Supreme Court of Canada dismissal is a win for public health in BC and nationally

Access to quality health care is a fundamental right that should not be determined by one's ability to pay.

And yet, 14 years ago, the CEO of a BC-based for-profit clinic launched a legal battle that aimed to dismantle key protections in the BC Medicare Protection Act ensuring equitable access to care. On April 6, 2023, that battle came to a close when the Supreme Court of Canada released its decision to dismiss Cambie Surgeries Corporation’s application for leave to appeal.

The Supreme Court of Canada’s dismissal upholds the decisions at the BC Supreme Court and BC Court of Appeal that protected the key principles of the BC Medicare Protection Act that ensure patients are prioritized based on medical need and not ability to pay. 

What does the Supreme Court’s dismissal mean?

At the heart of the case was an attempt to strike down provisions in the BC Act that prohibits physicians from extra billing patients whether out-of-pocket or through private duplicative insurance that covers what’s already covered under the provincial health plan. The Act also prohibits physicians from working in “dual practice” to prevent them from giving preferential access to patients who can afford to pay privately. These prohibitions are necessary so that patients are prioritized based on medical need and not ability to pay.

The appellants argued that a duplicative system was necessary to reduce surgical wait times. In fact, studies across the world and in Canada have shown that wait times in the public system increase as physicians and allied health professionals are drawn away from the public system. The landmark BC Supreme Court decision in the case found that the evidence overwhelmingly showed a strong connection between duplicative private healthcare and increases in wait times in the public system. 

While the appellants argued that this case was about an individual's right to access private health care, the reality is the case was about whether for-profit corporations could profit off of people’s health and use the public system to subsidize the cost. There is no ban on private, for-profit clinics operating in BC as long as they do not use the public system to subsidize private practice. 

Now, the court’s dismissal, which upholds the BC Supreme Court and BC Court of Appeal’s decisions, means that the province can finally enforce its own laws around extra billing. 

Where do we go from here?

The Supreme Court decision is a victory for the Canadian Doctors for Medicare, the BC Health Coalition, their members, allies, and the broader public. But, this case doesn’t shut the door on for-profit health care altogether. We need to continue advocating for public solutions and public health policies that strengthen our health care system. At the same time, we continue to raise the alarm in other areas of our health care system where for-profit interests are draining staffing capacity and resources.

For more information on the Cambie case including a timeline of the case, video/print resources, and media links, please go to the website.