09/12/2016 13:58 EDT | Updated 09/13/2017 01:12 EDT

B.C. court hears differing diagnoses on proper prescription to cure medicare ills

VANCOUVER — Advocates on either side of a polarizing debate over the future of universal public health care in Canada are offering opposing diagnoses on how to rejuvenate what many see as an overburdened medical system.

Jonathan Penner, a lawyer for the British Columbia government, told B.C. Supreme Court Monday that a lawsuit proposing to change the rules around how medicare operates risks undermining the principle of equal medical access for all.

"British Columbians, like other Canadians, are rightfully proud of their public health-care system, and in particular the commitment by Parliament and all the provincial legislatures to the principle that medically necessary services should be based on need rather than ability to pay," Penner said in an opening statement.

"The health-care system is highly complex and the repercussions to various components of that system of striking down those prohibitions are uncertain and problematic."

Cambie Surgery Centre, a private surgical clinic in Vancouver, is suing the B.C. government for stopping doctors from providing medically necessary treatments in both the public and private systems, as well as for forbidding private insurance for core medical services.

Last week a lawyer for the surgery centre argued that a public-private system would help B.C. curb skyrocketing health-care costs by releasing the pressure valve off the public system, freeing resources and shortening wait times.

Penner countered with an alternative prediction on how privatization would affect the access of Canadians to health-care services. He said it would "create perverse incentives for physicians and would introduce a private system that would depend on abandonment of present efforts to reduce wait times in the public system."

The plaintiffs, which besides Cambie Surgery Centre include several patients, argue that forcing people onto wait lists for medically necessary procedures violates Canadians' charter rights to life, liberty and security of person.

Penner made repeated references to the Chaoulli case, a lawsuit that was decided at the Supreme Court of Canada in 2005 ruling in favour of the allowance of some private health care in Quebec.

Privatization proponents point to the case as an instance in which the high court ruled in favour of a more hybrid model, but Penner dismissed those assertions, arguing that those circumstances were unique.

For instance, the Chaoulli case was argued based on an article in the Quebec charter of human rights and freedoms, whereas this case is alleged to be a violation of Canada's Charter of Rights and Freedoms, which could apply across the country.

"The evidence before this court will not be the same and will tell a very, very different story," Penner said.

The province's opening statement is expected to run until the end of Tuesday, followed by opening remarks from various interveners. Federal government lawyers will also provide input to the court.

The trial is scheduled to run through to February.

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