The Bans on Private Insurance and Extra Billing are Crucial to Protect Canadian Medicare, says Health Care Expert

For Immediate release

In the lawsuit against public health care currently being heard at the BC Supreme Court, lawyers for the plaintiff, Brian Day, are trying to prove that the introduction of private health care will not harm our public health care system. Read more about the court case here. 

Day’s arguments were dealt a blow this week with evidence from Quebec, where the introduction of private health care has caused severe problems for the administration and delivery of public health care.

Marie-Claude Premont, a noted health care expert from École Nationale d’Administration Publique in Quebec, showed that the restrictions Day seeks to eliminate are necessary to guarantee accessibility and universality of medically necessary health care services. This guarantee is required under the Canada Health Act.  She testified that banning extra billing, private insurance and capping the fees for medically necessary services are the legal mechanisms provinces have used to ensure that everyone has equal access to health care services.

In the BC case, Day is using the Charter to challenge those provisions in the BC Medicare Protection Act. He argues that patients should have the right to buy private insurance in order to obtain private medical care. He also wants the freedom to set his own fees and to get payed by both the public system and privately at the same time.

After the Supreme Court required Quebec to lift the ban on private insurance in 2015, Quebec made several changes to its health care legislation. In an effort to restrict the impact of private insurance, the Quebec government made sure that the ban on extra-billing and fee capping stayed in place. At the same time, it was forced to approve the expansion of private surgical facilities.

Even with these restrictions in place, the changes in Quebec have created a two-tier system where it has been impossible to curtail queue jumping by those with access to private health care, according to Premont. She also pointed out that private clinics are being subsidized by the public system while charging patients extra fees.  And since changing the regulations in Quebec, the number of doctors leaving the public system for private clinics has risen dramatically.

Premont was testifying on behalf of the group of intervenors that are defending public health care, which include the BC Health Coalition, Canadian Doctors for Medicare, two doctors and two patients.

Public health care advocates have long argued that two-tier health care will lead to unequal access and increase costs in the public system, all the while draining the public system of resources. This is happening in Quebec despite legislation and regulations aimed at preventing it.

The Court is expected to hear testimony later this week the importance of accessibility and universality to the overall health of the population. Later they will hear expertise on the high cost of two-tier health care in the United States.


Updates about the court case are here.

Pam Beattie (289) 828-5251

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