This is probably more of a legal diary this week than a crime diary, but it does pertain to a case currently before the courts.
A B.C. doctor and a number of his patients are challenging provincial regulations preventing people from obtaining private care for services also provided by the public health care system.
Dr. Brian Day runs a clinic in Cambie, B.C. that specializes in arthroscopic surgery and allows patients to pay out of pocket and “jump the public queue” so to speak. The B.C. government thinks that is illegal. Public system advocates say it is contrary to the heart of medicare that services should be provided on the basis of need, not the ability to pay. Some with the ability to pay argue preventing them from doing so is unconstitutional.
Canada’s justice system is by nature adversarial. Generally, it pits a plaintiff, in this case the doctor, against a defendant, in this case British Columbia’s Medical Services Commission, in what is frequently presented as a winner-take-all scenario.
Perhaps that is why there is very little in the way of nuanced discussion of the case.
Media coverage almost universally comes with headlines such as: “Canada’s public health care system on trial” and “B.C. lawsuit set to reignite debate about private health care.”
Unions and advocacy groups go even further with headlines on press releases such as: “The legal attack on public health care” and “B.C. court challenge threatens public health care.”
Simplistically—and in the increasingly polarized political environment we find ourselves simplistic extremism seems to be the only way we view things—it is the status quo versus a complete and immediate descent into American-style privatization.
There is little doubt the case does hold some ramifications for the future of health care in Canada, but the death of the public system, a foundational Canadian value, is not one of them.
In the first place, the Courts tend to be circumspect in their decisions. The parameters of the B.C. Supreme Court ruling—if in fact it goes in Dr. Day’s favour, which there is no guarantee it will despite his confidence—will likely be fairly restrictive.
And it will be moot anyway because there is no way, regardless of which way the provincial court goes, that this case is not going to the Supreme Court of Canada.
If the case does change things, it is going to be a long, long time before it fully plays out.
It started in 2008. The trial is scheduled for six months. After that the justices will conduct a lengthy deliberation. It will be more months, possibly years, before it makes its way to Ottawa and then more trial, more deliberation etc.
Finally, if the Supreme Court finds the ban on private services unconstitutional, or not, it is most likely—as we have seen on big issues such as prostitution, medical marijuana and physician-assisted death—to kick it back to Parliament and the provincial legislatures.
In the meantime, we need to roll up our collective sleeves and get serious about fixing what we’ve got. Another thing we sometimes fail to recognize, especially if we support fully public health care is that one of the reasons there is pressure toward privatization is that the public system is far from perfect.
The sky is not falling, but the current case makes the case for a nuanced discussion about health care starting yesterday.
