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Critics say BC ruling on private medical care highlights system flaws

Court rules in favor of BC law that prohibits extra billing and limits private health insurance

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The decision by BC’s highest court to uphold the ban on private health care has been hailed as a ‘big win’ by the province’s health minister, but critics say the government has failed not offered any solutions to address the long wait times that the court says are causing people to suffer.

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“It’s a good day,” Health Minister Adrian Dix said Friday at a news conference at his constituency office in Vancouver. “We won at trial. We won in the Court of Appeal, three nothings.

The three judges of the British Columbia Court of Appeal were unanimous that BC’s ban on extra billing for doctors and limits on private health insurance do not violate the Constitution, but recognize that people are suffering and dying from waiting too long for necessary medical care.

The case was brought by Dr Brian Day of the Cambie Surgery Center and argued that regulated private surgical services and private health insurance could reduce pressure on the public system and provide a “safety valve” for patients facing to long waiting times.

Dr. Melanie Bechard of Canadian Doctors for Medicare, an intervenor in the case, said the ruling reaffirms the B.C. Supreme Court’s decision “which essentially determined that privately funded health care is more likely to be harmful than helpful for the vast majority of us. ”

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Bechard, who works as a pediatric emergency physician at the Children’s Hospital of Eastern Ontario in Ottawa, said no one can deny that Canadians face “terrible” wait times in wards. emergency across the country.

“The problem, however, is that privately funded health care won’t solve the wait times problem,” she said. Bechard pointed out studies which found that parallel private medical care systems in Australia and the United States have not reduced waiting times and, in some cases, lengthened them for the majority of people who cannot pay to avoid waiting line.

Adrienne Yeung, co-chair of the BC Health Coalition, another stakeholder in the case, said she was concerned that Day was “presenting this as a waiting list issue.”

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“It’s not about waiting lists and waiting times. It’s about profit and the ability for surgeons to double bill private insurance companies and the public system at the same time,” Yeung said.

A two-tier system would increase wait times, she said, because it would incentivize surgeons to work in the private system, creating longer waits for those who cannot afford to pay, especially marginalized people, people with disabilities, older people and people of color.

Bechard and Yeung advocate a centralized surgical list that creates a triage system and allows the first available surgeon to perform the surgery instead of being put on the waiting list for the surgeon referred by their doctor.

Dix said the province and health authorities will continue to focus on hiring more healthcare workers and offering evening and weekend surgeries to reduce the backlog created when elective surgeries were canceled during the pandemic.

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“I think the test for us shouldn’t be in the courts, but in our ability to provide surgeries and diagnostic tests to people and that’s precisely what we do,” he said.

Dix acknowledged that the province’s public health care system faces challenges, but said the work to address them is “exceptional.”

Dr. Michael Curry, associate clinical professor in the University of British Columbia’s department of emergency medicine, said it would be a mistake to call the court’s decision a victory for the government.

“Unfortunately, this highlights the government’s responsibility,” said Curry, an emergency physician in Metro Vancouver. “If they more or less impose a monopoly on health care, then there is an additional responsibility on the government from an ethical point of view that they have to provide a certain level of care, which is increasingly becoming more difficult in British Columbia.

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Critical understaffing issues have led to temporary emergency room closures in small communities such as Clearwater and Chetwynd. More than a million British Columbians do not have a family doctor and the emergency primary care clinics set up by the government to provide primary care to those without a doctor are chronically understaffed .

BC Environmentalist Leader Sonia Furstenau said the decision protects the goal of BC’s Medical Protection Act to ensure medical services are universal and equitable.

However, the decision also laid bare gaps in the system, she said, that require specific action from Dix ​​to “address these crises and those actions must be focused on delivering health care.” first-line healthcare.

During the Council of the Federation conference earlier this week, where the country’s 13 prime ministers met in Victoria to discuss health care, inflation and post-pandemic recovery, the Prime Minister John Horgan painted a dire picture of a health care system “collapsing beneath our feet”. as he pleaded with Ottawa to increase its share of health care spending.

Furstenau said the political posture ignores the fact that provinces and territories are responsible for delivering health care.

“And so, for all these prime ministers to stand up and say ‘Our health care is in shambles, give us more money but we’re not going to tell you how we’re going to spend it’, that’s a miss. of responsibility.”

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