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Charter Health Crowd

Seminal BC case will test the limits on choice in health care


I recently returned from helping my son settle in as a freshman at Princeton University. An interesting form of socialism — the type I support — is practised by the private Ivy League colleges. If a student gains admission, they are eligible for means-tested financial aid. Students from families that cannot afford the cost are funded. Those who can afford to pay, do. None is denied access based on financial status. This is the principle (supplemental personal funding) that allows many developed countries (such as Germany, Switzerland, France etc.) to offer high-level universal health care without rationed access.

In early 2014, more than five years after the initial launch of our action, our lawyers will argue in the B.C. Supreme Court (on behalf of five patients and us) against current laws that restrict choice and access to care. Sadly, a seventh plaintiff (a brain tumour patient) died as the case has waited to go to trial. If our action succeeds, all Canadians (not just those in Quebec) will be granted rights similar to those available to citizens of the other 195 countries on Earth.

British Columbia, Alberta, and Ontario appear to be competing as to which has the most tyrannical approach to its citizens. The three are leaders (within a country that leads the world) when it comes to health laws, rules, and regulations that oppress suffering patients.

Alberta is widely perceived as a hub of business, free enterprise and open markets. A violation of their health legislation, such as allowing a suffering patient access to non-government care, may lead to a fine of $100,000. A government-appointed $10-million commission on queue jumping in health care (adding to about 288 previously held Canadian health commissions) recently released a report. The commission's 12 recommendations should have been condensed into one: eliminate inappropriate queues. The $10 million would have been better spent in achieving that outcome (or at least studying ways that they might). The premier proudly boasted that she is patiently suffering herself, and becoming deaf as she waits a year to see an ear specialist. It would be less costly in the long term to offer early treatment and stop her deteriorating health. Governments continue to pay to prevent patients from being treated.

The ruling body for physicians in Alberta recently demanded that patients not be able to pay privately for an MRI, describing the practice as an example of queue jumping: bizarre logic since those patients leave, and therefore shorten, the public queue. That college has lost sight of the fact that a physician's role is to protect patients rather than support government-enforced rationing of care.

The Ontario "Commitment to the Future of Medicare Act" has been implemented using principles borrowed from the style of the former Soviet Union, as it mandates fines of $10,000 to $25,000 on desperate patients or corporations who expedite their care.

British Columbia has on its books a law, having been passed by the legislature and received Royal assent, that is simply awaiting proclamation by cabinet. If proclaimed, the result will be an initial fine of $10,000 ($20,000 for a repeat offence).

The most authoritarian governments on earth do not have such prohibitions.

There is hope among our youth. Excessive government control is not supported by the younger generation. A recent Ipsos MORI poll in Britain revealed that members of Generation Y (born after 1979) do not support socialist principles of increased taxation and big government in the way that many of us previously did. They support freedom of choice and reject state control of their affairs. This amounts to an interesting hybrid form of libertarianism, influenced by freedoms associated with the Internet and social media age.

Recently, a high-school student asked for my help in preparation for a school debate on Medicare. He was assigned the role of arguing in favour of a stronger role for the private sector. He wanted me to help him with some pro-choice arguments. I made it clear that those who believe in a larger role for the private sector support a hybrid model that includes a strong, accountable, and efficient public system.

I provided him with data to support his arguments. I heard back from him two weeks later, when he told me the debate topic was abandoned, since none of the 100 or so students in his grade was prepared to argue in favour of our current public system.

Young people are aware that our generation has left them with a massive legacy of debt, and a large unfunded liability in health costs. Generation Y will not support a growing burden of heavy taxation on themselves, in order to support us as we age and demand ever more services from government. When two-thirds of the wealth of Canada is held by older generations, who can blame them?

Seventy-six per cent of Canadians think they should be able to buy private insurance for treatments outside the public system (Ipsos Reid poll, June 28, 2012). The plaintiffs in this case believe that in a free and democratic country no citizen should be denied the right to protect their body from harm.

"Primum non nocere" (First, do no harm), is entrenched in the code of ethics of all physicians. I suggest "Primum nocere" as an appropriate motto for those opposing our fight for patient rights.

Brian Day is the medical director of the Cambie Surgery Centre (and a former CMA President).


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