VANCOUVER — A proponent for private care wants to benefit from provincial regulation of private medical insurance if a British Columbia law aimed at discouraging a parallel public-private system is struck down, says a lawyer for patients and doctors fighting to preserve universal care.
Joe Arvay told B.C. Supreme Court on Thursday that Dr. Brian Day’s main objective is to cherry pick the abolishment of only parts of the Medicare Protection Act, which requires doctors to opt out of billing the government for work in the public system if they are also earning more money in private clinics.
Medical insurance used to pay for those services would usher in a complicated and expensive administrative regime dependent on public funds for the benefit of physicians wishing to expand private services that would not be regulated by the government, he said.
“The plaintiffs are not seeking to opt out of the public system in its entirety,” Arvay said. “Even in the private market they wish to establish, they would continue to benefit from society’s investment in health-care professionals and public funding of the entire health-care infrastructure.”
Arvay said doctors employed in the public system are known to refer patients to themselves in private clinics where they also work in order to bypass wait times that apply to everyone who can’t afford to pay out of pocket or through private insurance.
He said physicians are paid more money in the private system than they earn in hospitals so they stand to financially benefit twice from such a scheme, which only exacerbates wait times for those who can’t afford fast-tracked treatment because the public system then faces a shortage of doctors who are also unavailable for consultations.
Arvay represents an intervener group that includes two physicians, Canadian Doctors for Medicare, the BC Health Coalition and a pair of patients. One of the patients is disabled and the second was diagnosed with AIDS. Arvay said like most people, they rely on a public health-care system that ensures equitable access to care.
Day, an orthopedic surgeon who owns the Cambie Surgery Centre in Vancouver, has maintained that patients who have waited too long for an operation or diagnostic tests in the public system are deprived of timely care and should have a right to private treatment under the Charter of Rights and Freedoms.
However, Arvay said Day has failed to establish a threshold for how long a wait is too long and never argued that the law should be changed to allow patients to get private care if current benchmarks for wait times set by the province are surpassed, adding that would be an “easy fix” for the government and the surgeon’s primary aim is profit.
“It would be ironic indeed if this public system were to be dismantled as a result of the charter, when the charter itself is premised on the same fundamental values of human dignity and equal concern and respect for all,” Arvay said.
“There should be no mistaking the effects of this challenge if successful. It will privilege the interests of certain, already wealthy physicians and allow queue jumping by our most financially well-off citizens, all to the disadvantage of relatively less well-off and poorer patients and all of those physicians who are committed to the public health-care system,” he said.