It’s often been said that there are only three countries in the world where it is illegal to pay for your own health care: Cuba, North Korea and Canada.
I’m not sure if it’s strictly true. There may be a few other tin-pot dictatorships where access to life-saving procedures is held in the iron grip of a state monopoly, and buying private health insurance is an offence.
Here in B.C., the discussion remains trapped in a false narrative where we are good, the Americans are bad and the rest of the world doesn’t exist. Our politicians talk about protecting “Medicare,” seemingly unaware that this is actually the name of a U.S. program. B.C. has legislation misnamed the “Medicare Protection Act” to protect the monopoly.
Vancouver surgeon Dr. Brian Day continues to push for the mixed option in court, with federal and provincial government lawyers arrayed against him every step of the way. The constitutional battle for the right to pay for your own care was won years ago in Quebec, but somehow that hasn’t translated to other provinces.
Day’s lawyers have applied for an injunction against new penalties being brought into effect by Health Minister Adrian Dix. As of Oct. 1, extra billing for any procedure covered by B.C.’s Medical Services Plan could result in a $10,000 fine for the first offence and $20,000 for the second, along with refund of the extra billing.
These provisions were passed into B.C. law in 2003, but were not enacted. Then-premier Gordon Campbell provided an affidavit to Day’s court case to explain why. Barring private clinics while the public system can’t keep up with demand produces one of two outcomes: the patient waits, or goes to the U.S. or another country for treatment.
As premier, Campbell conducted the “conversation on health” to try to include the reality of today’s world. Across Europe, private and public health care coexist and the results are generally faster care and lower costs.
Here, no hospital can even tell you the cost of a heart surgery, because it’s un-Canadian to talk about money. Here, you wait in line for an MRI scan to see if you need surgery, but your dog can go right in as soon as you whip out your credit card.
And that’s not even discussing the arbitrarily non-essential matters like dental care and suffering-relieving treatments like massage and chiropractic therapy that Canadians are allowed to carry insurance for.
Dix shows the ideological rigidity one would expect from an NDP MLA from East Vancouver. One of his earliest moves as health minister was to ban payment for blood plasma donations in B.C.
This preserves the long-standing practice of importing plasma from paid blood donations in the U.S., since Canadians come nowhere near to donating enough blood to meet the demand for expanding blood product treatments as well as whole blood transfusions. There is no practical effect of the ban, other than an aura of ideological purity for Dix and his colleagues.
Social media comments on Campbell’s involvement in the Day case sum up the entrenched public attitude. Some say B.C. should simply raise taxes on the rich until the problem is solved. In fact, this would push more people to the U.S. permanently, rather than just to get their knees fixed.
Missing the point perfectly, one asked: “So the pain of the wealthy is worse than the pain of the poor?”
No, their pain is equally valued. That’s why it’s important to find the most efficient way to ease it.
Tom Fletcher is B.C. legislature reporter and columnist for Black Press. Email: tfletcher@blackpress.ca
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