Profit for doctors providing surgery in private clinics is at the heart of a trial that threatens to undermine Canada’s universal health-care system and its principles of equity and fairness for everyone, a federal lawyer says.
B.J. Wray, representing the attorney general of Canada, told the B.C. Supreme Court that a legal challenge by Dr. Brian Day aiming to strike down provisions of the province’s Medicare Protection Act is based on increasing income because doctors enrolled in the public system are prohibited from charging patients for medically necessary services in private clinics.
“The corporate plaintiffs want to make steady money in the public system and then make more money in the privately funded system,” she told Justice John Steeves.
Wray says doctors don’t have to enrol in the Medical Services Plan if they wish to work in the private system, but that is not in their best interest.
“The corporate plaintiffs want the impugned provisions gone, so they can implement their preferred business model and increase their bottom line,” she said Monday.
Challenge says public wait times are too long
Dr. Brian Day opened the Cambie Surgery Centre in 1996 and filed a court action against the British Columbia government in 2009 over sections of the Medicare Protection Act, arguing that patients have a constitutional right to pay for services if wait times in the public system are too long.
Wray disagreed, saying an argument based on Sections 7 and 15 of the Charter of Rights and Freedoms does not apply in the case being fought for the benefit of the wealthy at the expense of the vast majority of Canadians.
The main issue in the case is not wait times but whether provisions in the provincial act have caused any of the four patient plaintiffs any harm, Wray said.
“Overall, Canada’s position is that if the plaintiffs are successful the health-care system in British Columbia will be radically altered in favour of the privileged few and the lucky who can afford private care or who can qualify for private insurance,” she said.
“It is not an exaggeration to say that this case is about the future of medicare in Canada.”
Prohibitions to private billing put on hold
Health Minister Adrian Dix said in April 2018 that doctors would face initial fines of $10,000 if they charge for services that are available in the public system.
However, the policy did not go into effect in October 2018 as planned, because Day successfully sought an injunction from another judge who ordered the government to put the matter on hold until the end of the case.
It is expected to proceed to the Supreme Court of Canada no matter what the outcome.
The federal and British Columbia governments are interveners in the case as are the British Columbia Anesthesiologists’ Society and Canadian Doctors for Medicare.
With files from CBC News