VANCOUVER - A private clinic's legal crusade to expand the role of the free market in Canada's public health-care system puts profit over patients and would lead to greater hardship for most Canadians, especially the country's vulnerable, a court has heard.
Marjorie Brown, a lawyer for a group of patients who support medicare, told B.C. Supreme Court on Wednesday that Cambie Surgery Centre's lawsuit challenging prohibitions on private health insurance and doctors' billing threatens the foundation of universal health care.
Legal counsel for the Vancouver surgical facility has argued that the restrictions violate patients' charter rights by forcing them to endure unreasonable wait times. Several patients are also named as plaintiffs in the lawsuit.
Cambie Surgery Centre has been operating since 1996 under the direction of Dr. Brian Day, a former president of the Canadian Medical Association and an outspoken advocate for private health care.
"There's been 20 years of flagrantly unlawful profiteering," Brown told the court about the centre in her opening remarks.
"We say this case is really about advancing the self-interest of the plaintiff clinics at the expense of the continuation of the public health-care system."
Brown said private facilities hurt the overall medical system by "skimming" the easiest, most profitable cases from the patient pool, such as those needing hip and knee surgeries, while leaving the complicated, costly procedures to the public system, like brain and heart procedures.
Private facilities also use "bait-and-switch tactics" by overestimating public wait times and lowballing initial price quotes, and allow those with money to jump the queue ahead of patients who may have a greater need for treatment, she added.
Lawyer Alison Latimer addressed the court on behalf of another intervener group consisting of doctors, pro-medicare groups and patients she described as "some of the most vulnerable beneficiaries of B.C.'s universal public health-care system, who stand to lose the most in this case."
They include a former head of a provincial group of people living with AIDS and HIV, as well as a past co-chair for the B.C. Coalition of People with Disabilities, who was forced to resign for health reasons and now lives mostly off a disability pension.
The hybrid model proposed by the Cambie centre would create a "perverse incentive" for doctors to keep public wait lists long in order to drive patients toward the more lucrative private system, Latimer said.
A misplaced focus on expanding private health care diverts valuable time and energy from evidence-based strategies to improve the public system, she added.
Latimer said the court would also hear from several expert witnesses, including David Himmelstein, a medical lecturer at Harvard University and specialist in comparing the U.S. and Canadian health-care models.
The B.C. Anaesthesiologists' Society is another registered intervener in the case but has not given an opening statement.
The federal government will provide input into the case, but its lawyers aren't expected to begin making arguments for several months. The trial is scheduled to carry through to at least February 2017.