Vicious Predator

Canada severely restricts the emergence of a parallel private health care market for services that are covered by their Canadian Medicare system. Private insurance is basically unallowed for services covered by Medicare , and if you are a physician enrolled in Medicare your price is capped at what Medicare sets. You cannot balance bill patients (just like US Medicare). So if you opt out and unenroll as a physician from Medicare, your only market is patients wealthy enough to pay the full cost of a joint replacement. Why the only places in Canada that operate like this are cosmetic surgery / derm . A plucky orthopedic surgeon @DrBrianDay thought he would challenge the system and built a private clinic with 6 ORs in British Columbia because he was being given less and less OR time in the public hospital and his wait times were getting exceedingly long. He ultimately sued the State to allow British Columbian residents to pay to use his facilities (while still enrolled in Medicare), arguing that the ban on private care violated their constitutional rights and being forced to wait for care in the public system was damaging and dangerous to their health. The judge: "We accept the personal interest British Columbians have in avoiding a lengthy wait when they have resources to avail themselves of private care to avoid an increased risk of death. We do not minimize the seriousness of that issue," … "But, we also recognize that the objective of the MPA [Medicare Protection Act] includes ensuring that individuals without the ability to pay are not thereby deprived of medically necessary care." Ideologues will make picayune statements about different rules in different provinces or how technically private care is allowed — this is hugely disingenuous .. and is akin to East German government officials building the Berlin Wall and saying East German citizens are free to move about 🙄