A much-delayed B.C. court case challenging the ban on private health care slated to begin this fall could have widespread implications and impact all Canadians, according to a new critique.
The Canadian Centre for Policy Alternatives says the Cambie Surgeries Corp. challenge to the provincial Medicare Protection Act is not the first attempt to overhaul the system, “however, it poses the most serious threat to the principles of equality and universality that Canada’s public health care system is built upon.”
The left-leaning think tank said it believes the solution lies in reducing wait times in the public system and enhancing access. It also accuses the government of ignoring the problem and “turning a blind eye to illegal and fraudulent billing activities that ultimately harm patients.”
The clinic is expected to ask the court to eliminate the ban on extra billing and user fees in addition to the province’s ban on private insurance for services covered by public health insurance.
Originally scheduled to begin in 2012, the case was pushed to March 2015 before being delayed again to this fall. Witnesses include patients who went to the Cambie centre because they encountered long waits for surgery at a public hospital.
Doctors are not supposed to accept money from patients for surgeries already covered by government health insurance, but there are a small number of clinics, mostly in B.C., that do. Dr. Brian Day, co-owner of the Cambie clinic, has said Canada’s system is so outdated that the only other country trying to outlaw a private, parallel system is North Korea.
A win for private clinics could undercut governments’ ability and incentive to reduce wait times in the public system, said CCPA research associate Colleen Fuller. It could also affect the ability of existing provincial health care plans to allocate access to services according to need rather than pay, she added.
“Stripped of these regulatory pillars, Canadians can expect to pay more out of pocket for health care whether or not they are privately insured.”
The clinic argues wait times would improve under a hybrid system of public and private care, pointing to the systems in Europe where public and private systems coexist to the benefit of patients with virtually non-existent wait times.
But Fuller suggests her studies show countries with private payment options have increased wait times for those who rely on the public system. However, a true comparison is difficult as about half of OECD countries do not keep track of wait times.
One paper suggests patients whose surgeons operated in both the public system and a private surgery setting have the longest wait times in Manitoba, the CCPA report said.
About 64,000 surgeries, 10 per cent of B.C.’s total, are performed in private clinics across the country each year. Fees range from about $700 to $17,000 depending on the surgery.
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