The court case to legalize private healthcare in Canada is coming to a close this week, and it could potentially change the course of Canadian healthcare forever. For the past 10 years, Vancouver doctor Brian Day, former president of the Canadian Medical Association, has been leading a legal crusade to argue that private health care should be able to work together with Canada's publicly funded Medicare system. So, as we conclude the closing arguments in Day's case this week, let's take a look at why Canada prohibits private health care in the first place and how it differs from other countries with socialized healthcare. The Canadian system is strange even by the standards of other countries with socialized healthcare.
For example, Australia guarantees health coverage for all citizens, but you can still pay out-of-pocket for a boutique appendectomy if you feel like it. Not long ago, virtually all Canadian health care existed in the public sphere. In the years leading up to World War II, Canadian health care was similar to the current American system, since anyone who was admitted to a hospital without insurance was sent a bill upon discharge.The reason for this change was a wave of “overbilling” that swept through Canadian healthcare in the 1970s. Canadian patients were increasingly affected by user fees and co-pays, which was gradually reducing the supposed universality of Canadian healthcare.
A historic report from 1980 condemned these new fees for undermining the health system. Canadians, wrote the report's author Emmett Hall, were people who had long agreed that health services should never be “factory-bought and paid for at the checkout.”The Canadian Health Act, which grew out of Hall's recommendations, explicitly prohibited “additional billing” and prescribed reductions in funding to any province that tolerated it. It should be noted that it is one of the few important laws in Canadian history that was passed with almost unanimous support of the House of Commons. However, technically there is no general federal ban on private health care in Canada.
Any doctor can decide to opt for private companies, as long as they choose not to work for the public system.A doctor cannot simultaneously bill the province and bill patients directly; they have to choose one or the other. In addition, most provinces (including British Columbia) prevent private doctors from charging more than the amounts prescribed under the provincial health plan. Even so, a very small private sector dedicated to necessary health care manages to hold on to life in Canada.By some estimates, approximately 1% of critical health care in Canada takes place outside the public system. Brian Day, the doctor leading the challenge against the public health monopoly, is one of the few examples of private sector doctors in Canada.
Day runs the Cambie Surgery Center in Vancouver, which is promoted as “the only independent private hospital of its kind in Canada.” However, the average British Columbian can't just walk in and ask for a round of back surgery.In British Columbia, patients must meet certain criteria before they can access private healthcare services. As a result, Cambie Surgery Center can only serve a small demographic of patients who are explicitly exempt from provisions of Medical Services Plan (MSP), including prisoners, members of armed forces and injured workers covered by WorkSafeBC.Meanwhile, members of Brian Day camp say that by allowing patients option of paying for their own health care space in public system is freed up for everyone else. Private healthcare in Europe has not definitively eliminated waiting times or other inconveniences of rationed public healthcare but it has proven capable of coexisting with public system without precipitating collapse of country's socialized medicine system.That same article also pointed to curious dissonance between provinces that crack down on private hospital care and at same time leave dental care or pharmacy almost entirely in hands of for-profit actors. As a frequently cited section of decision said “waiting lists to access health services have caused deaths have increased time patients have to suffer and have reduced ability of patients to enjoy real quality of life.” Federal and provincial government officials are struggling to find out if new private health clinic in Calgary is breaking law by offering doctor-provided concierge drugs in exchange for annual membership fee.
Cleveland Clinic Canada's assisted medicine program offers personalized direct access to dedicated doctor and health care team 24 hours day 365 days year. Like all caregivers at Cleveland Clinic your Concierge Medicine doctor and health care team were selected for their skills reputation and commitment to providing compassionate high-quality care. So there you have it: an overview of why Canada prohibits private healthcare and how it differs from other countries with socialized healthcare systems. While we wait for a verdict on Brian Day's case this week, it remains unclear whether or not Canadians will be able to access private healthcare services anytime soon.
