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A Charter challenge is underway at the Supreme Court of B.C., championed by Dr. Brian Day, owner of the Cambie Surgical Centre. Day is arguing that the laws currently prohibiting doctors in Canada from practicing in the public and private health sectors simultaneously should be struck down, along with the prohibition on the extra billing of patients for services already covered by the provincial health plan.
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The plaintiffs' constitutional challenge is straightforward: if the government does not provide timely medical treatment, then it cannot at the same time legally prohibit patients who are suffering on long wait lists from taking control of their own health care and arranging treatment privately.
Since the inception of medicare in Canada, opinion polls in all parts of the country consistently show that a vast majority of Canadians believe in equal access to health care based on need, not ability to pay. Yet this is precisely what is at stake in the Charter challenge against medicare taking place in the B.C. Supreme Court this week.
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Provincial governments remain incapable of providing access to care within a reasonable timeframe, yet continue to maintain their monopoly over the provision of medical care. It's time for policy makers to make the changes required for Canada to have a universal and efficient health-care system.
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B.C. law prohibits residents from accessing private insurance to pay for medically necessary treatment in B.C. These prohibitions, together with the province's rationing of health-care services, has resulted in long waiting lists. Many residents in urgent need are forced to languish, suffering irreparable harm and risking death.
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Extra-billing in Ontario, private MRIs in Saskatchewan and user fees in Quebec: violations of the Canada Health Act are on the rise across the country. Canadian doctors are concerned about the impact of this trend not only on their patients, but on our public health care system as well.
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Canada is the only country to limit the role of private health insurance exclusively to the coverage of services not insured by the public system. Canada is also alone in prohibiting doctors from practicing in both the public and the private sectors. Whereas 99 per cent of hospitals in Canada are public, in all other countries, private institutions have an important role to play in the provision of hospital services. Private, for-profit hospitals make up over one third of all hospitals in Germany (42 per cent), France (39 per cent) and Australia (36 per cent). Beyond any doubt, patients would be the first to benefit from such a pragmatic, evidence-based outcome.
So it looks like the 'magic bullet' solution has been found at last to cure Canada's health care woes: medical tourism. It's a revenue-generating solution for a cash-strapped system, we are told. A handful of other hospitals already engage in this practice. Should we break out the champagne and celebrate? Not so fast.
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Rather than go backwards to a time before medicare, we can focus on the more important business of reforming the health delivery system so that it will improve the quality of life for all Canadians, not just a privileged few.
There is no single reform that is going to make medicare work better. But there is a general approach that would be useful. And that alternative approach recognizes the limitations of centralized planning and the need to allow more private money and leadership into the system.