VANCOUVER – Profit for physicians performing surgery in private clinics at the heart of a trial that threatens to undermine Canada’s universal healthcare system and its principles of fairness and equity for all, only bank accounts of some patients allow them or not to skip the public queue, says a federal lawyer.
BJ Wray, representing the Attorney General of Canada, told the British Columbia Supreme Court that an orthopedic surgeon’s legal challenge to overturn the provisions of the province’s Medicare Protection Act is based on the increase in costs. income, because doctors registered in the public system are not allowed to bill patients as well. for medically necessary services in private clinics.
She said doctors don’t have to enroll in the medical services plan if they want to work in the private system, but it’s not in their best interests.
“We say that the only conclusion that can be drawn is that the complaining companies want the challenged provisions to disappear so that they can implement their preferred business model and increase their bottom line,” Wray said on Monday.
Dr Brian Day opened the Cambie Surgery Center in 1996 and sued the British Columbia government in 2009 over sections of the Medicare Protection Act, arguing that patients have a constitutional right to pay for them. services if waiting times in the public system are too long. long.
Wray disagreed, saying that an argument based on sections 7 and 15 of the Charter of Rights and Freedoms did not apply in the case fought for the benefit of the rich at the expense of the vast majority of Canadians.
“Complainant companies want to make money steadily in the public system and then make more money in the privately funded system,” she told Justice John Steeves.
The main issue in the case is not the wait times, but whether the provisions of the provincial law caused harm to any of the four patient complainants, Wray said.
“The legal issue in this case does not require your Lordship to conduct a forensic examination of wait times, or to consider whether the wait is reasonable or not or to consider what should be the benchmark for a specific surgery These are matters the government may wish to investigate through a public inquiry or some other form, ”she said.
“Overall, Canada’s position is that if complainants are successful, BC’s healthcare system will be drastically altered in favor of the privileged few and the lucky few who can afford private care or who can qualify for private care. private insurance, ”she said.
“It is no exaggeration to say that this case concerns the future of medicare in Canada.
Medicare Protection Act bans involving overcharging have not been enforced in British Columbia since the law was introduced in 2003, but Health Minister Adrian Dix said in April 2018 that doctors would face initial fines. $ 10,000 if they billed for services available in the public system.
However, the policy did not go into effect in October 2018 as expected, as Day was successful in obtaining an injunction from another judge who ordered the government to stay the case until the case was concluded. which should be taken to the Supreme Court of Canada, regardless of the outcome.
In addition to the federal and British Columbia governments, intervenors in this case include the British Columbia Anesthesiologists’ Society and Canadian Doctors for Medicare.
Dr Roland Orfaly, chief of the society of anesthesiologists, told the trial that 308 patients died between 2015 and 2016 in the Fraser Health Authority alone while awaiting surgery.
Orfaly said he did not know the causes of death in the region, which is one of six health authorities in British Columbia.
“Whether the public or the courts support private care or not, the public system is still required by law to provide reasonable access to surgical care,” Orfaly said in an interview.
He said surgeries are sometimes canceled due to the shortage of anesthesiologists in British Columbia, a problem the government recognized 15 years ago but has not addressed, unlike other provinces, such as the ‘Alberta and Ontario, which recruited specialists even in rural communities.
This report by The Canadian Press was first published on November 25, 2019.