Court rules in favor of BC law that prohibits additional billing and limits private health insurance
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BC’s top court’s decision to uphold the ban on private healthcare was heralded as a “major victory” by the province’s health minister, but critics say the government has failed to find solutions to address long waiting times. hopes that, according to the court, they are causing people to suffer.
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“It’s a good day,” Health Minister Adrian Dix said at a news conference at his constituency office in Vancouver on Friday. “We won at trial. We won in the Court of Appeals, three nothings”.
The three judges of the BC Court of Appeals were unanimous that BC’s ban on additional physician billing and limits on private health insurance do not violate the Constitution, but acknowledged that people are suffering and dying from waiting too long for necessary medical care.
The case was brought by Dr. Brian Day of Cambie Surgery Center and he argued that regulated private surgical services and private health insurance could relieve pressure on the public system and provide a “safety valve” for patients facing long timeouts.
Dr. Melanie Bechard of Canadian Doctors for Medicare, an intervener in the case, said the decision reaffirms the BC Supreme Court’s decision “which essentially found that private health care is more likely to be harmful than helpful to the vast majority of us. ”
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Bechard, who works as a pediatric emergency physician at Children’s Hospital of Eastern Ontario in Ottawa, said no one can deny that Canadians face “terrible” wait times in emergency rooms across the country.
“The problem, however, is that private health care will not really solve the wait time problem,” he said. Bechard noted studies which found that parallel systems of private healthcare in Australia and the United States have not reduced waiting times and, in some cases, made them longer for most people who cannot afford to skip the queue.
Adrienne Yeung, co-chair of the BC Health Coalition, another intervener in the case, said she worries that Day “frames this as a waiting list issue.”
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“This is not about waiting lists and waiting times. It’s about profits and the ability of surgeons to double-bill both private insurance companies and the public system at the same time,” Yeung said.
He said a two-tier system would increase wait times because it would give surgeons incentives to work in the private system, thus creating longer waits for those who can’t pay, particularly marginalized people, people with disabilities, people seniors and people of color.
Bechard and Yeung advocate for a centralized surgical list that creates a triage system and allows surgery to be performed by the first available surgeon rather than being on the waiting list for the surgeon referred by your doctor.
Dix said the province and health authorities will continue to focus on hiring more health care staff and offering surgeries on nights and weekends to reduce the backlog created when non-urgent surgeries were canceled during the pandemic.
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“I think the test for us should not be in the courts, but in our ability to perform surgeries and diagnostic tests for people and that is precisely what we are doing,” he said.
Dix acknowledged that the province’s public health system faces challenges, but said the work to address that is “exceptional.”
Michael Curry, a clinical associate professor in the department of emergency medicine at the University of British Columbia, said it would be a mistake to characterize the court’s ruling as a government victory.
“Unfortunately, it highlights the responsibility of the government,” said Curry, an emergency room physician in Metro Vancouver. “If they are more or less imposing a monopoly on health care, then there is an additional responsibility on the government from an ethical perspective that they have to provide a certain level of care, which is becoming increasingly challenging in British Columbia.” .
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Critical staffing shortage issues have prompted the temporary closure of emergency rooms in small communities like Clearwater and Chetwynd. More than a million British Columbians do not have a family doctor, and emergency primary care clinics set up by the government to provide primary care to the doctorless are chronically understaffed.
BC Green Leader Sonia Furstenau said the ruling protects the goal of the BC Health Protection Act to ensure health services are universal and equitable.
However, the ruling also exposed gaps in the system, he said, that require specific action from Dix to “address those crises and those actions must focus on front-line health care delivery.”
During the Federation Council conference earlier this week, during which the country’s 13 prime ministers met in Victoria to discuss health care, inflation and post-pandemic recovery, Prime Minister John Horgan painted a dire picture. of a health care system “crumbling under our feet. ”While he implored Ottawa to increase its share of health care spending.
Furstenau said the political stance ignored the fact that provinces and territories are in charge of providing health care.
“So for all these prime ministers to stand up and say, ‘Our health care is in shambles, give us more money, but we won’t tell you how we’re going to spend it,’ that is a failure of accountability. .”
