Private health insurance will remain off-limits for most Canadians, especially those in British Columbia.
The Supreme Court of Canada just refused to hear an appeal challenging British Columbia's ban on private coverage.
It marks the end of a battle that Vancouver orthopedic surgeon Dr. Brian Day, founder of the successful private Cambie Surgery Centre, has been waging for more than a decade.
But it also serves as a cautionary tale for the United States. California's legislature is considering a measure that would require the state to begin moving toward a Canadian-style healthcare system in the near future.
Sen. Bernie Sanders, I-Vt., has made no secret that he'd press for Medicare for All at the federal level if he had the votes.
Canada's experience shows that single-payer systems don't just fail to deliver timely, high-quality care. They also require the most inhumane policies and tortured legal reasoning to stay afloat.
In British Columbia, individuals are prohibited from purchasing private insurance to cover care the province has deemed medically necessary.
Providers are also barred from charging patients additional fees to get faster service.
So patients have to wait their turn for government-paid care — unless they visit a private clinic in another province or another country and pay out of pocket.
The waits in Canada are growing longer by the year.
Last year, the median wait for treatment from a specialist following referral by a general practitioner in British Columbia was 25.8 weeks. Nationwide, the median wait was even longer — more than 27 weeks.
Thirty years ago, the median wait across Canada was just 9.3 weeks.
The waits in some specialties are even longer. Canadians waiting for orthopedic surgery — Dr. Day's specialty — face a median wait of 16 weeks to get an appointment with a specialist following referral by a general practitioner.
Then they face a median wait of 32 weeks to actually receive care — roughly 18 weeks more than is considered clinically appropriate.
Canadian policymakers would apparently rather force someone to live in pain for months as their health deteriorates than allow that person to purchase care on the open market.
This is the kind of tortured logic that's required to prop up single-payer health systems.
Canada's Charter of Rights and Freedoms states that everyone has "the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice."
This right was at the crux of Day's court case.
Evidently, the Canadian judiciary believes that it's fundamentally more just to require everyone to wait on equal terms for health care than to allow people to exercise their rights to life, liberty, and security.
That conclusion is at odds with what Canada's Supreme Court concluded in 2005 when it considered a legal challenge to Quebec's ban on private insurance. Madam Chief Justice Beverly McLachlin wrote in striking down the ban, "Access to a waiting list is not access to health care."
The median wait then was 17.7 weeks — 10 weeks less than in 2022.
Dr. Day's fight may have ended.
But private care is already proliferating in Canada, largely in response to the public waitlist crisis.
Ontario's government is looking to increase its reliance on private clinics to deliver publicly funded care, starting with cataract surgeries, diagnostic testing, and hip and knee replacement surgeries.
Saskatchewan will allow clinics to charge for quicker MRI and CT scans, provided they then scan someone on the waitlist at no cost.
Advocates for Medicare for All in the United States portray healthcare as a human right —one that can only be guaranteed by government.
Canada has failed miserably to guarantee that right.
Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is "False Premise, False Promise: The Disastrous Reality of Medicare for All," (Encounter Books 2020). Follow her on Twitter @sallypipes. Read Sally Pipes' Reports — More Here.