Profit and health care simply don’t mix

Cambie Trial Update

Brian Day’s profit-based cure for health care wait times is toxic.

We continue to follow the Charter challenge in BC that is threatening to further open the door to for-profit health care. Brian Day wants to charge patients higher fees than the public system will pay and put an end to the ban on private insurance. The trial has dangerous implications for the whole country because the laws that Day is trying to overturn uphold the principles of the Canada Health Act. These principles ensure that everyone is treated equitably, based only on their medical needs and not on their ability to pay.

After spending a year presenting his case, it is clear that Brian Day is not trying to argue the benefits of private versus public health care. Rather, he is attempting to argue that private health care will do no harm to the public system and that those with the means to pay for private care should have the right to jump to the front of the line.

Last week, witnesses for the defence brought forward some important facts.

Day has been trying to argue that the existence of the provincial workers compensation system, WorkSafe BC, demonstrates that a separate tier of health care already exists alongside the public system. The defence team took that argument on directly. An official from WorkSafe BC testified as to the purpose, procedures and limits of BC’s workers compensation system. This system was developed in the early 20th century to treat injured workers and get them back to work and to create an insurance system aimed at preventing workers from suing their employers. The system is paid for by employers. While patients are treated and doctors are paid differently than in the provincial health care system, WorkSafe BC is a publicly administered system with no profit motive driving its decision-making processes. The absence of a profit motive is the crucial point.

The court then heard from a second witness, Dr. Jeffrey Turnbull. Dr. Turnbull has been recognized with the Order of Canada, the Queen’s Diamond Jubilee Medal and the Order of Ontario for his treatment of the poor and the homeless. While serving as the President of the Canadian Medical Association, he conducted a cross-country consultation on expanding and improving public health care delivery in Canada. Dr. Turnbull testified about the importance of equitable treatment for everyone under the health care system and about the damage that a profit motive would cause. He argued that it would create behaviour that is detrimental to the principles we cherish in our health care system. Dr. Turnbull pointed out that a profit motive would skew resources, including physician time and diagnostic resources, towards patients and procedures that produce a profit. He argued that we should be making changes to overcome inequity in health care delivery rather than exacerbating it. Citing evidence from the U.K. and Manitoba, Dr. Turnbull demonstrated that for-profit health care delivery results in longer wait times and compromises patient safety.

Brian Day says he wants to introduce for-profit health care to alleviate surgical wait times. But he hasn’t proven that for-profit care will solve this problem. His arguments fail to acknowledge that long wait times are the result of underfunding. The third expert witness for the defence last week, Dr. James Hamilton, demonstrated that increased funding and innovation in delivery models can provide solutions. Dr. Hamilton’s work focuses on addressing surgical wait times through innovation in the public system in British Columbia. Drawing on success stories in the UK and Europe, Dr. Hamilton is piloting projects to centralize patient lists, open up more operating room time and refine waitlist data collection for more accuracy.

The trial continues this week with more expert testimony for the defence illustrating the danger of for-profit care based on evidence from the U.S. A decision is not expected until early in 2020. In the meantime, we’re continuing to monitor this important trial and advocate for fair funding and expansion of public health care.

 

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