Judge rules against private care
Decision rejects challenge of universal system
VANCOUVER • British Columbia’s health minister says a judge’s decision against a surgeon advocating for patients’ rights to pay for private care highlights the significant role of the public health-care system as a cornerstone of Canada’s identity.
“Our defence in the case was successful in its entirety,” Adrian Dix said Thursday.
Dr. Brian Day, CEO of Cambie Surgeries Corp. in Vancouver, challenged the province’s Medicare Protection Act, which bans extra billing and private insurance for medically necessary procedures.
Justice John Steeves said in a written ruling after a four-year trial that Day and other plaintiffs failed to show patients’ rights are being infringed by the act, adding its focus is on equitable access, not ability to pay.
“Equal or identical care between patients is not part of the purpose of the (Medicare Protection Act) and nor is it achievable,” Steeves said.
Lawyers also failed to provide enough evidence that patients’ constitutional rights are being violated, he said.
However, he noted some patients are waiting for elective surgery beyond established wait-time benchmarks because of a lack of capacity in the public system, which deteriorates their condition and reduces surgical outcomes.
Provinces have made attempts to reduce wait times in specific areas, such as cardiac and other surgical care, with the most significant development in 2003 when all the provinces affirmed Canadians should have timely access to insured health services on the basis of need, he said.
Provincial priority codes on reasonable maximum wait times for a number of procedures were developed in B.C. with input from medical experts and specialists, Steeves said, adding they are intended to guide the triaging process.
Duplicative private health care “would cause further inequitable access to timely care,” Steeves said.
Day argued wait times in the public system are too long and sometimes exceed those established by provinces in 2005.
Opponents have said a two-tier system would favour patients who are wealthy enough to pay for “queue-jumping” private insurance as well as doctors who could bill both the public and private systems.
Lawyers for both the B.C. and federal governments argued such an approach would erode Canada’s universal health-care system and hurt patients with complex chronic conditions and the elderly.
In April 2018, Dix announced that starting in October of that year, doctors who bill patients extra for services covered by the Medical Services Plan could face initial fines of $10,000.
However, Day sought and won an injunction in November 2018, when another judge stopped enforcement of parts of the act until their validity could be determined with the trial decision.
Dix said a decision on whether fines would be levied will be made after a review of the nearly 900-page ruling.