In protecting a mythical and utopian idea of Canada's healthcare system, the patients who rely on that system suffer.
Such is the realty of the British Columbia Supreme Court's decision in a case filed more than a decade ago, involving a private surgical clinic in Vancouver. The Cambie Surgery Centre has operated without issue since its founding in 1996 until a few years ago, that is, when the British Columbia health politburo decided to crack down on provisions in the province's medicare act banning, among other things, doctors from working public and private systems, as well as private health insurance covering services that the provincial health plan covers.
I understood from writing about the case previously that a key question for the court to decide was whether access to a waitlist constitutes access to healthcare. In a nutshell, the Supreme Court of Canada ruled previously, in a 2005 Quebec case, that it doesn't.
The BC Supreme Court agreed in its Cambie decision, and even agreed that the patient plaintiffs in the lawsuit had suffered at the hands of the public healthcare system and, thus, were deprived of their constitutional right to security of the person.
Slam dunk win for Cambie, right? Not so fast.
If you haven't read the case, it may shock you to note that even with this recognition, the court found the government had a right to deprive patients of their rights because it wasn't done in an "arbitrary" manner one of the legal tests for such a breach to be found truly unconstitutional.
Yes, the court found that the public healthcare system is terrible for some people, but still denied them the right to seek a private alternative.
The rationale for this comes from the fetishization of what the public healthcare system in Canada is, even when confronted with contradictory facts.
"There is a rational connection between the effects of the impugned provisions and the objectives of preserving and ensuring the sustainability of the universal public healthcare system and ensuring access to necessary medical services is based on need and not the ability to pay," Justice Steeves wrote in the ruling, coming in at over 800 pages.
In other words, it's better to protect a system that prevents some people from accessing healthcare because the alternative wouldâ€¦ prevent some people from accessing healthcare?
It's an objectionable premise in general. There's no evidence, contrary to the fear-mongering from medicare's fiercest proponents, that allowing private access would detract from the public system. If anything, it would improve it. The Cambie clinic was created because surgeons were unable to get operating room time in public hospitals and had time on their hands and a desire to see more patients. The same phenomenon still happens today.
What's clear is that Canada's universal healthcare system is not viewed for what it is but rather what it's supposed to be. This is letting ideology get in the way of the facts.
Challenging such dogma in Canada is heretical, eliciting accusations of trying to transform our system into that of the United States, when, in reality, Canada's and the United States' healthcare systems are among the costliest and least efficient in the world.
Most developed nations have systems in which private and public healthcare options are ubiquitous. In Canada, any private alternative to a government-funded service is seen as a threat to the government's monopoly on most healthcare. Government focuses more on ensuring the monopoly than the healthcare.
"I was in dire need of an MRI and the system asked me to wait eight months," wrote one acquaintance of mine on Twitter Thursday. "Cambie Surgery Centre got it done in two days. People should be allowed to have the option to pay."
Because someone was willing and able to pay for a private MRI, it gave them an option for better care, and ultimately freed up a space on the eight-month-long waitlist for someone else.
If government is going to monopolize healthcare, it has to provide the service in a manner that delivers real access to real healthcare.
As the recipient of world class healthcare, I don't think our system is akin to a North Korean field hospital or anything like that, but there are challenges. And we can't discount these stories simply because we don't like reality.
Photo Credit: CBC News