Dr. Day’s marathon to commercialize health care

He may be down but he’s not out. Dr. Brian Day has lost court case after court case but he’s not giving up. I’ve got to hand it to Dr. Day for his perseverance.

image: Eoin Kelleher

He started 13 years ago and isn’t finished yet.

He started his mission in 2009. In echoes of today’s economic turmoil, the Great Recession cast a cloud over the land and Stephen Harper was prime minster. The number one song in Canada was I Gotta Feeling by The Black Eyed Peas.

Dr. Brian Day launched his lawsuit after he learned his clinics were going to be audited by the B.C. Government. The audit was triggered by dozens of patients who complained that they’d been illegally overbilled at Day’s Cambie clinic.

Dr. Day figures that the best defence is an offence. As soon as he learned that the province was going to check into his illegal billing, he launched a court case arguing that B.C.’s Medicare Protection Act violated patient’s freedom under Canada’s Charter of Rights and Freedoms.

It’s so typical. Whenever someone is up to no good they throw up a smoke screen. The guy who’s caught speeding? He’s not breaking the law; he’s taking his terminally ill child to the hospital.

After years of legal delays, the audit by the B.C. Government in 2012 uncovered 170 instances of extra-billing to patients which were contrary to the Act. The audit only sampled 468 services over 10 years, so there were probable many more.

The investigation also uncovered 93 instances of “double-dipping”, in which 19 doctors including Dr. Day charged a total of $66,734 to the province while charged patients $424,232 for the same treatment.

Oh no, said Dr. Day in his defence, we don’t charge patients for treatments, we charge them for “consulting fees,” and “facility fees” for equipment and staff. And no, we don’t pay doctors extra beyond what any doctor would bill the provincial Medical Services Plan.

Financial records later filed in court showed that wasn’t true.

They showed that clinics, including Dr. Day’s,  paid 140 people, mostly doctors, $1.5-million or more per year in “consulting fees,” over five years. That included a total of $1.36-million paid to Dr. Day during that period.

Dr. Day is soldiering on, determined to create a two-tiered health care system in which doctors are pulled out of public health care into lucrative private practices.

British Columbia’s highest court recently upheld a lower court’s ruling that countered Dr. Day’s claim that Canadians should have the constitutional right to pay for private health care. B.C. Supreme Court ruled that Dr. Day’s model would undermine the very basis of universal health care.

In the ruling, the B.C. Supreme Court supported the value of public good.  It’s a concept that greedy heath care salesmen don’t understand. It’s like those “freedom fighters” who don’t get the concept of public good. Public health during a pandemic is paramount; individual rights to refuse a vaccine are outweighed by the need to protect all.

But Dr. Day will continue to try to undermine our health care system which, while struggling, is superior to any private system.

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Fear Dr. Day

Supporters of health care held their collective breath last month as the votes were counted in the election for the president of Doctors of BC. This was a runoff vote; the first one ended in a tie.

Dr. Alan Ruddiman, OPD Newsfeed

The candidates for president couldn’t have been more different in their vision for healthcare. Dr. Ruddiman wants to preserve our universal system in which patients are treated regardless of their ability to pay. His opponent, Dr. Day wants to set up a two-tier system in which wealthy patients buy treatment.

To the relief of everyone, Dr. Ruddiman won by a substantial margin although the turnout was only 50 per cent. Shortly after winning the physician from Oliver urged his colleagues to take a stand in defence of public health care. “It is fundamental that the medical profession take a firm stand for our publicly funded health care system (Globe and Mail, June 23, 2015)”

However, it’s too early to break out the champagne just yet. Dr. Day is determined undermine publicly funded health care and he doesn’t have to be president of Doctors of BC to do it. The B.C. Ministry of Health found that Dr. Day had been illegally charging patients. In one month alone, his Cambie Surgery Centre had billed patients $500,000.

Billing patients is illegal. The Medicare Protection Act of B.C., which parallels the Canada Health Act, states that the goals are to “preserve a publicly managed and fiscally sustainable health care system for British Columbia in which access to necessary medical care is based on need and not an individual’s ability to pay.

In retaliation to the audit from the B.C. Ministry of Health, Dr. Day launched a court case against the provincial government alleging that the Medical Protection Act violated his rights under the Canadian Charter of Rights and Freedoms.

In a warped sense of justice, Dr. Day sees himself a victim of a single-payer system. Wait times could be reduced, he argues, if patients were allowed to pay for treatment.

On first consideration, Dr. Day’s argument seems to make sense say Drs. Duncan Etches and Michael Klein. “At first glance, it might seem logical that allowing patients to pay privately at for-profit clinics would take paying patients off public wait lists, allowing others to move up the list faster (Monitor, a magazine from the Centre for Canadian Policy Alternatives, March, 2015).”

If it weren’t illegal, if there were an unlimited number of doctors, the argument might make sense. But there is a limited number of doctors. Because some surgeons work in both the private and public systems, for-profit clinics make surgeons unavailable in the public clinics; a phenomenon known as “crowding out” that can be seen in Quebec and Australia that have two-tier systems.

Also, private clinics skim off easier cases leaving difficult ones to the now underserved public system.

Even without the threat from Dr. Day, insidious corporate growth eats away at our healthcare says Dr. Ruddiman. “The threats of the corporatization of medicine and the barriers of layered administration that now exist in delivering efficient health care are a threat to the very ethos of medicine and indeed the profession.”