Charter challenge issue strike at the heart of the priniciples of medicare

KELLY GRANT HEALTH REPORTER NOVEMBER 14, 2019

Universal health care on trial: What you need to know about a historic Charter challenge in B.C.
For a decade, surgeon Brian Day has been fighting to undo laws barring patients from paying for medical care at private clinics like his. Here’s a primer on how the case came to be, and how its outcome could affect you.

The B.C. law doesn’t explicitly prohibit well-off patients from buying their way to the front of the queue. Rather, it dampens the market for private care by prohibiting physicians from “enrolling” to work in the public and private systems at the same time; by forbidding enrolled doctors from charging patients for publicly covered services; and by barring the sale of private insurance for medically necessary hospital and doctor care. (Private insurance is, of course, widely available for care not covered by Canada’s “universal” system, which does not include prescription drugs, most dental care, home care and other services provided outside hospitals and physicians’ offices.)

For more than two decades, the B.C. government looked the other way while Dr. Day’s Cambie Surgery Centre, which opened in 1996, and other private surgical clinics bucked the law. 

The BC Health Coalition, Canadian Doctors for Medicare and the patients and doctors who intervened with them, described in their written closing arguments how they believe shortages of anesthesiologists, nurses and doctors contributed to waiting lists in the public system. One doctor who testified in the case made $965,826 in 2016-17 working for Cambie and the Specialist Referral Clinic, another plaintiff in the case – about four times as much as what he usually earned in public billings.

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