A self-styled champion of privatized health care is bringing his fight to British Columbia Supreme Court next week for the start of a months-long trial he says is about patients' access to affordable treatment, while his opponents accuse him of trying to gut the core of Canada's medical system.
Dr. Brian Day of Cambie Surgery Centre in Vancouver is challenging B.C.'s ban on the purchase of private insurance for medically necessary services that are already covered by the public system. He argues the restriction violates patients' constitutional rights by forcing them to endure gruelling wait times that often exacerbate their health problems.
"This is about making medicare better," said Day.
A statement from the B.C. Health Ministry, the defendant in the case, said its priority is to uphold the Medicare Protection Act and the benefits it safeguards. It declined further comment while the case is before the courts.
Day launched the lawsuit in 2010. There have been a number of delays, including a one-year postponement while the two sides unsuccessfully tried to reach an out-of-court settlement.
Canada's inefficient system is the product of a wasteful bureaucracy, a lack of competition and a misguided attachment to universal coverage, Day argues.
He said opening the door for private insurance would ease pressure on the public system, freeing up resources to cut wait times and boost the quality of care for everyone, whether publicly or privately insured.
It's widely agreed the lawsuit could have far-reaching ramifications for health care in Canada.
Adam Lynes-Ford of the B.C. Health Coalition, one of the interveners in the case, said making space for private health care flies in the face of the core Canadian value that people should have access to medical care based on need, not on ability to pay.
"This is such a profound threat to the health of everybody in Canada," Lynes-Ford said.
He said a win for Day would lead to a more U.S.-style medical system, meaning longer wait times for the average Canadian and skyrocketing costs as limits are lifted on what doctors can charge patients.
Colleen Flood, a law professor at the University of Ottawa, described Day's lawsuit as one of the biggest constitutional cases "perhaps ever."
"Basically, medicare is being put on trial, and will likely be found wanting in many regards," she said.
"But the question is whether the cure for what ails medicare is more privatization. That's what Dr. Day is arguing," she added. "I don't think so myself and I think the weight of the evidence is against that."