Brian Day

Last updated

Brian Day
Dr Brian Day speech at the CMA.jpg
Dr. Brian Day speaking as president of the CMA in 2008.
Born(1947-01-29)January 29, 1947
Liverpool, England
NationalityEnglish-Canadian
Education University of Manchester
University of British Columbia
Medical career
ProfessionSurgeon
FieldOrthopedics
InstitutionsCambie Surgery Centre
UBC Hospital
AwardsEdouard Samson Award

Brian Day MRCP (UK), FRCS (Eng), FRCS (C), (born January 29, 1947) is an orthopedic surgeon and health researcher in Canada, a past president of the Canadian Medical Association, and a prominent sometimes controversial advocate [1] for privatization of Canada's health system.

Contents

As the founder and medical director of a private clinic Cambie Surgery Centre and Specialist Referral Clinic [2] in Vancouver, British Columbia, Day is a spokesperson for a high-profile, multi-year and ongoing lawsuit against the provincial government, Cambie Surgeries Corporation v. British Columbia (Medical Services Commission) . [3] that is sometimes cited publicly as 'The Day Case'. [4]

Early life and education

Day was raised in Toxteth, a working-class area of post-war Liverpool, England. He was the eldest of four children in a family with strong Labour views. Both his mother and father were socialists. [1] Day credited his personal shift from the political left to the political center-right by his disenchantment with the British labour movement's jurisdictional inertia and contributions to inefficiency in health care. [5]

Day attended the Liverpool Institute, the same high school attended by Paul McCartney and George Harrison. [1] His family's neighbourhood could be tough. Day has a permanent scar on a finger from a knife fight when he was 10 years old. [1] [6] His father, a pharmacist, was killed in 1981 by hooligans looking for drugs during riots in the neighbourhood. [1] The possible contribution of misdiagnosis by British doctors for the death of Day's mother in 1986 is cited as his dissatisfaction with the British health system. [7] [8]

Day entered medical school at age 18 at the University of Manchester, from where he graduated in 1970. After an initial interest in general surgery, which he pursued as a postgraduate in Manchester and at the Hammersmith Hospital in London, he focused on orthopaedics. [1] He obtained his medical degrees, MB ChB from the University of Manchester, and post-graduate qualifications in both internal medicine and general surgery. In July 1973, Day moved to Vancouver, British Columbia, Canada. [1] In 1978, Day completed his training and a M.Sc. degree at the University of British Columbia (UBC).

Medical career

In 1979, Day received the Canadian Orthopaedic Association's Edouard Samson Award for outstanding orthopaedic research in Canada. Following a fellowship in traumatology, in Basel, Switzerland, Oxford, and Los Angeles, he began practice at the Vancouver General Hospital. After starting in trauma, he developed an interest and expertise in orthopaedic sports medicine and arthroscopy.

As an orthopedic surgeon, he earned an international reputation for performing arthroscopic surgery on hips, knees, shoulders and elbows. Day is regarded as being instrumental in the introduction of arthroscopic joint surgery in Canada. [5]

From 1970 to 2014, Day wrote more than 150 scientific articles or book chapters, in areas of orthopaedics and arthroscopic surgery / sports medicine, and on the topic of health policy.[ citation needed ]

Medical association leadership (Canada and North America)

Day is a founding member and was 2004 president of the Arthroscopy Association of North America, being the second Canadian elected to that position.

In August 2006, Day was elected president of the Canadian Medical Association (CMA) for the 2007/08 term, despite a challenge at the convention floor by another British Columbian physician (whom Day had beaten in the nomination process) regarding Day's views about for-profit health care. [1] He was the first orthopaedic surgeon in the 148-year history of the CMA to be elected president. [9] Day states that his advocacy as president of CMA was for a hybrid public-private system, not a full replacement by private hospitals. [10] The CMA policy drafted in 2007 was "When access to timely care cannot be provided in the publicly funded system, Canadians should be able to use private health insurance to reimburse the cost of care obtained in the private sector." [3]

Doctors of BC

In 2015, Day was temporarily announced as the president-elect for Doctors of BC, the provincial medical association in British Columbia, because of a win by a single vote difference. The election was then rescinded because of an error found in properly categorizing one ballot. Day then lost the subsequent run-off election in June 2015 to Alan Ruddiman by 603 votes after the publicity about the single-vote win escalated participation to the highest turnout by physician members of the association. [11] In May 2016, Day was defeated 1,896 to 1,674 votes by Trina Larsen Soles in the election for the 2017–18 Doctors of BC presidency. [12]

Day is a member of the editorial board for the BC Medical Journal. [2]

Advocacy for access to private care

In 2003, Maclean's Magazine named Day one its top 50 Canadians "to watch", describing him as "an iconoclast, whose time is now." [13] He is referred to as "Dr. Profit" by opponents who believe his legal challenges will threaten Canada's publicly funded medicare system, and Prophet by supporters for his advocacy of a role for patient choice and the right to obtain private insurance in the face of long government wait lists for care. [5]

Day has argued many Canadians are being hypocritical towards private healthcare, because 70 per cent of Canadians buy healthcare insurance. Many with such insurance themselves claim to oppose private healthcare, while embracing it for themselves. The other 30 per cent of Canadians who cannot afford the extra healthcare insurance receive poorer access to care. [14]

Day cites the Canada Health Act of 1984 being responsible for rationing of care that has resulted in over a million Canadians suffering on wait lists, and to more than 5 million without a doctor. In the 2005 Chaoulli v Quebec (AG) decision, the Supreme Court of Canada struck down prohibitions on private insurance in that province because it was an infringement of the Quebec Charter of Human Rights and Freedoms; the decision did not extend to the rest of Canada, but constitutional experts opined that it would certainly have major impact on similar cases brought to court elsewhere. Day also supports the end of block funding for hospitals and a change to "Patient Focused Funding" where revenue follows the patient. He advocates a patient-centered system with a greater role for competition in Canadian healthcare as a means to reduce waiting times and save government money by treating people before their condition worsens. [1] He is a frequent spokesman for the topic with news media and submits position papers with government. For instance, his submission to Roy Romanow's Commission on the Future of Health Care in Canada made 10 recommendations:

  1. De-politicize the debate
  2. Repeal the Canada Health Act
  3. Eliminate global budgets and reward productivity
  4. Incorporate business methods
  5. Increase privatization and contracting out
  6. Introduce competition, choice and accountability
  7. Massively reduce bureaucracy
  8. Reduce influence of public sector health unions
  9. Accept economic reality, and introduce user fees
  10. Rank "core services" and de-insure unnecessary services [15]

US 'Conservatives For Patient Rights' commercial controversy

In May 2009, Day drew criticism after he was shown in a series of television ads for a US lobby group called Conservatives for Patients' Rights that opposed President Obama's health care reforms. Day appeared on the television program BNN on May 11, 2009, to clarify that he issued a letter distancing himself from the ad. He also pointed out that Obamacare was based on private insurance and private delivery, the opposite of what many Canadians believe in. [16]

In 1995, Day founded Cambie Surgery Centre, a for-profit Vancouver clinic. Day is the facility's medical director, and one of its 40-plus shareholders. The Cambie Surgery Centre has 50 full- and part-time nurses and 125 doctors performing operations and other procedures for up to 5,000 patients a year which may be the busiest private hospital in Canada. [17]

Day has said he decided to set up the Cambie Surgical Centre, which is non-union, after government funding decreased in the mid-90s cut his operating time at UBC from 17 hours a week to about six. The start-up was during the province's premiership of Michael Harcourt. [8] To demolish an old nursing home and build a surgery centre on the site, Day needed to raise about $5 million. [8] He succeeded in convincing notable Vancouverites such as the late Milan Ilich and Jack Poole, as well as Kip Woodward (chair of Providence Health Care and future chair of Vancouver Coastal Health), and 19 others including Jim Wyse and Hugh Magee, [8] to commit $100,000 each with the remainder financed by the Royal Bank of Canada.

Cambie Surgeries Corporation v. British Columbia (Medical Services Commission)

In 2009, the Cambie Surgery Centre and patients filed a lawsuit versus the province's Medical Services Commission. Six of the eight plaintiffs are patients, two of whom died before the conclusion of the court case. [3] The trial which took place from 2016 to 2020, included over a hundred witnesses. [18] [19] [20] [21] [22] [23] [24]

In 2012, the British Columbia Medical Services Commission confirmed what the clinics had openly admitted to doing since 1996—namely allowing patients, in violation of the Medicare Protection Act, to spend their own funds to jump the queue and access the clinic. [25] [26]

The Commission asked the Cambie Surgery Centre not to permit patients access to earlier treatment. [27] The plaintiffs pointed out the constitutional challenge had been brought before the courts 3 years earlier. In the Supreme Court of British Columbia, the plaintiffs are challenging the prohibition against patients being prohibited from using their own funds to access care, instead of receiving it in order based on medical priority. Specifically, they are challenging the ban on private health insurance to cover medically necessary care, and the ban preventing doctors from working in both the public and private health systems at the same time.

Proponents of publicly funded healthcare in Canada argue that this legal challenge against medicare could set a dangerous precedent. Proponents of for-profit care argue the opposite and that patients will be protected from the dangers of waiting for care. In the Chaoulli decision (2005) the Supreme Court of Canada declared it was a fact that Canadians were suffering and dying on wait lists. If the case is decided at trial in B.C., as is expected, either side may seek an appeal of the outcome at the Supreme Court of Canada. A decision at this level would mean the outcome would be binding in all provinces and territories across the country. Some legal experts have described this case as one of the most significant legal challenges in Canadian history. [28]

On September 10, 2020 Justice John J. Steeves, of the Supreme Court of British Columbia (BCSC), handed down his 880-page decision, in which he found that the "impugned provisions do not deprive the right to life or liberty of the patient plaintiffs or similarly situated individuals." He said that there was a "rational connection between the effects of the impugned provisions and the objectives of preserving...the universal health care system and ensuring access to necessary medical services is based on need and not the ability to pay."Justice Steeves ruled against legalizing private health care.

Recognition

Related Research Articles

Medicare (Canada) Canadas publicly funded, single-payer health care system

Medicare is an unofficial designation used to refer to the publicly funded single-payer healthcare system of Canada. Canada's health care system consists of 13 provincial and territorial health insurance plans, which provide universal healthcare coverage to Canadian citizens, permanent residents, and depending on the province or territory, certain temporary residents. The systems are individually administered on a provincial or territorial basis, within guidelines set by the federal government. The formal terminology for the insurance system is provided by the Canada Health Act and the health insurance legislation of the individual provinces and territories.

Arthroscopy Medical procedure

Arthroscopy is a minimally invasive surgical procedure on a joint in which an examination and sometimes treatment of damage is performed using an arthroscope, an endoscope that is inserted into the joint through a small incision. Arthroscopic procedures can be performed during ACL reconstruction.

<i>Canada Health Act</i> Canadian federal law for health care funding

The Canada Health Act is a statute of the Parliament of Canada, adopted in 1984, which establishes the framework for federal financial contributions to the provincial and territorial health insurance programs, commonly called "medicare". To receive federal funding, the provinces and territories must comply with the terms of the CHA, which establishes the principle of universal, single-payer healthcare.

Health insurance or medical insurance is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance is risk among many individuals. By estimating the overall risk of health risk and health system expenses over the risk pool, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to provide the money to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization, such as a government agency, private business, or not-for-profit entity.

Comparison of the healthcare systems in Canada and the United States Healthcare system comparison

A comparison of the healthcare systems in Canada and the United States is often made by government, public health and public policy analysts. The two countries had similar healthcare systems before Canada changed its system in the 1960s and 1970s. The United States spends much more money on healthcare than Canada, on both a per-capita basis and as a percentage of GDP. In 2006, per-capita spending for health care in Canada was US$3,678; in the U.S., US$6,714. The U.S. spent 15.3% of GDP on healthcare in that year; Canada spent 10.0%. In 2006, 70% of healthcare spending in Canada was financed by government, versus 46% in the United States. Total government spending per capita in the U.S. on healthcare was 23% higher than Canadian government spending. And U.S. government expenditure on healthcare was just under 83% of total Canadian spending.

Healthcare in Canada Overview of healthcare

Healthcare in Canada is delivered through the provincial and territorial systems of publicly funded health care, informally called Medicare. It is guided by the provisions of the Canada Health Act of 1984, and is universal. The 2002 Royal Commission, known as the Romanow Report, revealed that Canadians consider universal access to publicly funded health services as a "fundamental value that ensures national health care insurance for everyone wherever they live in the country."

Two-tier healthcare Unequal access to higher quality healthcare

Two-tier healthcare is a situation in which a basic government-provided healthcare system provides basic care, and a secondary tier of care exists for those who can pay for additional, better quality or faster access. Most countries have both publicly and privately funded healthcare, but the degree to which it creates a quality differential depends on the way the two systems are managed, funded, and regulated.

<i>Chaoulli v Quebec (AG)</i> Supreme Court of Canada case

Chaoulli v Quebec (AG) [2005] 1 S.C.R. 791, 2005 SCC 35, was a decision by the Supreme Court of Canada of which the Court ruled that the Quebec Health Insurance Act and the Hospital Insurance Act prohibiting private medical insurance in the face of long wait times violated the Quebec Charter of Human Rights and Freedoms. In a 4 to 3 decision, the Court found the Acts violated Quebecers' right to life and security of person under the Quebec Charter. The ruling is binding only in Quebec. Three of the seven judges also found that the laws violated section seven of the Canadian Charter of Rights and Freedoms. One judge did not rule on the Canadian Charter. The result was a 3–3 tie on the question of the Canadian Charter, so Chaoulli decision does not apply to any other province.

Vancouver General Hospital Hospital in British Columbia, Canada

Vancouver General Hospital is a medical facility located in Vancouver, British Columbia. It is the largest facility in the Vancouver Hospital and Health Sciences Centre (VHHSC) group of medical facilities. VGH is Canada's third largest hospital by bed count, after Hamilton General Hospital, and Foothills Medical Centre.

A public hospital, or government hospital, is a hospital which is government owned and is fully funded by the government and operates solely off the money that is collected from taxpayers to fund healthcare initiatives. In some countries, this type of hospital provides medical care free of charge to patients, covering expenses and wages by government reimbursement.

United States National Health Care Act Proposed U.S. law

The Expanded and Improved Medicare for All Act, also known as Medicare for All or United States National Health Care Act, is a bill first introduced in the United States House of Representatives by Representative John Conyers (D-MI) in 2003, with 38 co-sponsors. In 2019, the original 16-year-old proposal was renumbered, and Pramila Jayapal (D-WA) introduced a broadly similar, but more detailed, bill, HR 1384, in the 116th Congress. As of November 3, 2019, it had 116 co-sponsors still in the House at the time, or 49.8% of House Democrats.

Health care in Australia Availability, funding, and provision of health services in Australia

Health care in Australia is primarily funded through the public Medicare program and delivered by highly regulated public and private health care providers. Individuals may purchase health insurance to cover services offered in the private sector and further fund health care. Health is a state jurisdiction although national Medicare funding gives the Australian or Commonwealth Government a role in shaping health policy and delivery.

Healthcare in Israel Overview of the health care system in Israel

Healthcare in Israel is universal and participation in a medical insurance plan is compulsory. All Israeli residents are entitled to basic health care as a fundamental right. The Israeli healthcare system is based on the National Health Insurance Law of 1995, which mandates all citizens resident in the country to join one of four official health insurance organizations, known as Kupat Holim which are run as not-for-profit organizations and are prohibited by law from denying any Israeli resident membership. Israelis can increase their medical coverage and improve their options by purchasing private health insurance. In a survey of 48 countries in 2013, Israel's health system was ranked fourth in the world in terms of efficiency, and in 2014 it ranked seventh out of 51. In 2020, Israel's health system was ranked third most efficient in the world. In 2015, Israel was ranked sixth-healthiest country in the world by Bloomberg rankings and ranked eighth in terms of life expectancy.

Health facility Any location at which medicine is practiced regularly

A health facility is, in general, any location where healthcare is provided. Health facilities range from small clinics and doctor's offices to urgent care centers and large hospitals with elaborate emergency rooms and trauma centers. The number and quality of health facilities in a country or region is one common measure of that area's prosperity and quality of life. In many countries, health facilities are regulated to some extent by law; licensing by a regulatory agency is often required before a facility may open for business. Health facilities may be owned and operated by for-profit businesses, non-profit organizations, governments, and in some cases by individuals, with proportions varying by country. See also the recent review paper,

The healthcare reform debate in the United States has been a political issue focusing upon increasing medical coverage, decreasing costs, insurance reform, and the philosophy of its provision, funding, and government involvement.

Royal Columbian Hospital Hospital in British Columbia, Canada

Royal Columbian Hospital (RCH) is the oldest hospital in British Columbia and one of the busiest in the Fraser Health Authority. It is located in New Westminster overlooking the Fraser River and is the only hospital in the Lower Mainland that is immediately adjacent to a Skytrain station (Sapperton). RCH is on the unceded and traditional shared territories of the Kwikwetlem First Nation, the New Westminster Indian Band and the Kwantlen First Nation.

Healthcare in Belgium Overview of the health care system in Belgium

Healthcare in Belgium is composed of three parts. Firstly there is a primarily publicly funded healthcare and social security service run by the federal government, which organises and regulates healthcare; independent private/public practitioners, university/semi-private hospitals and care institutions. There are a few private hospitals. Secondly is the insurance coverage provided for patients. Finally, industry coverage; which covers the production and distribution of healthcare products for research and development. The primary aspect of this research is done in universities and hospitals.

Health care finance in the United States discusses how Americans obtain and pay for their healthcare, and why U.S. healthcare costs are the highest in the world based on various measures.

Physicians in Canada Canadian physician

Physicians and surgeons play an important role in the provision of health care in Canada. They are responsible for the promotion, maintenance, and restoration of health through the study, diagnosis, prognosis, and treatment of disease, injury, and other physical and mental impairments. As Canadian medical schools solely offer the Doctor of Medicine (M.D.) or Doctor of Medicine and Master of Surgery degrees, these represent the degrees held by the vast majority of physicians and surgeons in Canada, though some have a Doctor of Osteopathic Medicine (D.O.) from the United States or Bachelor of Medicine, Bachelor of Surgery from Europe.

Cambie Surgeries Corporation v. British Columbia [2020 BCSC 1310] was a high-profile, multi-year Supreme Court of British Columbia (BCSC) case brought by Brian Day, an advocate for private healthcare, against the province of British Columbia. Day, who runs the Vancouver-based private clinic Cambie Surgery Centre, challenged the sections of the province's Medicare Protection Act (MPA) that prevent private practitioners from charging patients who are enrolled in Canada's universal healthcare system for services available in that system. The lawsuit stated that the MPA was unconstitutional because it violated sections 7 and 15 of the Canadian Charter of Rights and Freedoms.

References

  1. 1 2 3 4 5 6 7 8 9 Mason, Gary (1 August 2007). "Brian Day: Day in Your Life". 'BC Business Magazine'. Vancouver. Retrieved 1 August 2014.
  2. 1 2 "Editorial Board". BC Medical Journal. Retrieved 2 September 2016.
  3. 1 2 3 Fayerman, Pamela (1 September 2016). "B.C. trial over private health care could reshape Canadian medicare". The Vancouver Sun .
  4. ↑ Peden, Alex. "Backgrounder: Court challenges to one-tier medicare". EvidenceNetwork.ca. University of Manitoba. Retrieved 2 September 2016.
  5. 1 2 3 Ward, Doug (8 April 2002). "A new Day for health care". Vancouver Sun. Retrieved 2 August 2014.
  6. ↑ Mickleburgh, Rod (5 November 2010). "Part 1: Is this private clinic surgeon a crusader or criminal?". The Globe and Mail . Retrieved 2 September 2016.
  7. ↑ Mason, Gary (2 September 2016). "Changing Canada's health-care system is a life-long fight". The Globe and Mail .
  8. 1 2 3 4 Fayerman, Pamela (24 February 2015). "Dr. Brian Day #3: his dad's murder, mom's misdiagnosis, Beatles connection and the prominent families who were his investors". The Vancouver Sun . Retrieved 3 September 2016.
  9. ↑ "First orthopedic surgeon voted CMA president-elect calls for health care reform". healio.com. Orthopedics Today 2006. Retrieved 2 September 2016.
  10. ↑ Day, Brian (18 June 2015). "Rebuttal from Brian Day: my prescription for Canada's health care". Opinion: National Observer. Retrieved 5 July 2015.
  11. ↑ Canadian Press (19 June 2015). "B.C. doctors elect new president; Dr. Brian Day loses by 600 votes". Global BC. Retrieved 5 July 2015.
  12. ↑ Britten, Liam (16 May 2016). "Brian Day, private medical care advocate, loses Doctors of B.C. election". CBC News.
  13. ↑ 50 Canadians to watch in 2003, Maclean's Magazine, January 20, 2003
  14. ↑ Brian Day's diagnosis: The president of the Canadian Medical Association explains how to fix our health-care system - Full Comment Archived October 29, 2007, at the Wayback Machine
  15. ↑ Dr. Brian Day - Submission to the Commission on the Future of Health Care in Canada
  16. ↑ Ward, Doug (10 October 2009). "Canadian critics slam Obamacare in U.S." Vancouver Sun. Archived from the original on 9 August 2014. Retrieved 2 August 2014.
  17. ↑ Fayerman, Pamela (15 February 2015). "Dr. Brian Day #1: Everything you need to know about him and his legal case against the government health care "monopoly"". The Vancouver Sun staff blog. Retrieved 2 September 2016.
  18. ↑ "B.C. Supreme Court rules against legalizing private healthcare in landmark case". Global News. Retrieved 10 September 2020.
  19. ↑ "Cambie Surgeries Corporation v. British Columbia – BC INJURY LAW" . Retrieved 10 September 2020.
  20. ↑ "Private health care battle draws to a close after a decade in B.C." British Columbia. 28 February 2020. Retrieved 10 September 2020.
  21. ↑ Weisgarber, Maria (10 September 2020). "B.C. Supreme Court rules against legalizing private health care following decade-long battle". British Columbia. Retrieved 10 September 2020.
  22. ↑ "B.C. Supreme Court rules against legalizing private health care following decade-long battle | CTV News" . Retrieved 10 September 2020.
  23. ↑ "Private Vancouver clinic loses constitutional challenge of public health-care rules | CBC News" . Retrieved 10 September 2020.
  24. ↑ "CHC » Cambie Case (ongoing)" . Retrieved 10 September 2020.
  25. ↑ Ministry of Health Billing Integrity Program (June 2012). Specialist Referral Clinic (Vancouver) Inc. and Cambie Surgeries Corporation: Audit Report (PDF).
  26. ↑ Brend, Yvette. "Epic court battle over private health care rages in B.C. courts". cbc news.
  27. ↑ "Medical Services Commission releases audit". gov.bc.ca.
  28. ↑ Macleod, Andrew (17 April 2014). "For-Profit Clinic Lawsuit May Transform Health Care". TheTyee.ca. Retrieved 22 April 2014.
  29. ↑ "The Globe's Power 50 list- 2012". Globe and Mail. 6 February 2012. Retrieved 2 August 2014.

Further reading

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.