Opinion: The latest Supreme Court health care decision is a huge opportunity lost
April 27, 2023
Tony Felll is a former chair of the University Health Network and a fundraiser for the Cambie Clinic constitutional challenge.
The recent decision by the Supreme Court of Canada not to hear a constitutional challenge regarding surgical wait times in British Columbia is a travesty, a dereliction of duty and a huge opportunity lost. With all the turmoil in our hospitals and record surgical wait times, the case submitted by Dr. Brian Day and the Cambie Surgery Center in BC was highly anticipated as a chance to fix a broken and costly system.
Chief Justice Richard Wagner and his fellow judges should understand that their refusal to hear this case (or even explain their rationale for the refusal) has cost the Supreme Court considerable public credibility and respect. Canadians rightly expect and deserve strong leadership from their highest court on major national issues. This cop-out makes it apparent we have a timid and politicized court, which does not augur well for the future of this country.
This decision enshrines a dual health care system in Canada: one for Quebec, with private insurance and care permitted by the Supreme Court’s Chaoulli decision in 2005; and one for the rest of Canada, with private insurance and treatment prohibited by federal and provincial law. How does the Supreme Court reconcile this?
It gets even worse. Under present federal and provincial laws, a private for-profit or not-for-profit surgical clinic in any province is not permitted to treat patients from that province, but can instead welcome and treat patients from any other province or from outside the country. Many Ontario patients cross over to Quebec for procedures and MRIs and thousands of Albertans go to BC for surgery. Private MRIs are legal in most provinces, but not in Ontario. How dysfunctional is that? It’s particularly frustrating that the Supreme Court judges and federal politicians who force these regulations upon us are themselves exempt from such laws.
Those in government and in the courts who refuse to accept the need for some private-sector involvement are mired down in a socialistic political dogma of the past. Even Russia gave up its state-monopolized health care system in 1996 and now it runs a growing private sector. In addition, many democratic countries, including Australia, South Korea, Britain and Denmark all successfully operate health care systems that have robust public and private options.
It’s of interest that over the past year the federal government has twisted itself into a pretzel to ensure there are four strong, competitive players in Canada’s telecom industry. It correctly believes that strong competition provides lower prices, better service and innovation. The government has also shown its displeasure for a perceived lack of competition in the grocery business.
Why, then, does this same government insist on having a total monopoly on medically necessary services and prohibiting private-sector competition via the law? How does the government reconcile this? The answer is, it can’t. It is evident that in Canada, Trump’s self-serving politics is a good public policy every time.
By denying private-sector involvement in our health care system, governments exclude all the benefits that businesses could contribute to Canadians’ well-being with complementary and innovative care. Governments are being forced to pour tens of billions of dollars of additional funding into our dysfunctional and high-cost health care system instead of using that money for our universities, public infrastructure or military, which are all starved for funds and are in serious decline. This policy only reinforces the downward spiral of Canada’s economic vitality, which has been evidenced by our abysmal productivity and growth in per capita GDP for the past many years.
Is it any wonder many Canadians are giving up hope and just don’t care about the country’s direction any more? In Canada, we haven’t been able to significantly increase our flow of free trade; we can’t reform health care, which is, by far, our largest industry; we haven’t been able to get rid of supply management; and we can’t seem to get projects building pipelines or LNG plants off the ground. But we can, somehow, quickly implement daycare, pharma care and dental care programs, along with a whole array of costly new socialistic initiatives, all financed by big deficits.
With the Supreme Court opting out of the health care file, there are those who say we should turn to voters and governments to implement change. What a pipe dream that is – we’ve had 20 years to implement health care reform but conditions and wait times have gotten progressively worse.
This Supreme Court decision confirms Canada has indeed become a land of disappointment, pessimism, division and unfulfilled promises. Compared with the 50 years after the Second World War, when our country was filled with optimism, energy, excitement, big ideas, big projects, pride in our military and, most importantly, our national purpose, it’s an incredibly sad story of potentially irreversible decline.