There’s Nothing Fair About Canadian Health Care

For the past 14 years, Vancouver surgeon Dr. Brian Day has led the charge for health-care reform, pushing for the right of patients to pay for private care if their […]
Published on April 16, 2023

For the past 14 years, Vancouver surgeon Dr. Brian Day has led the charge for health-care reform, pushing for the right of patients to pay for private care if their health and well-being are threatened as a result of waiting in a stagnant and overburdened public system.

He argued that these prolonged waits violate a patient’s constitutional right to life, liberty, and security of the person.

This seems like a reasonable argument for two reasons.

First, Canadians can pay for plastic surgery, fertility treatments, and eye surgeries, as well as treatments at dermatology, vein, and foot clinics, among others.

Likewise, it makes sense that if Canadians can pay to look good, they can also pay to get relief from pain and sickness.

Second, Canada is the only nation in the developed world that exclusively relies on a publicly funded system and prevents its citizens from using their own money to pay for necessary medical care. Every other developed country has parallel public and private systems that ensure timely care for citizens. Notably, these countries do not have wait lists like the ones that are now standard in Canada.

But a B.C. court ruled that it was lawful for the government to prevent people from paying for their own medical care. Despite the harm to would-be patients, the medicare system is a public good that must be protected even though people die every day waiting for the medical service they need.

Not surprisingly, Dr. Day took this issue to the Supreme Court of Canada, but the highest court in the country has refused to hear the case. This hearing, if it had taken place, could have initiated much-needed positive change in the growing wasteland of Canada’s health-care system.

The response to news of the abrupt end to Day’s lawsuit was, quite simply, hypocritical and uninformed.

On the political side, most provincial and territorial health ministers declared it a victory for universal health care, even as many provinces now rely on (i.e., pay) private clinics to perform surgeries in an effort to reduce the public system’s dangerously ridiculously long wait lists.

Similarly, many Canadians viewed the Supreme Court decision as a triumph for “regular” people because it signifies that Canadian health care ostensibly treats all people as equal and the so-called “rich” cannot use their money to “buy” medical treatment and receive faster service. For some reason, these Canadians think that the ideal of universal access—everyone waiting their turn—for health care somehow levels the playing field.

But guess what?

Canadian health care is not the great equalizer that it claims—some people are allowed to access medical care more quickly than others.

The list of the entitled people includes anyone covered by federal health insurance. Judges, members of Parliament, federal employees, senators, the RCMP, the military and federal prisoners have privileged access to health-care services, including access to private health care. In other words, the federal lawmakers who uphold the archaic laws that make private care illegal enjoy full access to private health care when they need it.

According to Dr. Day, unionized workers covered by Workers’ Compensation Board insurance comprise the “most common [largest] single demographic” of patients at his private surgical clinic. Unions long ago figured out that it was less costly to pay for a worker’s surgery than to make payments to workers as they languish on wait lists for months or even years. The same is true for employees of our many Crown corporations.

Being rich is not the difference that many Canadians seem to believe. Remarkably, those who pay out of pocket for surgical services represent just 10 percent of Day’s patients.

Why so few?

Because most people with money take their health-care dollars to the United States or other countries to buy immediate access to health care. Canadian court rulings have no impact on their decisions. So, the idea that eliminating private health-care facilities in Canada will pose limitations on Canada’s “rich” is contrary to reality. The double standard remains.

Ironically, the end to Day’s lawsuit comes just as Canadians are beginning to acknowledge that universal health care is broken and there is not enough cash to fix it. A January Ipsos poll found that 59 percent of Canadians support the private delivery of publicly funded health care, and 85 percent say that “drastic changes” are needed to meet their health needs.

This decision by the Supreme Court clearly shows that we can no longer trust the courts to instigate health care’s necessary reforms. Nor can we expect our political leaders to make the necessary changes; for the most part, they lack the vision and perspective needed to initiate positive innovations.

That leaves Canadians or, more likely, Canadian patients, to point out the failures of our public system and advocate for serious change.


Susan Martinuk is a Senior Fellow at the Frontier Centre for Public Policy and author of Patients at Risk: Exposing Canada’s Healthcare Crisis. 

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