Concluding evidence in defence of public health care in BC Charter challenge

Cambie Trial Update

In the ongoing and lengthy Charter challenge to Canada’s public health care system taking place in BC, the final defence witness testified on June 19th.  Dr. John Frank presented evidence demonstrating that public, universal health care works best to ensure the health of our population.

Dr. Frank, an expert in epidemiology and public health from Toronto, testified that poor health and premature death are more common among low-income populations. Health care based on the ability to pay intensifies this reality and the overall health of society suffers as a result. Dr. Frank’s testimony demonstrated that the introduction of for-profit health care in Canada will have a negative impact on our health care system.

In this case, Brian Day, the CEO of a private, for-profit surgical clinic, is seeking to overturn the ban on extra-billing and private insurance for medically necessary health care services in BC. His case is based on anecdotal evidence of long wait times experienced by patients seeking hip and knee replacement surgeries. Day is asserting that people should have the right to seek care outside the public system in a private system based on competition and profit.

To be viable, a for-profit system in Canada would require higher fees and the availability of private insurance. This would provide faster care to those who can pay for it and/or qualify for private insurance. Last week’s testimony pointed out that allowing for-profit health care in Canada would exacerbate socio-economic inequalities.

Earlier in the week, the court heard from Dr. J.P. Devereaux, whose work compares for-profit and not-for-profit health care in the U.S.. Dr. Devereaux demonstrated that because of the profit imperative in for-profit facilities, cost cutting measures affect the administration of pharmaceuticals, the maintenance of equipment and the number and quality of staff. This has led to higher mortality rates in the for-profit health care sector.

This concluded the wide body of evidence presented by the BC Attorney General and the intervenors, which include the Attorney General of Canada, the BC Health Coalition and Canadian Doctors for Medicare. The defence’s experts showed that for-profit health care will hurt the Canadian system and lead to potentially dangerous health outcomes. They also pointed out the lack of reliable evidence proving that long wait times are responsible for poorer health outcomes for patients. Their testimonies provide a direct challenge to Brian Day’s case.

The defence presented evidence from around the world on the impact of for-profit health care.  Experts brought forward research and analysis showing that for-profit health care doesn’t shorten wait times, that it costs more and that it can actually increase wait times. Evidence also showed how private insurance skews health care investments and priorities. Private insurance and for-profit care favour investment in the most profitable health care services.

Expert evidence also showed how wait times have been successfully shortened within the public system in other countries and how wait times are currently being addressed in BC. Experts also showed that for-profit health care will have a negative impact on the overall health of the Canadian population.

Day’s lawyers have attempted to show that for-profit health care and private insurance won’t harm our public, universal health care system. But the evidence from the defence has shown that the opposite is true. While we do need to work to improve wait times in the public system, for-profit care is not the answer. For-profit health care would negatively impact British Columbians, and it could affect all Canadians since the very foundation of the Canada Health Act is at stake here.

Both sides have now presented their evidence in this case. Court is adjourned until closing arguments are presented in November. A judgment is expected early in 2020.

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