manifesto, which was a Globe and Mail Best Book of 2009 and a finalist for the Shaughnessy Cohen Prize for Political Writing. He lives in Toronto.

  BRIAN STEWART is one of Canada’s most respected television reporters. Beginning in 1971, he hosted the current affairs program Hourglass, and soon moved on to reporting on national affairs from Ottawa. A specialist in military and foreign affairs, Stewart reported from overseas for both the CBC and NBC in the 1980s. He received international recognition for his reports on the civil war in Sudan and the Ethiopian famine. Stewart joined the CBC current affairs program The Journal in 1987 and The National in 1992, and most recently hosted CBC News: Our World on CBC Newsworld. He is the recipient of numerous prestigious honours and awards, including a Gemini Award and the Gordon Sinclair Award from the Academy of Canadian Cinema and Television.