Canadian orthopedic surgeon Dr. Brian Day may spend more time in the courtroom than the operating room.
For the past three years, Day has been arguing that Canadians should have a right to private healthcare before British Columbia's Supreme Court. His trial ended last month. A ruling could come as early as December.
If Day prevails, Canadians could finally gain the ability to access timely care—something their government routinely denies them. But win or lose, his case illuminates for Americans the pitfalls of government-run healthcare.
In 1996, Day opened the Cambie Surgery Center, a private clinic in Vancouver, British Columbia, intending to provide efficient, high-quality care. Some of his patients are not covered by the province's single-payer system—like members of the Royal Canadian Mounted Police. Others are receiving procedures paid for by workers' compensation insurers, who want to get injured beneficiaries back on the job as soon as possible.
British Columbia prohibits clinics like Cambie from charging beneficiaries of the province's single-payer plan for procedures deemed "medically necessary" by the government.
For more than a decade, Day has fought these restrictions. Last month, the provincial government tried to clinch victory with a series of "expert" testimonies.
Things didn't go as planned. Dr. Jeffrey Turnbull, an Ontario doctor and former head of the Canadian Medical Association, admitted under cross-examination that there was "no evidence" to suggest private clinics had lower-quality care.
The government's star witness, Dr. Gordon Guyatt, fared just as poorly. A long-time pro-Medicare activist and researcher at McMaster University in Hamilton, Ontario, Guyatt has previously claimed that wait times are "a problem that may be much smaller than we imagine."
During the trial, he admitted he was unfamiliar with the realities of healthcare in British Columbia. He's right about that. Last year, the median wait between referral by a general practitioner and receipt of treatment from a specialist in British Columbia was over 23 weeks—more than double the wait in 1993.
These queues are more than an inconvenience. Patients often wait in pain, unable to work. Last year, Canadians waiting for medical treatment lost more than $2 billion in wages.
Officials in British Columbia argue that their ban on private care guards against the development of a "two-tiered system," where rich Canadians can pay for quicker private care. They say such a system would divert resources from public hospitals and the Canadians who rely on them.
That argument is off-base. For starters, Canadians already pay a lot for healthcare. The average family of four pays just over $13,300 a year in taxes to underwrite the cost of the nation's healthcare system.
Additionally, Canadians already have access to a "second tier"—the U.S. According to SecondStreet.org, a think tank, Canadians took more than 320,000 trips abroad to receive care in 2017. Plenty of those trips were just south of the border.
Even Dr. Guyatt admitted it was an "overstatement" to claim private care could "bring down single-tier Medicare."
By prizing equity in healthcare, British Columbia's leaders seem to believe it's more important for their subjects to be equally miserable than to ensure they receive the care they need.
Fifteen years ago, Madam Chief Justice Beverley McLachlin of the Canadian Supreme Court seemed to take issue with this line of thinking. In her opinion invalidating Quebec's ban on private insurance, she wrote, "Access to a waiting list is not access to health care."
Lifting restrictions on private clinics would help Canadians access care. Day claims private clinics like his perform over 60,000 surgeries and save the Canadian government more than $300 million each year. The judge in Day's case has been among the beneficiaries—he underwent sinus surgery at a private clinic.
As Day fights to give his countrymen a way out of single-payer healthcare, the Canadian left is trying to further socialize the country's healthcare system. Prime Minister Justin Trudeau is making a new national prescription drug entitlement a core element of his pitch to voters in this fall's elections. The New Democratic Party, which is to the left of Trudeau, has called for free vision and dental care in addition to prescription drugs.
The American left is following suit. Six Democratic presidential hopefuls are on record supporting "Medicare for All," which could run $40 trillion over 10 years.
Day's saga, not to mention the poor care countless Canadians have been subjected to, demonstrates the dangers of Medicare for All. If the good doctor prevails—and if Medicare for All takes root in the U.S.—Day's clinic may have a crop of new American customers looking to escape long waits and rationed care in their home country.
Sally C. Pipes is president, CEO and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute, a conservative think tank.