Friday, August 29, 2014

Court case has critical implications for public health care


AUGUST 29, 2014 12:00 AM

A B.C. court case challenging the very foundations of public health care could undermine the comprehensiveness and fairness of Canadian medicare and erode the competitive advantage it provides to B.C. businesses.

Dr. Brian Day, owner of two for profit clinics in Vancouver, was scheduled to start the next phase of his controversial case on Sept. 8 in B.C. Supreme Court, but was recently granted a sixmonth delay until next March.

The case has been called the most significant constitutional challenge in Canadian history, as it seeks to introduce twotier health care into this country. It's likely to go as far as the Supreme Court of Canada, but what happens in B.C. will be crucial.

Canada's system of public health care anchored by singlepayer, universal health insurance ensures that access to care is comprehensive and based on need, rather than ability to pay. Because we all share the risks and the costs, it's both efficient and fair. Everybody is covered. Everybody benefits. But Day has spent years testing the rules that protect universal health coverage. A 2012 B.C. government audit revealed that Day's clinics have been unlawfully extrabilling patients for medical services covered by the provincial Medical Services Plan. In this legal case, Day is challenging the laws that prohibit doctors from charging patients extra for services already covered under provincial insurance plans. He's also taking aim at B.C.'s ban on duplicate private health insurance, claiming that these rules violate the Canadian Charter of Rights and Freedoms.

If Day has his way, those who can afford to pay privately will jump the queue, and private health insurers will expand into a lucrative new Canadian market. Health care advocates are concerned that this would lengthen wait times and wait lists as private clinics compete to attract surgeons and other health professionals from the public system. Private clinics ensure their profits by performing only a limited range of highvolume, lowcost procedures on healthy patients. There's also the potential of higher costs for B.C. businesses.

As it stands, our current system of singlepayer health insurance provides these businesses a competitive advantage when compared to U.S.based firms who are required to provide expensive (and often less comprehensive) private health insurance for their employees.

That's an advantage worth protecting. That's not to say that our current public health care system is perfect. There's lots of room for improvement, especially in areas like seniors' care and prescription drug coverage.

But Canada's universal public health care system is widely supported by the public and for good reason.

This ongoing legal case being prosecuted against public health care is a stark reminder that no one should take it for granted.