‘MONOPOLY’ MUST END, DOCTOR SAYS
Closing arguments resumed Monday in a years-long B.C. Supreme Court battle over whether medical patients, when faced with long wait times, have the constitutional right to seek out medically necessary services by paying out of pocket or through private insurance.
Those opposed to a two-tier or parallel public-private system worry that such a system favours patients who can afford to pay as opposed to those who most need services. Last year, the B.C. government said it would begin enforcing provisions of the province’s Medicare Protection Act that prohibit private billing for medically necessary care. But plaintiffs in the current case succeeded in getting an injunction on enforcement until the constitutional case was heard.
Lead plaintiff Dr. Brian Day, who has operated his private clinic, Cambie Surgery Centre, for more than 20 years, argues that the current prohibitions violate patients’ rights to life, liberty and security. He spoke to the Post during a recess in proceedings.
Q How are you feeling as we enter the final stages of the trial?
A Just relief that it’s almost over and that we are in the hands of what I hope will be an objective process in evaluating the evidence, because the evidence is overwhelming that patients are suffering and dying on wait lists and the government is complicit in that process.
Q What exactly are you seeking?
A We’re seeking the right for Canadians — because it will go to the Supreme Court of Canada — to have an alternative when the government has promised health care, failed to deliver it and then you are stuck on a government-controlled wait list. Canada is the only jurisdiction on Earth where it’s unlawful to obtain private health insurance to cover hospital and physician services. You can buy that insurance for your pets but not for yourself.
Q How have you been able to run a private clinic this whole time?
A We’re running it in violation of British Columbia laws. We have been since 1996 — with the support of the government. But after a long period of time the government has decided to stop that safety valve that British Columbians and others — we treat a lot of non-residents — have had for over 20 years. The local British Columbia laws that make it unlawful to use private health care when you are in need — those laws are unconstitutional, that’s our argument.
Q Why not put all your effort into bolstering the public system?
A The way to bolster the public system is to eliminate its monopoly on the funding of hospital and physician services. That’s why countries like Holland, Denmark, Belgium, Germany, France and New Zealand have public systems that outperform ours — because they don’t have a monopoly. Like in every other aspect of society, monopolies are very poor for the end consumer. That’s what the world has shown us. Most of the patients we treated when we opened our clinic were covered by B.C.’S workers’ compensation agency (Worksafebc) or the RCMP and these were arbitrarily exempted. One of the witnesses in our case was a fellow who had the same injury on both knees — on one knee it was covered by Worksafebc and he got it treated quickly and the other knee he was facing a wait of 18 months.
Q What’s the typical profile of the person who seeks out your services?
A
The most common single demographic of a patient coming through our surgery centre is a unionized worker covered by workers’ compensation. They are exempt. Also, if you cross the border from Alberta you are exempt. And the other group that is of course never considered: do you think a high-profile professional athlete from the Canucks is going on a wait list? Absolutely not. It’d be ludicrous. There’s a blind eye to that. Perhaps the most outrageous examples are the fact that governments use our facilities. Major hypocrisy.
Q What do you say to critics who say a dual system ends up benefiting those who can afford to pay as opposed to those who need the care most?
A The experience in other developed countries that have a parallel system is the lower-income groups wait much less than they do in Canada and I believe that’s the result of the competition that the monopoly is exposed to in those systems. The point is: a government cannot promise health care in a timely manner, fail to deliver it and then force options out of your control. This is government control of the bodily health of its citizens. That’s unacceptable in a free country.