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Careful, Canada: What Ireland has learned about two-tier health care

Steve Thomas – for CBC News Opinion
December 14, 2019

The introduction of private health insurance in Ireland allowed a two-tier system to develop with long waiting lists in the public system and limited financial protection for households, says Steve Thomas. 

It is striking that as Canada seems on the cusp of embracing two-tier health care, Ireland is struggling to limit it.

In 1957, the Irish Republic decided to set up a voluntary health insurer owned by the state to take the pressure off the public system, allowing health care to be bought by those who had the means.

It sounded reasonable, and 60 years later, private health insurance has taken off with almost half the population covered and plans offered by private companies. This allows faster access to public care subsidized by the state, and queue-jumping of the very long waiting lists by those who are better off financially.


Thirteen things you need to know about the people trying to end Canadian health care as we know it.

PressProgress September 7, 2016


Although Day claims his court challenge is all about his constitutional rights, it’s hard to overlook the influence of an audit that found “significant evidence” Day had been “extra billing” patients on a “frequent and recurring basis.”

Day originally filed his lawsuit in 2009. But the BC Medical Services Commission first raised concerns about “extra billing” practices at Day’s company as far back as May 2007. His company was formally notified it would be audited in September 2008. Lo and behold, Day filed a lawsuit several months later.

The audit, completed in 2012, found evidence Day’s clinics extra billed patients for “publicly-insured medical services” to the tune of half-a-million dollars during just one 30-day time span.
Canadian Doctors for Medicare explains “extra billing” is “against federal and provincial law” and can include “extra fees for medical consultations, examinations, diagnostic testing and other manners of ‘upgraded services’.”

Day recently told the National Post that he thinks “a wealthy person” deserves a higher standard of care than everybody else:
“We in Canada will give the same level of services to a wealthy person as to person who isn’t wealthy, and that doesn’t make sense.”


Private health-care is all about doctor profits, federal lawyer tells B.C. court

Camille Bains · The Canadian Press · Posted: Nov 25, 2019
Plaintiffs ‘want to make steady money in the public system and then make more money [in the private system]’

Profit for doctors providing surgery in private clinics is at the heart of a trial that threatens to undermine Canada’s universal health-care system and its principles of equity and fairness for everyone, a federal lawyer says.

B.J. Wray, representing the attorney general of Canada, told the B.C. Supreme Court that a legal challenge by Dr. Brian Day  aiming to strike down provisions of the province’s Medicare Protection Act is based on increasing income because doctors enrolled in the public system are prohibited from charging patients for medically necessary services in private clinics.
“The corporate plaintiffs want to make steady money in the public system and then make more money in the privately funded system,” she told Justice John Steeves.


The secret moves to increase private health care

By Bob Hepburn Star ColumnistWed., Jan. 9, 2019

……..major financial interests in Toronto are quietly supporting a controversial lawsuit by Dr. Brian Day of Vancouver, founder of the private Cambie Surgery Centre, who has brought a constitution challenge to B.C.’s restriction to private health care. The case is now before the B.C. Supreme Court and is expected to land eventually before the Supreme Court of Canada. These interests are reportedly ramping up an $8-million war chest to help fund Day’s court cases. 


China Caring for our Seniors

CASTANET Colin Dacre – May 26, 2018

The Summerland Seniors Village is one of 21 B.C. facilities owned by Retirement Concepts, a company purchased by China’s Anbang Insurance for $1B last year. In February, the Chinese government seized control of the company and jailed its CEO for fraud.

Central Okanagan MP Dan Albas says he’s heard from family members of residents at the Summerland Seniors Village that care has degraded since the takeover.
He said he’s been told of instances where the facility has been staffed so short, a single nurse is supervising 20 residents overnight.


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


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.


Advocates demand end to extra billing, upset over 15.9 million federal claw back


A Welcome Second Chance for BC Medicare Protection

This article points out a few aspects that are not often talked about.

For every dollar of extra billing by a private for profit clinic, the federal government claws back an equal amount from its cash transfers.

In 2015-16, that amount was $15.9 million, enough for 53,000 MRIs. So effectively, we all pay for the extra billing.

B.C. is the only province that Ottawa has repeatedly fined for unlawful extra billing.