Why B.C.'s ban on private health care is bad for patients and doctors

The recent decision by the B.C. Court of Appeal to uphold the ban on private health care clinics in the province is a blow to patients and doctors who are seeking better access and quality of care. The court dismissed the appeal of Dr. Brian Day, who challenged the constitutionality of the Medicare Protection Act, which prohibits extra billing and private insurance for medically necessary services covered by the public system.

Dr. Day, who runs the Cambie Surgery Centre, a private clinic that offers various procedures, argued that the ban violates the Charter rights of patients who suffer from long wait times and harm to their health in the public system. He also claimed that the ban infringes on the freedom of doctors to practice medicine according to their conscience and professional judgment.

The court, however, ruled that the ban is justified as a reasonable limit on Charter rights in order to preserve the principles of universality, accessibility and equity in the public health care system. The court also rejected the evidence that private health care would reduce wait times and improve quality of care in the public system, citing studies from other countries that show mixed or negative effects of parallel private systems.

The court's decision is disappointing and misguided for several reasons. First, it ignores the reality of many patients who are suffering or dying while waiting for treatment in the public system. According to a report by the Fraser Institute, an estimated 1.2 million Canadians were waiting for medically necessary treatment in 2020, with an average wait time of 22.6 weeks. In B.C., the average wait time was 28.9 weeks, the second highest in the country.

These wait times are not only inconvenient, but also harmful to patients' health and well-being. The report found that more than 18% of patients waiting for treatment experienced adverse health consequences, such as pain, disability, stress and reduced quality of life. Some patients even died while waiting for surgery or diagnostic tests.

Second, the court's decision disregards the rights and interests of doctors who want to offer more options and better care to their patients. The ban on private health care restricts doctors' ability to practice medicine according to their professional standards and ethical values. It also prevents them from earning a fair income for their services, as they are subject to low fees and caps imposed by the government.

The ban also creates a paradoxical situation where doctors can legally provide private health care to non-residents or workers' compensation claimants, but not to ordinary residents who need it most. This is unfair and discriminatory to both doctors and patients.

Third, the court's decision fails to recognize the potential benefits of private health care for the public system and society as a whole. Private health care can reduce wait times and costs in the public system by creating more capacity and competition. It can also improve quality and innovation by offering more choices and incentives for patients and doctors.

Private health care does not have to undermine or replace the public system, but rather complement and enhance it. Many countries, such as France, Germany, Australia and Japan, have successfully integrated public and private health care systems that offer universal coverage and high-quality care to their citizens.

The court's decision is not the final word on this issue, as Dr. Day has indicated that he will appeal to the Supreme Court of Canada. Hopefully, the highest court will overturn this ruling and uphold the rights of patients and doctors to access and provide private health care in B.C.