In Part I of this series on Canadian healthcare, we learned that waiting times for treatment by a specialist are getting worse. In Part II we will see how one doctor is trying to make things better – with little success.
Dr. Brian Day is an orthopedic surgeon, like myself, and he opened the Cambie Surgery Centre in 1996 with a simple goal: provide timely, state-of-the art medical care to Canadians who were unwilling to wait months – even years – for surgery they needed. Sally Pipes, writing in The Wall Street Journal, says his efforts have met such resistance from the government he has challenged them before the provincial Supreme Court.
Canada’s single-payer healthcare system is known as Medicare. It is notoriously slow with average waiting times from referral to a specialist to treatment now at 21.2 weeks. Private clinics like the one operated by Dr. Day are willing to see these patients sooner, but the government is prohibiting them from charging patients for operations that public hospitals would provide free – if they wait.
Private clinics like Cambie initially sprang up to treat members of the armed forces, Royal Canadian Mounted Police officers, and those covered by worker’s compensation claims. These and other protected classes are exempt from the single-payer system.
Pipes says the waiting times are actually worse than the numbers publically stated. The official clock starts only when a surgeon books the patient, not when a general practitioner makes the referral. That adds months and sometimes much longer.
Many people would gladly pay out of their own pockets to receive treatment sooner. But Canadian law bans private coverage for “medically necessary care” which the public system provides and effectively forbids the private clinics from charging patients directly for such services. Doctors who try to beat the system by accepting such payments can be disqualified from the single-payer system.
Ironically, the government itself has paid private doctors outside the system at times when the demands on the system have been considered unacceptable. Yet the government refuses to allow private citizens to use their own money to do the same.
Dr. Day claims the government has long tacitly approved of patients paying private clinics on their own. Politicians, both conservative and liberal, have privately praised his work while publically defending the single-payer system. Currently, private clinics perform more than 60,000 operations a year, saving the public treasury about $240 million.
The pending suit before the Supreme Court could greatly alter the healthcare system in Canada if Dr. Day prevails. Let us hope that we in America will never have to go to the Supreme Court just to be able to see a private physician even with our own money!