B.C. judge rules against private-care in test of universal system

Ruling against private care

UPDATE 3:15 p.m.

B.C. Supreme Court has upheld restrictions on public and private practice by doctors and private health insurance, handing a win to the B.C. government.

Vancouver orthopaedic surgeon Brian Day and his Cambie Surgery Centre championed the constitutional challenge against B.C.’s Medicare Protection Act, leading to the Sept. 10 decision after years of court cases.

What Justice John Steeves ruled, however, further validates Canada’s universal public health care system.

B.C. Minister of Health Adrian Dix described that system as “a cornerstone of our identity in B.C., a cornerstone of our identity in all of Canada.”

Day and other plaintiffs asserted the Medicare Protection Act violated their Charter of Rights and Freedom rights regarding equality and life, liberty and security of the person.

The plaintiffs said it’s unconstitutional to prevent patients from accessing private medically necessary healthcare, including private surgeries, when unable to access timely care in the public system.

Steeves said the section targeted in the complaint exists “to preserve and ensure the sustainability of a universal public healthcare system that ensures access to necessary medical care is based on need and not on an individual’s ability to pay.”

He said in his 880-page ruling that the act serves to suppress and discourage “the emergence of a parallel duplicative private healthcare system for the financing and provision of necessary medical services to MSP beneficiaries.”

Steeves said MPA provisions prevent duplication of health care in B.C. through the emergence of a private healthcare system by restricting prices physicians can charge patients and the scope of private funding for healthcare.

The judge said the MPA prohibits some physicians and healthcare facilities providing necessary services covered by the public plan from charging user fees and billing MSP beyond the MSP schedule. The act prohibits the sale of private health insurance to MSP beneficiaries for medically necessary services covered by the public plan, he said.

“This is a very good day for public health care and for people in B.C. who want access to care, Dix said. 

“We're obviously extremely pleased with Mr. Justice Steeves' decision today. Our defence in the case was successful in its entirety,” Dix said.

Steeves did, though, conclude that situations B.C. patients facing waiting times affecting their health violates their right to security of the person.

Dix said private surgeries have played a role in reducing wait times, a situation the provincial government continues to work on.

“We've talked about some of the methods that we're putting in place in our surgical plan and we're detailing them monthly in our surgical plan, but they include extending the hours of operating rooms by an hour every day, which will add, as you can imagine, a significant amount of capacity to the system,” Dix said.

That includes new operating rooms and re-opening old ones, he said.


A British Columbia Supreme Court judge has ruled against a surgeon advocating for the right of patients to access private care in violation of a provincial law banning extra billing and private insurance.

Justice John Steeves says in a written ruling after a four-year trial that Dr. Brian Day and other plaintiffs have failed to show patients' constitutional rights are being infringed by the Medicare Protection Act, which focuses on medically necessary care, not ability to pay.

Day, CEO of Cambie Surgeries Corp., had argued patients have a constitutional right to pay for private care when wait times in the public system are too long.

Opponents have said a two-tier system would favour patients who are wealthy enough to pay for "queue-jumping" private insurance as well as doctors who could bill both the public and private systems.

Lawyers for both the B.C. and federal governments have argued such a system would erode Canada's universal health-care system and negatively impact patients with complex chronic conditions and the elderly.

More to come..

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