Charles MacDonald worked at Queen's Park. He still wasn't equipped to deal with Ontario's health care system - Toronto Star

MacDonald is in the midst of a bureaucratic foofaraw with the Ontario health care system. If it persists, it could result in the amputation of one of his feet.

Charles MacDonald’s nickname is “The Hero.” 

Steve Paikin is a contributing columnist at the Star and the host of "The Paikin Podcast."  

Charles MacDonald’s nickname is “The Hero” and it’s not hard to see why. In January 1990, when he was 16, the car he was driving skidded on black ice in eastern Ontario near Prescott, was rammed by another driver, and burst into flames. MacDonald sustained burns to 85 per cent of his body. His family was told he’d be dead in two weeks. Somehow, after dozens of surgeries, he survived, but it’s taken decades of myriad encounters with health care systems to remain alive. Now, at 54, MacDonald is in the midst of a bureaucratic foofaraw with the Ontario health care system which, if it persists, could result in the  amputation of one of his feet. 

Steve Paikin: Charles, I first met you a couple of decades ago when you worked as an executive assistant for a Progressive Conservative MPP, at Queen’s Park. How are you doing?

Charles MacDonald: Well, I’ve had better days. It’s a challenge these days.

We’ll get into why in a second, but first, how exactly did you not die in that car accident in January, 1990?

As fate would have it, my old hockey coach was the volunteer firefighter that responded to the scene, and when I heard his name, he knelt beside me and he stayed with me all the way to Brockville and then Kingston. Eventually, after seeing my story in local newspapers, the Shriners (hospital) in Boston looked us up and said, ‘We think he needs to go here.’

Yes. I left the Kingston hospital “against medical advice“ there. So had to pay for my own air ambulance to get from Kingston to Boston. The Shriners paid for all my treatment there. We flew out in a snowstorm and we couldn’t land. Boston’s Airport was closed except for one runway that was being plowed. We got security clearance and landed on it. It turns out, the Vice-President of the United States was in Boston and had to get out to Washington that night. So if Dan Quayle hadn’t been there that night and they weren’t plowing his runway, I would have gone back to Kingston, and wouldn’t be here today.

Some days, the stars really do have to align for things to work out, eh? 

Seems to be the case. And when I met the Vice-President four years later when he was on a book tour, I told him he saved my life!

What happened at Shriners Hospital?

Everything. Three operations a week, constant medical care and skin grafts. I was 165 pounds of chiseled hockey player when I went in, and the next time they weighed me I was 90.  

What did you see when you looked in the mirror?

I saw that there was one person responsible for my success or my failure. It was going to be me and that’s it.

Your 20 years at Queen’s Park certainly helped you understand how to navigate the health care system, how to get services for constituents, etc., yes?

Absolutely. You have a lot of people that are in need and they don’t know how to navigate a Goliath of a government. So they call their local MPP and I navigate for them.  

So, you know how to do this, and yet even you’re having trouble accessing health care for yourself. What’s going on?

Last December, I noticed that my right ankle was changing and its angle was shifting. And I went to my family doctor and asked for a referral but it didn’t go anywhere. So, I needed a decision from OHIP for “out-of-country” services because I’ve been unable to get the medical care I need here in Ontario.

An ankle reconstruction of my right ankle. We did this in 2009 on the left ankle, but now it’s the right one. And what’s really shocking is that pretty much all the same players, all the same procedures and all the same obstacles are happening again, and it’s 2026.

Why are you unable to get this procedure in Canada right now?

I can’t access a specialist to get it done. Right now, the individual that I was referred to has a wait list of 18-to-22 months. He referred me to colleagues here in the city. But they have seven-to-nine-month wait lists just for a consultation, never mind diagnosis, X-rays, follow up, course of action and, of course, operating room time.

What happens if you can’t get this ankle reconstruction surgery for another two years?

Well the prognosis is grim. I have outstanding medical issues with respect to most of my body being grafted skin. And with tissue damage comes potential infection. And with infection comes the possibility of amputation. The specialist in Toronto formally denied my care on compassionate grounds.  

By “denying care,” he’s in effect opening the door for you to get more immediate care south of the border. Is that right?

But I always thought if you need a procedure done in any province in Canada, and if the healthcare system of that province is unable to do it in a timely fashion, we send you to the States and you get it done faster and the provincial health insurance plan pays for it. Is that not happening here?

You need to have the specialist that can perform the surgery sign the paperwork that the surgery is necessary and cannot be completed in Ontario. My general practitioner signed my application. And while it wasn’t denied, it wasn’t processed because the wrong doctor signed it. I just had to get the right signature on the paperwork. But because of his wait times, he couldn’t see me and did not sign my form. So, I had to go to my local orthopedic surgeon who did my follow up care in 2009. His wait list is 24 months long. But the people in Chicago (where MacDonald hopes to have the surgery) don’t answer telephones or reply to emails. So then I emailed OHIP Out-of-country but they do not communicate with applicants by phone or by email, only on the OHIP Out-of-country Secure Communications Portal. I applied in June for Out-of-country care and I heard back in August about this portal.

Yes, because up until this point, their inquiries and follow-ups were sent to me by mail.

Well, I know the system, I know governments, I know the game. But I feel for the people who used to call me, who don’t know what to do and don’t know where to go. What’s fascinating is that we’re 17 years later (since my first foot surgery), we’ve had two different parties in government, and a lot of announcements about hundreds of millions of dollars of investment in healthcare. And I’m exactly where I was in October 2009 today. Nothing’s changed. It was an 18-month wait list in 2009, and it’s an 18-month wait list to see the specialist in 2026.

Well, the changes have come in the procedures. I’m going from a three-day hospital stay to a day-surgery for an equally complicated surgery on my ankle. So progress exists. But administration is grinding people out. And that’s what’s really sad.

Is OHIP going to pay for you to go to Chicago?

Well, in order to get the diagnosis in the first place, I had to go to Chicago to see a doctor. I paid for that trip. When my ankle was doing something it shouldn’t be doing, I had to self-diagnose because I didn’t have access to a specialist. So I went to my physiotherapist and spent six weeks working on my ankle at my cost, in order to determine this isn’t soft tissue, this is skeletal. I tried to see my specialist at his clinic but he’s got a 24-month wait list. So I went back to my specialist in Chicago. I could see him within two weeks. I booked the appointment online, and it was $800 US. Within four minutes I had a diagnosis, I had a surgical course of action, and I had an identified specialist, who said, I think we can get rid of this brace you’ve been wearing since you were 16.

How much are you out of pocket right now?

Between physio, car rentals, gas, hotel, meals, traveling the province, traveling back and forth to Chicago for appointments, X-rays, meetings and discussions: somewhere around $7,000.

You get nothing unless it’s pre-approved. And I haven’t been approved for anything. And what my story shows is there’s no access, no support and no coverage unless you go get it. You can’t have universal health care if there’s no access to it.

Politicians boast about our having the best health care system anywhere.  

I think it’s the best joke in the province. But it’s not funny. After everything I’ve been through, I’m not even in the queue. No one’s waiting to see me. I have had no contact from any Ontario doctor that I’ve been referred to. Zero. Other than the specialist who saw me 17 years ago who compassionately said he didn’t have time to see me.  

Do you have any sense of how much of that OHIP will pick up?

Not at this time, but there’s a really fancy sign near Lake Ontario that kinda cost half as much.

Well, I think that was the Premier trying to remind people that it was Lake Ontario and not Lake America. But I guess what you’re saying is, the cost of that sign basically could pay for half your surgery. Are you just exhausted with this whole mess?

My friends keep asking, Why aren’t you angry? And I confess I am a little bit. Someone once asked me, “How much would you pay if you had to?” And my response was, “Well, what would you pay to walk?”

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Opinion articles are based on the author’s interpretations and judgments of facts, data and events. More details

Steve Paikin is a contributing columnist at the Star and the former host of TVO’s “The Agenda.”