Fraser Institute Senior Policy Fellow Nadeem Esmail believes all British Columbians were the losers of a B.C. Court of Appeal decision that upheld the ban on private health care..In an interview with Western Standard, the Vancouver resident said judges got it wrong on July 15 when they said the ban on private health care did more good than harm..“This is not the road to the destruction of Medicare. In fact, having allowed the private sector to form in British Columbia as a parallel stream would have led to a better Medicare system for all British Columbians,” Esmail said..“Clearly, all of the systems that are better than Canada's in the developed world have a private parallel healthcare system.”.Esmail studied the topic for years. He said he still believes the title of his report “Paying More, Getting Less” sums it up well..“We have a health care system that isn't delivering for Canadians, that costs taxpayers one of the highest bills in the world for a universal access health care system, and yet delivers care that is mediocre to terrible when it comes to access,” Esmail said..“We don't have a great healthcare system, our policy structure is unique. And it's well time we moved beyond this old Canadian idea that we must have government dominate everything in healthcare in order to have universality. It's simply not true.”.OECD data shows Canada has just one bed for every 400 citizens. A 2021 Commonwealth Fund study found Canada had the worst performance score of among ten high-income countries with universal health care systems. Esmail says a private market would address the shortfalls..“Where waiting lists are exceedingly long, you would likely see a higher level of private activities, simply because that's where a larger number of people are not being looked after in a time frame that provides comfort and peace of mind, if not in a time frame that is medically reasonable,” Esmail said..“Alberta [and] Saskatchewan, under a very successful initiative to reduce waiting lists, [offered some] access to private sector and privately owned clinics to deliver publicly funded services.”.Esmail said Canadians who think it’s either our way or the American way are wrong..“We're stuck in this false dichotomy where there's the Canadian universal way of doing health care and the American private, non-universal, and it's just not an accurate reflection or an honest reflection of the reality of how some of the world's highest performing universal access health care systems are structured,” Esmail said..“When we look at countries like Australia, Sweden, and even the United Kingdom, we have better universal access health care systems in these countries that cost less than Canada's do, because, in part, they have that option to seek care privately.”.The Canadian Constitution Foundation echoes Esmail’s calls for reform. The CCF dedicated a web page to highlight the legal challenge on the private health care ban made by Cambie Surgery Centre and four patients. CCF Executive Director Joanna Barron expressed disappointment at the decision by the B.C. Court of Appeal to uphold the ban..“[O]ur heart goes out to the patients who have suffered on endless government wait lists while their health deteriorates,” Baron said in a statement..“We disagree this bizarre form of social cruelty that traps patients in a dysfunctional government monopoly can be justified by the principles of fundamental justice.”.In 2005, the Supreme Court of Canada agreed with Quebec physician Jacques Chaoulli that his province’s ban on private health care was unconstitutional. Chief Justice Beverley McLaughlin wrote, “Access to a waiting list is not access to health care.” But that landmark decision had a limited impact, according to Esmail..“The climate for those wishing to deliver a private parallel service in Canada is not very friendly. All we have is the Chaoulli decision that says you can do it under certain conditions in Quebec, and it's been interpreted very conditionally throughout the country.”
