Fellow politicians are loath to criticize Danny Williams's decision to forgo Canada's medicare system and pay for heart surgery in the U.S., but cardiac experts insist the Newfoundland Premier could easily have received top-notch care in this country instead.

Mr. Williams, thus far a staunch champion of medicare, has reignited debate about the adequacy of Canada's single-payer system and given opponents of health-care reform in the U.S. ammunition to vindicate their claims.

Arvind Koshal, a prominent Alberta cardiac surgeon, said virtually all heart procedures available in the U.S. are provided in Canada and he thinks Mr. Williams is sending the wrong message by travelling across the border for surgery.

“The optics are very poor, especially for people who are proponents of the Canadian health-care system,” said Dr. Koshal, director of development and external affairs at the Mazankowski Alberta Heart Institute in Edmonton. “It also says if you can buy your way out, then you can go to the U.S. and get it done right away.”

Mr. Williams's office is tight-lipped on the Premier's medical trip, refusing to disclose the location of his treatment or what procedures he will undergo this week. They said he is leaving Newfoundland because the treatment was not available in his home province, but refused to say if Mr. Williams could have been treated elsewhere in Canada.

Wilbert Keon, a heart surgery pioneer in Ottawa and a Conservative senator, said there's “no question” Mr. Williams could have been cared for in Canadian facilities.

“He's going to have to admit that when he recovers and has to face you guys,” he said.

Mr. Williams could get emergency surgery “tonight or tomorrow” in Canada and urgent procedures performed “in a couple of days,” Dr. Keon said. Elective procedures – medically-required but not an emergency – could take weeks.

But the Ottawa doctor doesn't begrudge the Newfoundland Premier for heading south for health care. “If he can afford to pay for that, who can deny somebody the right to drive a Mercedes as opposed to a Honda?”

Dr. Keon said he thinks one reason Canadians might favour U.S. hospitals is their more luxurious facilities.

“If for example he came to the Ottawa Heart Institute he would be in a little private room where there's just a chair for his wife to sit on and his family [would] have to stand around the end of the bed. He goes to one of the American luxury institutions and he gets a suite for his wife and family and so forth.”

Mr. Williams's trip became fodder for opponents of President Barack Obama's proposed reform of the U.S. health care system, which is aimed at extending coverage to most of the country's 47 million uninsured. Although the latest version of Mr. Obama's plan does not include a state-run health plan for Americans under 65, the U.S. right has warned further government involvement in the American system would lead to “Canadian-style” rationing and wait times.

The Newfoundland Premier's move sheds “light once again on the shortcomings of his nation's single-payer system,” charged Americans for Prosperity (AFP), a libertarian advocacy group founded by billionaire oilman David Koch.

Brian Day, a past president of the Canadian Medical Association, said he doesn't begrudge Mr. Williams for paying for care, but wants more private-sector incentives in Canada's health-care system to eradicate waitlists. “It was urgent enough for [Mr. Williams] to be worried about it and if you're worried about [health] you should have the right to do something about it.”

Canada's political class, from St. John's to Victoria, had only sympathy for Mr. Williams as he faces serious surgery.

“I don't think we should read more into this than the fact that Danny Williams, unfortunately, is going to have to have a significant operation,” B.C. premier Gordon Campbell told reporters.

One exception was former Prime Minister's Office director of communications Kory Teneycke who attacked Mr. Williams as a hypocrite for accepting U.S. medical care after his 2008 campaign against Mr. Harper where he warned the federal leader was a threat to medicare. “It's a clear case of hypocrisy,” Mr. Teneycke said. He no longer works for the government and said Ottawa clearly wants to take the “high road” in this instance. “That doesn't prevent others from pointing out the hypocrisy.”

With reports from Konrad Yakabuski, Karen Howlett, Rod Mickleburgh and Dawn Walton