Government funded healthcare was first established in 1947 in Saskatchewan, by Premier Tommy Douglas. This was soon followed by similar programs in Alberta, BC, and Ontario, and eventually expanded to involve all ten provinces.

The Canada Health Act was implemented in 1984, which ensures equal access to healthcare for all Canadians. This applies to all essential services, which includes hospital care, doctors visits and surgical services. What is not considered essential, and is therefore not paid for includes prescription drugs, home care, long-term care, dental care, ambulance transportation, cosmetic surgery, physiotherapy, massage therapy, chiropractic treatment and psychological counseling. Each province decides what services are considered essential.

Healthcare is funded through income tax revenues. Each province administers and funds its own healthcare system. The federal government provides transfer payments to the provinces to help fund healthcare. Physicians are paid on a fee for service basis. Each province negotiates the amount that they pay for these services. Hospitals operate within a fixed budget. As the cost of patient care increases, hospitals are forced to cut costs or reduce services to stay within their budget. This leads to wait lists for services, which vary depending on the medical condition. People with an emergency condition are treated quickly. The government provides extra funding for certain conditions such as cancer care, cardiac care, cataract surgery and hip and knee replacements to reduce wait times. Other conditions that are considered elective such as chronic pain, tonsil surgery, hernia surgery, etc often experience very long waitlists for consultation with a specialist or to receive surgical treatment.

Canada is one of the few countries in the world that does not have a blend of public and private healthcare systems. While Canada has a publically funded system, 75% of healthcare services are delivered privately. Surveys comparing wait times in Canada to other developed countries such as Australia, France, Germany, New Zealand, etc. rank Canada at or near the bottom of the list for access to services such as specialist consultation, elective surgery and diagnostic imaging. The Canada Health Act prohibits patients from paying for insured services but allows Workers Compensation and Veterans Affairs to pay for expedited healthcare services for their members.

There have been two constitutional challenges in the courts relating to access to private healthcare. In 2005, the Supreme Court of Canada ruled that the prohibition against private healthcare in Quebec violated the Charter of Rights and Freedoms. Chief Justice Beverly McLachlin stated in her summary, that “access to a waiting list is not access to Healthcare.” As a result, Quebec has a blend of public and private healthcare services. Dr. Brian Day initiated a similar challenge in British Columbia in 2008, which is still in the courts. The premise is that it is unconstitutional to make someone wait for months or years for treatment of a medical condition if they are willing and able to pay for it.

I am of the opinion that if people want to pay for healthcare they should be allowed to do so. Private healthcare should not replace our public healthcare system. Medical conditions that require urgent or emergent care should be treated in the public system in a timely manner without any cost to the patient. Elective conditions should be available in the public system for those who are willing and able to wait their turn. However for those people who do not want to wait, there should be a private option. People should be allowed to take out alternative healthcare plans to fund the services or pay out of pocket to obtain quicker access to care. The people who are opponents of private healthcare argue that only the rich can afford to pay for it and that jumping the queue is unfair. Those in favor of private healthcare say that allowing people to pay privately will decrease the wait time for those who elect to use the public system. My personal experience is that it is not the rich people who pay for private healthcare. There are many self-employed or hard working individuals who suffer in pain and are unable to work while they endure the long wait lists for consultation with a specialist, for diagnostic imaging (CT or MRI) or for surgery. Making people wait for treatment leads to prolonged disability, emotional and financial stress, depression, narcotic addiction and other unnecessary consequences of the public healthcare system. Freedom of choice applies to everything except healthcare. It is time that people ask our politicians for a change in the way that healthcare is delivered.

The aging population is going to bankrupt our healthcare system. People are living longer and experience more healthcare problems. The per capita cost of healthcare in 1975 was $1, 715. In 2009 it was $4,089 and in 2017 it was $6,321. The cost for people over 80 years of age was $17,469. The cost of healthcare will continue to rise as technology improves and people live longer. Unless there is a change in how healthcare is funded and delivered waitlists for elective services will continue to rise and people will continue to suffer. If you agree that it is time for a change to our healthcare system then talk to your MLA and consider donating to Dr. Brian Day’s legal action. We do not want to replace the current public healthcare system. The most effective way is to adopt a blend of public and private healthcare delivery like most developed countries around the world. The alternative is to implement user fees for all healthcare services or to increase taxes to improve the public system.