Day wants a B.C. court to allow citizens to pay — privately — for medically necessary services. Doctors would be able to charge patients for those services. If the court rules in his favour, it could end equal access that is at the heart of the country’s health-care system.
Medicare promises universal, free and equal access to health services for all Canadians. There are no qualifying tests about money, social status, family or power. All citizens are equal.
Day, a former president of the Canadian Medical Association, says Canada is the only country in the world that bans citizens from paying for medically covered services privately. He himself has charged both the B.C. government and patients for some medical services.
The Canada Health Act, passed in 1984 to amalgamate various major pieces of legislation, affirmed five founding principles: that it be administered by a public authority on a non-profit basis; that it cover medically necessary procedures; is universal; portable; and accessible — or free of financial barriers. The two-tier system Day is asking for would violate those principles.
But his key argument is a powerful one. He contends that restricting private, for-profit care violates the Canadian Charter of Rights and Freedoms. Day contends that Canada Health Act restrictions curb patients’ constitutional rights by forcing them to endure long wait times that often worsen their health problems. He suggests that his battle is similar to overcoming injustices like same-sex marriage and abortion rights — issues that overcame initial opposition and are now widely accepted.
The fear is that under the model Day is proposing, private clinics will lure doctors from hospitals and public practices, and that wait times for the majority will get even longer. People who can pay will get treatment ahead of a person whose life might depend on getting immediate care.
Day’s opponents agree that improvements are needed to help our current system meet the needs of today’s population, such as community-based primary health care, a national public drug plan and enhanced health promotion and disease prevention. But they don’t agree that profit-driven, private care is the way to change and improve the system.
Much depends on the court ruling which could strike down medicare as we know it and allow a U.S.-style system with longer wait times, high insurance rates and skyrocketing costs, as limits are lifted on what doctors can charge patients.
Charter challenges have found much success in courtrooms of late. Medicare supporters have reason to worry.
One day, our health-care system might not be there when we need it.