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Supreme Court of British Columbia Rules Against Private Clinic Service Fees

In Short

Last week, the Supreme Court of British Columbia issued a ruling that could change healthcare services across Canada. Dr. Brian Day, a Vancouver orthopedist, challenged a provincial law preventing patients from paying private clinics for essential health services covered by Medicare.

  • Dr. Day filed his case against B.C. in 2009 to challenge a law preventing doctors from billing the government for their work in the public system if they also earn money in the private system by billing patients and insurance companies.

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The Timeline:          

  • On September 10th, the B.C. Supreme Court ruled that under the province’s Medicare Protection Act, healthcare services must be based on public funding and necessity, not the patient’s ability to pay for quicker access.
  • According to this ruling, Dr. Day’s private clinic is violating federal and provincial law by charging patients for reduced waiting times to receive surgery covered by Medicare.
  • Dr. Day argued that in prohibiting sped-up private services at a fee, the government is violating Section 7 (the right to life, liberty, and security) of the Charter of Rights and Freedoms, stating that patients are suffering from waiting for surgery under the public healthcare system.

The Context:

While federal law prohibits private clinics from offering paid services covered by Medicare, many do offer such services without legal penalty.

Private healthcare services across Canada have been challenged and courts have issued conflicting rulings:

  • While the B.C. Supreme Court has just ruled against private clinics reducing patients’ wait times at a fee, the Quebec Supreme Court ruled in favor of private health insurance in 2005.

With this division and inconsistency in interpreting federal healthcare laws, Dr. Day’s case may go to the Supreme Court of Canada. Dr. Day himself has said that he will seek an appeal to the B.C. Supreme Court ruling.

  • While Dr. Day cited the Quebec Supreme Court’s 2005 ruling in his public statement after the B.C. Supreme Court’s ruling, the 2005 ruling is inapplicable outside Quebec.

The Bottom Line

If this case goes to the Supreme Court of Canada, it could lead to fundamental changes in Canada’s healthcare system.

Currently, essential health services are covered by the public system and all Canadians are treated equally regardless of ability to pay. If Dr. Day’s case goes to the Supreme Court of Canada:

  • And the ruling goes in Dr. Day’s favour, healthcare across the country could move closer to a two-tiered model split between a lengthier and lower quality public option and a private option with higher quality and shorter waiting times available to those that can afford it.
  • Alternately, judges may rule in favor of preserving the single-tiered healthcare model, establishing private insurance for essential services as unconstitutional.

Whatever may happen, the B.C. Supreme Court ruling against Dr. Day’s private clinic has sparked debate about healthcare practices all across Canada.