Ontario docs are leaving – patients have trouble finding good doctors











{August 21, 2012}   DR. BRIAN DAY CONTINUES FIGHT FOR PATIENTS’ RIGHTS
  1. Behind my legal challenge, and why it matters so much

     
    Written by Dr. Brian Day on August 20, 2012 for CanadianHealthcareNetwork.ca
     

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    by Dr. Brian Day

    “When we look to the evidence rather than to assumptions, the connection between prohibiting private insurance and maintaining quality public health care vanishes. The evidence before us establishes that where the public system fails to deliver adequate care, the denial of private insurance subjects people to long waiting lists and negatively affects their health and security of the person. The government contends that this is necessary in order to preserve the public health system. The evidence, however, belies that contention. . . . The evidence shows that delays in the public health care system are widespread and patients die as a result of waiting lists for public health care.” —Supreme Court of Canada, Chaoulli decision, June 2005

    The optics of our clinic (the Cambie Surgery Centre in Vancouver) challenging B.C. provincial laws, which force patients to wait and suffer (and sometimes die), has taken on a new perspective as patients have joined our lawsuit.

    (Earlier this summer, the Medical Services Commission announced an audit had found 205 incidents where the Cambie Surgery Centre violated the Medical Protection Act by billing for services covered by medicare. Dr. Day’s clinic is challenging this ruling in court.)

    B.C. laws, which mirror similar legislation in other major provinces (excluding Quebec), have been shown to sometimes impose a death penalty on innocent victims through rationed access to care.

    In the Chaoulli case, the Supreme Court of Canada simply brought Quebec in line with the laws of the other 196 countries. Our purpose in the current litigation is to ask that B.C. patients have the same protection under the laws of Canada that were granted to Quebec residents.

    We will ask the Court to reject enforced rationing as a government strategy to achieve health-care sustainability.

    When Patrick Monahan, former dean of the Osgoode Hall Law School in Toronto, and co-author Stanley Hartt wrote, “…We conclude that where the publicly funded system fails to deliver timely access, governments act unlawfully in prohibiting Canadians to use their own resources to access those services privately,” they were answering the question we will now pose before the courts.

    Patients suffering, and in need of care, should not be prevented from using their own resources to alleviate their pain.

    Each of the four patients joining us as plaintiffs in the constitutional challenge has suffered as a result of laws that, we believe, violate the Canadian Charter of Rights and Freedoms. They are just four of the millions of Canadians who have suffered irreversible harm as a direct result of such laws. Let me summarize our patients’ stories.

    • Chris Chiavatti suffered from a serious knee joint injury at school. Delayed treatment caused him significant harm and damage, and he would have suffered even more if his care had not been expedited through treatment at Cambie Surgery Centre. If his teacher had suffered an identical injury in the same school gym, that teacher would have received immediate investigation and treatment through the Workers’ Compensation Board.

    • Mandy Martens, a young woman in her 30s, was concerned about blood and mucus in her stool. She faced unacceptable delays under the public system, and underwent a colonoscopy at our centre. She was diagnosed with colon cancer and has undergone successful treatment as a result of the earlier diagnosis.

    • Krystiana Corrado, a 17-year-old student and an elite soccer player, injured her knee ligaments during a game. After a prolonged wait for a specialist consultation at B.C. Children’s Hospital, she learned she was above the age limit for that institution and faced another 18-month-delay. Following treatment at Cambie Surgery Centre, she has reduced her risk of increased knee damage and regained the chance to qualify for a soccer scholarship.

    • Erma Krahn is a 79-year-old with metastatic lung cancer. Her estimated life expectancy is between several months and two years. Despite this diagnosis, she had been able to remain active, even playing golf until she sustained a torn knee meniscus. She has been in pain disabled since then. An 18-month wait for care in the public sector represented a life sentence. She has undergone treatment at our centre and will enjoy a better quality of life for her remaining years.

    In a free and democratic society, patients should not have to sue for access. It is often said by supporters of the status quo that no one should be denied access to health care based on their ability to pay. It is equally unacceptable to be denied based on governments’ inability to deliver promised care.

    The Supreme Court of Canada has given prisoners the right to vote. Is it not time that non-jailed citizens were given reciprocity with another “right” that prisoners have—namely the freedom to bypass the public system and access non-government care?

    We believe this challenge is one of the most important legal actions ever embarked upon in Canada. Our hope is that the irrational debate and rhetoric that have prevented objective discussion and decision-making by governments in Canada will be resolved by the dispassionate process of our legal system.

    A 2007 survey of Canadian doctors by the Medical Post revealed that an astounding 24% had experienced patients dying while on a wait list. Those who support the status quo should reflect on the findings of the Supreme Court of Canada. They should question whether they are guilty of complicity in causing Canadians to suffer, and sometimes die, as they are forced to wait for care.

    Dr. Brian Day is a Vancouver-based orthopedic surgeon who served as President of the Canadian Medical Association in 2007-08.

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