Closing statements for the defense are scheduled to begin on Monday, 25 November 2019 before the Supreme Court of British Columbia in a landmark legal challenge that threatens the central organizing principle of Canada’s public health care system – that care should be provided first to those who need it most, not to those who can afford to pay for quicker access.
The corporate plaintiffs in the trial, the Cambie Surgeries Corporation, are seeking to overturn provisions of the BC Medicare Protection Act that ban extra billing (charging patients more than the rates paid under the public plan); private duplicative insurance (for medically necessary services covered by the public plan); and dual practice (precluding doctors from being paid both under the public plan and charging patients outside of the public plan).
“The Cambie trial is not about the mere existence of private clinics or facilities,” said Dr. Richard Klasa, a member of Canadian Doctors for Medicare’s Board of Directors and a retired British Columbia physician. “It is not unlawful to operate a private, for-profit, investor-owned facility in British Columbia. What is unlawful is to charge patients insured by B.C.’s Medical Services Plan for medically necessary hospital and physician care, when those services are already covered by MSP, and when that care is provided by physicians enrolled in MSP.”
Doctors in British Columbia may unenroll from MSP altogether, and they may charge their patients as much as they want, provided they don't provide care in a hospital or community care facility. However, under B.C. law, physicians who are enrolled in MSP are prohibited from charging B.C. residents any fee for, or in relation to, benefits covered under the plan.
The Cambie Surgery Centre and affiliated Specialist Referral Clinic have charged patients "facilities fees" for years, violating the BC Medicare Protection Act (BC-MPA). They argue that by denying patients the right to obtain medically necessary services more quickly by paying privately, the BC-MPA infringes on patients’ rights to life, liberty, and security of the person under the Canadian Charter of Rights and Freedoms.
The Attorney General of BC and the Attorney General of Canada, along with CDM and other intervenors, have presented evidence that striking down the ban on extra-billing, duplicative private insurance and dual practice would harm the public health care system; increase wait times for those unable to pay privately for priority care; lure much-needed physicians, nurses and operating room staff from the public-pay sector; and drive up costs, forcing B.C.’s public payer to pay higher prices to “compete” with private insurers.
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