BC Court Case: Health care based on need not on greed
Dr. Brian Day, owner and CEO of Cambie Surgeries Corporation and past president of the Canadian Medical Association has put Canadian Medicare on trial. And this week, after a long and much delayed court process, Brian Day takes the stand to make his case.
We expect that Brian Day will repeat what he has been saying over the past number of years – that by removing the prohibitions on double billing and private insurance, we will have shorter wait times for medical services. However, Brian Day has no evidence to support this claim. In fact, he has been found to have made many misleading claims about wait times and also to have attempted to cover up his illegal billing practises.
A BC provincial audit found evidence of double-billing (that is charging the public system and patients at the same time for the same service). Having broken the law by double billing, Day is seeking to overturn the laws he broke. He wants the freedom to double bill, and he wants the ban on private insurance lifted so that a private system with multiple payers can exist alongside, and subsidized by, the public system.
Brian Day has no direct evidence that adding a private tier of care will shorten medical wait times. It is interesting to note that in all European health care systems with both a public and a private tier, the private tier is heavily regulated. He often turns to Europe for examples. But, there are no comparable examples. In Germany, for example, once you opt out of the public system, there is no returning. You are either in it or out of it. As a result, 90 per cent of care is delivered by the public system. In no European system where there are two-tiers can you bill both public and private insurance for procedures. You can’t have it both ways the way Brian Day wants it.
Evidence from around the world demonstrates that adding a private tier based on the ability to pay only serves to increase wait times for medical procedures. In two-tier systems, the private tier pulls resources from the public sphere in favour of the more lucrative user fee driven system. There is a built-in incentive for doctors move those with money or straightforward cases onto the private list, those without means or more complex health situations language on the public list. Now a doctor has two lists to manage with an economic incentive to attend to the private list faster.
The public discourse over this case to date has demonstrated one thing quite clearly. Brian Day is ideologically opposed to public health care, he believes the wealthy should be able to buy “better” health care and he wants to usher in a multi-billion dollar private health care industry. Of course, it is no accident that he stands to make a lot of money himself.
While health care is on trial, Canadians have reasserted their support for public health care. Nine out of ten Canadians want government to protect our health care system and both the government of BC and the Government of Canada will defend our system in this case. Our interests are also being represented by both the BC Health Coalition and Canadian Doctors for Medicare as intervenors. We will watch this case with our continuing commitment to a health care system that is based on need not on greed.