ATTENTION: This is a beta website, the final version will look significantly different. Thanks for bearing with us while HJM is under construction! Posts can now be found here.

British Columbia rules health care access to be based on need and not ability to pay

September 11, 2020

Topics: Quote of the Day

Business Wire, September 10, 2020

In today’s landmark ruling in the Cambie Surgery Centre case, Justice Steeves dealt a strong blow to the efforts of Dr. Brian Day and others to undermine Canada’s publicly-funded health care system. The decade-long legal attack launched by one of the largest for-profit surgical centres in Canada sought to invalidate key sections of the BC Medicare Protection Act (MPA). This decision ensures that access to health care will continue to be based on need and not on ability to pay.

“This is a historic victory against profit-driven health care in Canada,” said Dr. Danyaal Raza, Chair of Canadian Doctors for Medicare. “We know that single-payer publicly-funded health care is the fairest way to pay for health care, rather than forcing patients to pay out-of-pocket or buy private insurance. This case was never about wait times – it was always about profit.”

The sections of the MPA that the plaintiffs sought to strike down are in place to preserve a public health care system in which access to necessary medical care is based on need and not an individual’s ability to pay. This case has always been about increasing profits for doctors and investor-owned health care facilities.

“As a group of patients, doctors and health care advocates, we became involved in this case in order to defend and protect public health care,” said Edith MacHattie, co-chair of the BC Health Coalition. “This is a victory for everyone who uses health care in Canada. Even though the attack had been launched in BC, it took aim at the very heart of the Canada Health Act and every provincial health care insurance plan.”

Justice Steeves’ ruling affirmed that access to health care be based on need and not the ability to pay. He wrote that the sections of the MPA challenged in this case are in keeping with the “objectives of preserving and ensuring the sustainability of the universal public healthcare system and ensuring access to necessary medical services is based on need and not the ability to pay.”

The recent public health emergency caused by COVID-19 has underscored just how important our public health care system is. This decision protects our ability to endure crises and care for one other into the future.



Cambie Surgeries Corporation v. British Columbia (Attorney General), 2020 BCSC 1310
September 10, 2020

From the Summary of Judgement

[21] In the context of a complex social program such as healthcare where there is a need to balance conflicting interests and claims over limited resources, a high degree of deference is owed to the government under s. 1 (paras. 2885-2893, 2898, 2922, 2931, 2936). Bearing this in mind, I find that the objectives of the impugned provisions, preserving and ensuring the sustainability of the universal public healthcare system and ensuring access to necessary medical services is based on need and not the ability to pay, are pressing and substantial (paras. 2895-2903). I also find that there is a rational connection between deterring the emergence of a competitive duplicative private healthcare system and these objectives (paras. 2904‑2909). Finally, the evidence also supports the defendant’s claim that the impugned provisions are minimally impairing and their effects are proportionate to their objectives (paras. 2910-2934).

[22] Thus, even if I had found a violation of ss. 7 or 15 of the Charter, I would have nonetheless concluded that the impugned provisions are a reasonable limit on those rights and are demonstrably justified in a free and democratic society under s. 1 (paras. 2935-2937).

[23] The plaintiffs’ claim is dismissed (paras. 2938-2940).

The Honourable Mr. Justice Steeves



By Don McCanne, M.D. 

This landmark decision has preserved Canada’s single payer health care system, ruling against the establishment of a two-tiered, parallel private system, which basically would allow higher fees in the private system plus an avenue for the wealthy to bypass the public queue.

One of the more important findings is that relieving the public sector of the private patients would not shorten the public queue, but, in fact, would lengthen it. It would have opened the doors to U.S.-style profit-driven care. Instead, health care will continue to be based on need and not the ability to pay.

The legal process has been exhaustive – the British Columbia Supreme Court phase of the trial alone began in 2016 – but it is not over. The plaintiff, Brian Day, stated that he plans to appeal, beginning with applying for a stay to prevent his private clinics from being closed.

Although this case may not be over, the cause for health care justice for all has carved another major victory notch. Laws may be made and interpreted by legislators and judges, but the moral authority in a democracy still belongs to the people, though they have to exercise their right to keep it.

Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.

About the Commentator, Don McCanne

Don McCanne is a retired family practitioner who dedicated the 2nd phase of his career to speaking and writing extensively on single payer and related issues. He served as Physicians for a National Health Program president in 2002 and 2003, then as Senior Health Policy Fellow. For two decades, Don wrote "Quote of the Day", a daily health policy update which inspired HJM.

See All Posts

You might also be interested in...

© Health Justice Monitor
Facebook Twitter