Canadians Can’t Wait Any Longer For Healthcare Justice
Canada’s health care system is back on trial. Last month, a nine-year-old lawsuit challenging British Columbia’s prohibition on private health insurance and private payment for medical care resumed.
The government has responded by keeping the doctor waiting — for justice. Day filed his suit in 2009. The case finally reached British Columbia’s Supreme Court in September 2016. Since then, the government has done just about everything it can to stall, delay, and obfuscate — ostensibly to try to get Day to give up.
Day — and Canadian patients — can’t afford to wait any longer. The Canadian single-payer regime subjects thousands of patients to life-threatening delays for treatment.
Our northern neighbors’ wait times grow longer with each passing year. According to the Fraser Institute, a Canadian think tank, the typical patient in need of specialist treatment last year waited 21.2 weeks after referral from a general practitioner — a record high. In 1993, the median wait time was less than half that figure — 9.3 weeks.
In British Columbia, the median wait is even longer — a grand total of 26.5 weeks from referral from a general practitioner to receipt of treatment from a specialist. That’s more than half a year.
Lengthy delays are a hallmark of single-payer. Demand for care is essentially limitless when someone else is paying the bill.
But the provincial and federal governments in Canada don’t have limitless resources. So they typically set a global budget for care. Doctors and hospitals can only provide so much care before their costs exceed their revenue from the government. And they can only afford to keep a limited amount of equipment operational, such as MRI machines or CT scanners.
Demand for care inevitably outstrips supply. So the government has to establish wait lists.
Long waits aren’t merely inconvenient; they’re dangerous. Consider the case of Walid Khalfallah, a British Columbian boy with severe scoliosis profiled by the Vancouver Sun in 2012. The Sun reported that he faced a three-year wait for spinal surgery, even though medical guidelines recommended a maximum wait of three months.
Delays can even prove fatal. Long waits have contributed to the deaths of more than 44,000 Canadian women in the past two decades, according to a Fraser Institute study.
Many patients would gladly pay extra to receive care more quickly. But British Columbian law makes it effectively impossible to do so.
‘Necessary’ Health Care
The law bans any doctor who accepts private money from receiving payments from the government for “medically necessary care.” Private insurers aren’t allowed to pay for such care, which the single-payer plan has the exclusive right to cover.
That’s out of step with public opinion. According to a March Ipsos poll, more than three-quarters of Canadians believe patients should be able to pay for private treatment if they’ve been on a waiting list for longer than the maximum recommended. Eighty percent of British Columbians feel that way.
As Day sees it, the province’s prohibitions violate the rights to life, liberty, and security enshrined in Canada’s Charter of Rights and Freedoms. He argues that patients should be able to buy private insurance that covers the same services as the single-payer plan. And patients should be able to use their government insurance — which they pay for through their taxes — to cover at least part of the bill at private clinics.
Day stands on solid legal ground, if a previous Canadian Supreme Court case — Chaoulli v. Quebec — is any indication. In 2005, the Court examined Quebec’s single-payer system and ruled it infringed upon patients’ rights. According to Madam Chief Justice Beverley McLachlin, Quebec’s ban on private insurance gave the public sector a monopoly on health care. That monopoly resulted “in delays in treatment that adversely affect the citizen’s security of the person” — thus violating the Charter of Rights and Freedoms.
The ruling only applied within Quebec. A similar ruling in Day’s case, however, could apply to the whole country — and mark the beginning of the end of Canada’s single-payer system.