You need look no farther than what's happening with out-of-country health care to find out why our one-size-fits-all system doesn't work.

If you don't get treatment in this province, don't expect OHIP to pay.

According to Toronto lawyer Perry Brodkin, who represents many patients in battles with OHIP, the Health Insurance Act regulations around out-of-country care were quietly changed last year.

Before that, any doctor could sign a request for out-of-province surgery. Now it has to be a specialist. And if any doctor in this province claims to be able to perform the surgery the patient needs to go out of province for -- well, they're out of luck. The request is denied -- even if that doctor has never performed the surgery before.

"The warning is medicare means medical care in Ontario. It does not mean medical care outside Canada, except in very, very, very -- add a hundred verys -- limited circumstances," Brodkin said.

Since OHIP makes up the rules, it's almost impossible to fight them -- because the rules are a moving target.

"The law is skewed in favour of OHIP because OHIP controls the law and changes the law when appeals are granted by the board that they don't like," he said.

Look, at one time, there was plenty of room to tighten up the OHIP rules around out-of-province care.

In 2004, the province spent about $8.1 million to send 225 chronically and morbidly obese people out of province for stomach stapling (bariatric surgery.

That was an outrageous waste of tax money.

The government has since increased those surgeries in this province and stopped sending patients to the US.

The problem is the unusual cases, such as Whitby tot Liam Reid and Brantford teen Erika Crawford.
They suffer from rare diseases and need highly specialized surgery.

Liam needs eye surgery in Detroit to stop him from going blind.

The Hospital for Sick Children in Toronto insists they can do the surgery.

Liam already has had an unsuccessful surgery at HSC and his parents refuse to take him back. A doctor across the border in the US has a better track record, they believe, and they've been paying $5,000 per treatment to take him there.

In Erika's case, the province insists her complex neurological surgery can be done in this province. Her family disagrees and knows of no doctor who's done such surgery here. Again, they're not taking the risk, so they headed to Maryland last week.

Any sensible person can see the difference between someone suffering from a rare disease who needs treatment from a doctor who sees a number of people with similar conditions and the person who's simply a medical tourist looking for Cadillac treatment at socialized medicine prices.

If the government that blew $1 billion on eHealth, countless millions on Ornge and hundreds of millions to move two power plants had instead spent that money wisely, we'd have no problem paying for the surgery for folk like Liam and Erika.

We've lulled ourselves into believing our health system can be all things to all people, so we fund sex-change operations but have no cash for life-saving surgery for people with rare conditions.

We're kidding ourselves if we think we don't have two-tier health. Rich people take their credit cards and head south.

Meanwhile, Liam and Erika's families are left relying on charity -- on the kindness of strangers -- who raise money with raffles and bake sales so they can get the care they need.

That's no way to run a health system.

And it's no way to run a government.