B.C. health clinic slapped for private billing vows to continue challenge

The Cambie Surgery Centre is seen in this undated Google Maps image.

VANCOUVER -- The president of a health clinic in British Columbia is vowing to continue his legal fight to allow the public to access private care, in the face of a ruling this week that ordered two facilities to stop illegally billing patients.

An audit by the B.C. Medical Services Commission found Cambie Surgeries Corp. and the Specialist Referral Clinic, both owned by the same company, illegally billed patients for services funded under the provincial health plan.

But Dr. Brian Day, president of Cambie Surgeries Corp., said Thursday his lawyer will file an amended statement of claim early next week as part of a 2009 lawsuit that argues Canadians have a right to timely health care that's not being provided in the public system.

The developments in B.C. come after a similar lawsuit was launched in Alberta by two people who say they were forced to pay for care in the United States because they couldn't get it in a timely fashion at home.

Both follow a Quebec case that saw the Supreme Court of Canada strike down that province's ban on private insurance for medically necessary services.

"The ultimate outcome from what we're fighting for will be the end of wait lists," said Day.

"When we change the system to allow competition, wait lists will go away."

B.C.'s Ministry of Health declined to comment on the court action Thursday, saying it would be inappropriate to comment on an issue before the courts, particularly for a statement of claim that has yet to be filed.

Vanessa Brcic, the executive board member of Canadian Doctors for Medicare, said issues such as wait lists can be resolved within the public system and without developing a parallel for-profit system.

"If you start delivering care within the for-profit system, you're basically allowing certain Canadians to bypass the wait lists and buy their way to the top of it," said Brcic, a family practice physician.

"So you're providing better access to a very select group of people, and in turn, providing worse access to everyone else."

The lawsuit was originally filed against the B.C. government in January 2009. Six companies, including Cambie Surgeries Corp., say B.C.'s Medicare Protection Act is unconstitutional because it prevents patients from receiving timely and reasonable access to health care.

Day said his amended statement of claim will name Cambie Surgeries Corp. and three patients, including two children and one cancer patient, as plaintiffs.

He said the provincial government will have to argue that patients suffering on wait lists in the public system should have no alternatives, and residents of B.C. should not have the same freedoms as people in Quebec.

A 2005 decision by the Supreme Court of Canada struck down a Quebec law that banned private insurance.

Recently in Alberta, Dr. Darcy Allen and Richard Cross also filed separate applications in Alberta's Court of Queen's Bench, questioning the province's ban on private insurance.

Day said medicare was set up in Canada to look after the poor and underprivileged, but those groups have the worst health outcomes and he argued medicare is not fulfilling its mandate.

He also pointed to public-private parallel systems that operate in Germany, France, Belgium, Switzerland and Holland.

The poorest in Switzerland get instant access to consultations, investigations and tests under a private system, he said, adding that the government pays the insurance premiums of the poor, ensuring they receive the same health care as the rich.

"We're under this delusion that health care has to be run by the government. It doesn't. It has to be regulated by the government, otherwise you get this dysfunctional system as in the United States," he said.

"But it does not have to be funded by a public insurance company.

Brcic, of Canadian Doctors for Medicare, said she doesn't doubt Day wants to provide better care for his patients, but she said he's not providing better care for all patients.

She said wait lists can actually grow longer under a system proposed by Day, because doctors and nurses leave the public system for the private system, resulting in fewer public resources to deal with wait lists.

Brcic also said another problem develops in which for-profit clinics deliver services to the healthiest and wealthiest looking for simpler procedures.

The more complex and expensive cases, which take more time, are left for the public system, she added.

"Our obligations as physicians is to look after our practice population, and the obligation of our governments are to look after the entire Canadian population, not just those who can pay," said Brcic.

Peter Gall, the lawyer for Cambie Surgeries Corp., said he hopes the case will be heard early next year.

On Wednesday, B.C. Medical Services Commission chair Tom Vincent announced an audit had found more than 200 cases in which Cambie Surgeries Corp. and the Specialist Referral Clinic billed patients for medical services that are already publicly-funded under the provincial health plan.

The bills for the services totalled almost $500,000. and Vincent said the practice violates the B.C.'s Medicare Protection Act.

He said the commission has no power to impose financial penalties or recover funds from the clinics, but the commission ordered the clinics to stop.