The decision in a BC case seeking to strike down laws limiting private health care (including private insurance and extra billing) comes out tomorrow (apparently at 1pm). The decision is a rumoured 800 pages, but I will summarize and dissect it on twitter starting at 1.
For those not familiar with the case, Brian Day, a doctor who founded a private surgical facility in BC, is arguing that the combination of 1) wait times, and 2) limits on private care (similar to those in Alberta) violate the Charter rights to life and security of the person.
The court is likely to agree that waiting for care can, in some cases, threaten a patient's life and, due to the physical/psychological effects of waiting, violate security of the person. The SCC agreed with these arguments in a 2005 Quebec case (Chaoulli).
However, rights to life and security of the person aren't absolute. Dr Day also has to show that those deprivations are not in accordance with the principles of fundamental justice, which will be challenging. These principles include things like arbitrariness and overbreadth.
In determining whether BC laws limiting private $ are arbitrary, overbroad, etc., the court will look at international experiences with two-tier care.
In a previous Quebec case (Chaoulli), the Supreme Court was divided on this international evidence. 3 felt that the gov was acting to protect the public health care system, while 3 judges felt that countries with 2-tier care have successful health care systems.
One of the main critiques of Chaoulli was that the role of the court is not to assess different health system models and pick which one they think is best. Also, you can't simply take the manner in which another country finances health care and import it into Canada.
The Alberta gov will, no doubt, be watching this case closely. Kenney discussed the Quebec case in the middle-of-the-night Bill 30 debates, suggesting that it supported his argument for private delivery.
The gov has also shown hints of receptiveness to private finance. The Fair Deal Panel was critical of the Canada Health Act, which helps limit private $. The UCP also voted at its annual meeting not to reject policy proposals merely because they violate the Canada Health Act.
A few people asked about the principles of fundamental justice (POFJ) that I mentioned earlier. Day has to show that limits on privatization engage the rights to life/security of the person and that these limits are not in accordance with the POFJ. I put together a brief summary:

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More from @Lorian_H

10 Sep
A summary of and some thoughts on today's decision upholding BC's limits on private health care...
The plaintiff argued that the combination of long waits and limits on private care violated Charter. The Court found that "there is in fact expert evidence that wait times would actually increase" with privatization.
As expected, the court agreed that waits could engage the Charter-protected right to security of the person. Specifically, court noted that some patients wait longer than provincial benchmark to receive care.
Read 34 tweets
22 Aug
Let's examine the claims in this opinion: calgaryherald.com/opinion/column…
As with others making similar arguments, the author points out the surgeries already being performed in private facilities. The fact that something is already done doesn't make it a good idea. This is a huge expansion in the # and nature of private surgeries.
The author claims that there's no evidence the surgeries done in private facilities in Alberta are of lower quality. This is true. However, there's also no studies they are of equal or better quality. And there is evidence about lower quality for-profit care in other contexts.
Read 12 tweets
10 Aug
Alberta in discussions re: large private orthopedic facility. Some thoughts...cbc.ca/news/canada/ed…
270,000 sq ft private ortho hospital to be built in Edmonton. Plan is to send all ortho cases there other than emergencies. All nurses and other staff will be non-unionized (@UnitedNurses).
Concerning that AHS seemingly frozen out of these discussions even though they are responsible for delivering health services in the province.
Read 12 tweets
6 Aug
Some thoughts on this opinion. I apologize for sounding like a broken record since I just did a similar thread on a Sun opinion, but these flawed arguments keep popping up... calgaryherald.com/opinion/column…
In retweeting this opinion, Kenney urges followers to listen to the views of one single dr, despite the fact that the majority of Alberta's drs do not seem to support this legislation. Also, this gov seems pretty determined not to listen to the views of drs, so why start now?
This opinion correctly condemns the racist incident at Grande Prairie hospital, which was a failing at many levels (AHS, college, etc.). However, increasing public representation in colleges would have been highly unlikely to have prevented this.
Read 9 tweets
29 Jul
Bill 30 is again being discussed in the legislative assembly. Some thoughts...
The government again claims to care about transparency, yet there was no interest in salary disclosure until tensions rose between drs and the government.
While it is true that private facilities may provide physical space for additional surgeries, those surgeries also require additional health professional hours. Where will those come from?
Read 36 tweets
28 Jul
Up late watching the Health Statutes Amendment Act debate. Some thoughts...
Ridiculous that the government is acting like disclosing compensation is about transparency. If they cared about transparency, they would have done compensation disclosure long before they were losing in the court of public opinion and were scrambling to regain the upper hand.
Hypocritical for the government to be complaining about how much drs make when their own salaries and those of their issues managers are so bloated compared to other provinces.
Read 41 tweets

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