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Speaking out against two-tiered health care

| February 26, 2013
Photo: Sweeter Lemon/Flickr

Since 1996, Dr. Brian Day has been running the private Cambie Surgical Centre in Vancouver. For the past 17 years, Dr. Day has been illegally charging patients and the province and now he's taking the B.C. government to court.

The Canada Health Act was created to offer everyone free medically necessary care and protect patients from being charged extra billing or user fees (a.k.a. "facility fees" at the Cambie Centre) for this care. But in 2008, the province of B.C. -- after extensive lobbying from medicare allies like our friends at the British Columbia Health Coalition-conducted an audit on the Cambie Centre and found that in just 30 days the clinic made $500,000 from illegal billings (charging patients privately for medically necessary services) and $66,000 in double billing (charging the patient privately and charging tax payers through medicare for the same procedure)!

Dr. Day has confessed to conducting this illegal behaviour and the province sought an injunction to prevent Day from continuing his illegal billing. So now Day is taking the B.C. government to court over Section 7 of the Charter of Rights and Freedom.

Despite the fact that private clinics create longer wait times for Canadians, Dr. Day is arguing that by allowing him to serve the healthy and wealthy -- and continue to rip off Canadian taxpayers by charging tax payers and his patients for the same service -- Canada is infringing on a person's security, right to life and liberty.

This isn't the first time we've seen this argument. In the Chaoulli vs. the Supreme court a very similar argument was used. We expressed our concerns then that two-tiered health care in our country and others has heavily burdened the public system. In New Zealand, where doctors are allowed to work in both public and private sectors, specialists spend less than 49 per cent of their time in public hospitals. Further privatization of Canada's health-care systems leads to longer wait times for everyone and that leaves millions of Canadians needlessly suffering.

Private clinics make a profit because they choose the healthiest patients with minor or acute care needs -- this is often referred to as "cherry-picking"-- because those patients are the most profitable for doctors. More complicated and chronic care patients are often denied services because they require more time and therefore the clinic makes less profit.

Public health care is really a system of public insurance. We pool our financial resources and pay into the health-care system regardless of how much we use it. Then, when we become ill or an accident occurs, we're able to use this resource without an enormous financial burden (for hospital and physician services at least).

Profiteers like Dr. Day claim that a two-tiered health-care system will reduce wait times for everyone and we'll become more like European countries. But the fact remains that two-tiered health care has only lengthened wait times for the majority of people. With trade agreements like the North American Free Trade Agreement in place, once Canada's health-care system is opened to for-profit private interests, American health care corporations can move in. Under NAFTA, Canada must give "national treatment" rights to U.S.-based companies to compete for health-care services. Saying a new system would be based on public-private systems in Sweden, France, Switzerland or other European countries is a complete fallacy. Private is private -- no matter what country is promoting the concept -- and in Canada, increased privatization would leave our public health-care system vulnerable to American interests because of our historic trade relationship with the United States.

While the Americans are moving to Obamacare, large health corporations are desperately trying to protect their financial interests. Dr. Day is working hard to help them and himself. Through his Canadian Constitution Foundation Day has established court cases to challenge medicare in B.C. and Ontario (you're going to have to Google this one -- there doesn't seem to be any unbiased information about it) with his "Freedom's Defense Team." And more cases are happening in courts across the country.

Now is the time for Canadians to speak out against two-tiered health care. Private clinics do not create shorter wait times, instead they create needless suffering for those who need care the most. We must act now to strengthen public health care and stop the Americanization of our systems. Profit for Dr. Day and his buddies is simply not the cure.

Further reading:

http://www.cmaj.ca/content/183/8/E437.full

http://www.lawtimesnews.com/Focus-On/Private-health-insurance-litigation

http://www.thestar.com/news/canada/2012/08/21/bc_doctor_faces_court_for_billing_for_private_healthcare_services.html

http://www.theglobeandmail.com/news/british-columbia/private-clinic-opens-doors-to-auditors/article563149/

http://www.thecourt.ca/2007/09/25/chaoulli-comes-to-ontario/

Photo: Sweeter Lemon/Flickr

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Comments

When advocates of private health care speak of "European style" health care, they really mean U.S. style health care. There are 50 countries in Europe and 50 heath care systems. The variations are considerable. If you ask these advocates of "European style health care" what European countries they have in mind, they will cites examples like France and Switzerland that have a significant private insurance component, giving patients what they call "choice." What they do not tell you is that many of the countries they cite also devote considerable public resources to dealing in advance with determinants of health. Count on it that these same private health care adocates would be strongly opposed to such spending in Canada. So don't be fooled. What private health care advocates have in mind is the catastrophic U.S. system. Period. Full stop. 

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