VANCOUVER — A lawsuit that begins today in B.C. Supreme Court in Vancouver has the potential to fundamentally change the way Canadians access health care.
Dr. Brian Day, who operates a private surgical centre in Vancouver, is challenging B.C.'s ban on Canadians buying private insurance for medically necessary services already covered by medicare.
Day alleges the restriction violates the constitutional rights of patients by forcing them to endure lengthy wait times, even as their health problems worsen.
British Columbia's Ministry of Health, a defendant in the case, isn't commenting while the matter is before the courts, but has said its priority is to uphold the Medicare Protection Act and the benefits it safeguards.
Adam Lynes-Ford of the B.C. Health Coalition, one of the interveners in the case, says a core Canadian value ensures patients have access to medical care based on need, not on ability to pay, but this case could derail that concept.
The lawsuit, described by University of Ottawa law professor Colleen Flood, as one of the biggest constitutional cases "perhaps ever," is scheduled to continue for at least six months.
"This is about making medicare better," says Day, arguing that opening the door for private insurance will ease pressure on the public system, freeing up resources that will cut wait times and boost quality of care for everyone, whether publicly or privately insured.
"Every time you allow the Canada Health Act to be chipped away at, it's chipping away at some fundamental Canadian values," says Ian Culbert of the Canadian Public Health Association.
He says he worries a victory for Day could introduce a hybrid public-private model of medicare, which he believes will lower the quality of care for those who can't afford private health insurance.
In 2005, a Supreme Court of Canada decision gave Quebeckers access to private insurance when the top court ruled excessive wait times infringed on patients' constitutional rights.
That decision was argued under the Quebec Charter, so didn't extend beyond that province's boundaries, but a judgment in Day's favour has the potential to affect health care delivery nationwide.