Dr. Brian Day @DrBrianDay Twitter

  • Past President Canadian Medical Association
  • Past President Arthroscopy Association of North America
  • Honourary Associate Professor University of British Columbia
  • 2014 Doctors of BC Don Rix Leadership Award

B.C.'s private health-care clinics are part of the solution

Aug 17, 2012

Nanaimo Daily News

"When we look to the evidence rather than to assumptions, the connection between prohibiting private insurance and maintaining quality public health care vanishes. The evidence before us establishes that where the public system fails to deliver adequate care, the denial of private insurance subjects people to long waiting lists and negatively affects their health and security of the person. The government contends that this is necessary in order to preserve the public health system. The evidence, however, belies that contention."

"The evidence shows that delays in the public health care system are widespread and patients die as a result of waiting lists for public health care"

Supreme Court of Canada, Chaoulli decision, June 2005

Mark Twain's plea to get your facts first, and then distort them as much as you please, should be heeded by writer Paul Walton. His recent article ("Two-tiered health-care system unacceptable," Nanaimo News, Aug. 14) was misleading. He failed to mention that the Seafield Surgical Centre, one of the first and biggest private for-profit surgery clinics in Canada, is in Nanaimo. And, yes, it is very much like our Cambie Surgery Centre, being privately owned and operated.

Like our centre, it offers expedited surgical care to those whose access in the public system is restricted by policies of rationing. Walton should also know that we filed our lawsuit in 2009, not "last month after it was found by the province that they had violated the Medical Protection Act."

He appears to be unaware that Canada is the only one of 196 or so countries on Earth in which it is it illegal to spend one's own after tax dollars to care for oneself or a loved one. Even countries like Cuba and Communist China have embraced the private sector and competition in an effort to improve their health systems.

Walton should know that a "two-tier" system already exists in Canada. Groups such as WorkSafe B.C., RCMP, Canadian Armed Forces, federal prisoners and others have access to private care. Almost 70% of Canadians have two-tier private insurance for treatments not covered by Medicare.

These services are arbitrarily designated as not medically necessary by government bureaucrats (who ensure they have the extra coverage). By definition, more than 30% of Canadians receive a lower level of care as they lack coverage for such essential services as ambulances, prescription drugs, dentistry, physiotherapy and even an artificial limb after an amputation.

Walton's belief that competition is bad for the consumer and increases costs is ludicrous. His assertion that waiting lists in England have grown because of private clinics is factually incorrect. Changes initiated by Tony Blair six or seven years ago, including an increased role for the private sector, have led to the virtual elimination of waiting lists. Interestingly, the demand for private surgery has subsequently lessened.

Universal care does not, as Walton believes, equate with a government monopoly. Switzerland, France, Belgium, Germany, Austria, and many other social democracies, combine universal care with a hybrid public private system and spend the same or less than Canada.

Canadian-style waiting lists do not exist in those countries. When a European consumer group ranked our health system along with 29 European countries, we came in 23rd overall, and 30th in "value for money."

One reason for this is the fact that much of our health budget is wasted on a bloated bureaucracy. A study published this year revealed that Canada has one public health bureaucrat for every 1,400 citizens, while Germany (universal care, hybrid public-private system, no waiting lists) has one for every 15,000.

The 76% of Canadians who, in a June 2012 Ipsos Reid poll, supported the introduction of a hybrid parallel private system in Canada are on the right track. Walton is on the wrong track.

Dr. Brian Day is an orthopedic surgeon and medical director of the Cambie Surgery Centre.