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The long-awaited ruling in the Cambie case, Dr. Brian Day’s challenge to British Columbia’s Medicare Protection Act, has upheld the rules that effectively bar private provision of publicly covered medical services. But it does not say whether suppressing privately funded care, as the act seeks to do, is good policy. It is not. Absent some degree of competition from private care, the Canadian health-care system will continue to be both expensive and mediocre in comparison with those in peer countries other than the United States.
Like the courts in the 2002 Chaoulli case, the judge in this case found that long wait times for care could be considered inconsistent with the Charter of Rights and Freedoms’ guarantee of “the right to security of the person.” But he also finds that even if the act does deprive some patients of that right, it is not “contrary to the principles of fundamental justice”: governments believe it is necessary in order to attain two objectives that the public wants. The first is to ensure that “access to necessary medical services is based on need and not the ability to pay.” The second is to protect the publicly funded system, which might not be “sustainable” without laws to suppress “duplicative private health care.”