Dr. Brian Day, former Canadian Medical Association president and long-time medical director of Cambie Surgery Centre, recently sat down with Stephen Skyvington, former manager of government relations for the Ontario Medical Association and health-care advocate, to discuss Dr. Day's ongoing charter challenge against the B.C. government, why Canada's health-care system is failing patients and what can be done about it.
Q. You initiated your Charter challenge in January 2009. Why has it taken so long to get this important issue before a judge?
A. The B.C. government has repeatedly stalled. I believe this was in the hope they might force us to abandon the case because of the high cost of litigation ... Last year, just weeks before the trial was to finally begin, the government announced that they had discovered 300,000 documents they had neglected to disclose, as required by law. This resulted in a six-month delay. The most recent delay was simply an admission that they needed more time. Wait lists for access to care and justice are, we have found, both unacceptably long.
Q. Now that it's finally arrived, are you glad to have to your day in court?
A. Absolutely. It is important to recognize that the plaintiffs in this case included not only our clinic, but six patients who had suffered at the hands of government failings on access to care. Sadly, two of the adult cancer sufferers have died during the delay. We were anxious to emphasize the plight of children on wait lists and three children joined us as plaintiffs. They are now young adults. One child was paralyzed for life, after a 27-month delay in accessing spine surgery. The patient plaintiffs in our case represent just six of an estimated two million Canadians waiting for care.
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Q. What, exactly, is the crux of your argument?
A. Simple. If the government promises necessary care, and then fails to deliver it in a timely manner, do they have the right to prevent a citizen from accessing that care independently? Interestingly, those injured at work, RCMP officers, members of the Canadian Armed Forces, and federal prisoners have that right. No country on Earth — other than Canada — has such draconian legislation, which forces its citizens to suffer and even die on wait lists.
Q. How is your case different from the case successfully argued before the Supreme Court by Dr. Jacques Chaoulli in 2005?
A. The Supreme Court of Canada already ruled that residents of Quebec have the right to access private insurance under the Quebec Charter. All seven judges in Chaoulli agreed that patients in Canada were suffering and sometimes dying on wait lists. We are asking that citizens outside of Quebec have similar protection under the Canadian Charter of Rights and Freedoms. The B.C. and federal governments will be arguing that other Canadians do not deserve similar rights.
Q. If you win this Charter challenge, do you think the judge's decision will finally open the door to a hybrid healthcare system by 2020?
A. Even before then. We believe companies that currently offer private medical insurance for such services as prescription drugs, physiotherapy, dentistry, and ambulances, etc. — which are excluded from medicare because they are inaccurately and arbitrarily labelled by bureaucrats as not "medically necessary" — will very quickly offer full supplemental coverage for all services under their plans. Most Canadians will likely be covered through their employment benefits.
Q. Do Canadians have anything to be afraid of should our country finally (as just about every other country in the world has done) allow a private system to operate alongside our public system?
A. On the contrary, we will see the public system evolve for the better. Public systems in other developed countries collaborate and integrate closely with the private sector in mixed hybrid systems. Wait lists are non-existent or extremely short in those countries, and most spend less on health care than we do.
Q. So if we have nothing to fear, and our current system is clearly unsustainable, why do you think the vast majority of politicians and union leaders favour protecting the status quo? Are they simply misguided, or do they have an ulterior motive?
A. The public sector union leadership is afraid of competing with the private sector. The paradox, curiously, is that the most common demographic of a patient treated at private clinics like Cambie Surgery Centre is that of a unionized worker. Most politicians — even those who might deny it publicly — and the majority of the public support our case and want us to win. Competition and choice are not considerations that our opponents, such as the union-funded, so-called "health coalitions" and Doctors for Medicare, believe should be offered to Canadians. Strangely ... patients treated at our private clinics include leaders from the very groups that are going to court to make sure others can't receive the same benefits that they have enjoyed. Hypocrisy reigns supreme.
Q. Tommy Douglas is generally acknowledged by most Canadians to be the "Father of Medicare." How do you think he'd view the state of our country's health-care system in 2016?
A. He also believed in user fees. I believe that Douglas would not be happy with the current state of affairs, where statistics show that the lowest socio-economic groups in Canada suffer the worst access and have the worst health outcomes. This is the opposite of what Douglas' plan was initially intended to do.