Seniors across Canada may be breathing a collective sigh of relief now that three BC Court of Appeals judges have rejected Cambie Surgeries Corp.’s appeal of Judge John Steeves’ 2020 BC Supreme Court decision that upheld the province’s health care law.
In their appeal from Steeves, Cambie Surgeries argued that the judge was wrong to dismiss their case and argued that the ban on private surgeries in Canada is contrary to rights guaranteed in the Canadian Charter of Rights and Freedoms, which in Sec. 7 guarantees “the right to life, liberty and security of the person”.
The stated goal of Cambie Surgeries Corp. and its founder, Dr. Brian Day, is to be able to offer paid private medical services (mainly hip and knee surgeries) legally to Canadians so that people can avoid suffering and putting their lives at risk. by having to wait too long in line to receive these medically necessary services in the public system.
The judges on the Court of Appeals reviewed the previous court’s ruling for legal errors and agreed with Justice Steeves’ decisions on all but one point. They wrote that Steeves was wrong in his analysis of Sec. 7 and that the long waiting lists for necessary surgeries in BC could lead to the death of some people. They said: “There is no question that many patients in most surgical categories are waiting beyond the prescribed benchmark for care.” They found, however, that the breach of Sec. 7 was justifiable given the egalitarian goals of the Canadian health care system set out in Sec. 1 of the Charter.
The majority of people on waiting lists for knee and hip surgeries in BC are seniors living on modest incomes who do not have the means to travel to other countries for orthopedic surgery. Therefore, we would argue that, for the greater good, older people must sometimes bear a heavy and unequal burden of the cost of maintaining the current health care system.
Even if seniors were given the option of private surgical care in Canada, few seniors are likely to be able to afford the cost. We don’t know what the Cambie corporation currently charges, but a knee replacement operation costs about $25,000 or more in California for non-US residents (according to a US orthopedic surgeon). In Canada, the cost to the public system, not including rehabilitation, in 2019-20 is estimated to average $10,500. Regardless of what the Cambie clinic charges, the cost is likely to be prohibitive for many older Canadians, given that the median annual income of adults aged 65 and over in 2019 in Canada was $29,940, according to Statistics Canada.
Many older people today will remember with fear the situation of 60 years ago when Canada did not have a universal health care system and access to care was based on private insurance or the ability to pay out of pocket. People suffered and died because they couldn’t afford the medical treatment they needed.
It is worth noting that while Judge Lauri Ann Fenlon agreed with Judge Robert Bauman that the appeal should be dismissed, she added: “The conclusion we are forced to reach is far from satisfactory.”
Judge Fenlon also expressed concern that those who cannot access timely surgical care in BC are ordinary, non-affluent individuals who can afford to travel to other countries for private surgical care.
The BC Court of Appeals decision has implications for all of Canada, as a victory by the Cambie corporation would have undermined the basic tenets of the Canadian health care system and forced major changes to a system that is based on egalitarian values and designed to be based on in need. and not on the ability to pay. That is a fundamental principle cherished by the Canadian health care system and one that makes Canada’s system very different from that of the US and many other developed countries that have several parallel public and private systems.
Meanwhile, seniors in BC and across Canada are calling on their governments to ensure that timely health care is equally available to all Canadian residents. Older people are willing to work with our governments and all stakeholders to strengthen today’s weakening health care system, to find ways to put the patient first and ensure that those most in need of care are reached. front of the row.
Leslie Gaudette is president and Kathleen Jamieson is chair of the British Columbia Council of Senior Citizens Organizations health committee.