Bring on Investigation, Defiant Private Clinic Owner Tells Province
BC gov't seeks warrant to audit Brian Day's Cambie Surgeries Corp. for extra billing.
'Happy to submit': Cambie Surgeries Corp. owner Brian Day
The British Columbia government will seek a warrant so it can press ahead with an audit of private surgery clinics in Vancouver. But the head of those clinics says the audit is a smoke screen so the government can avoid going to court on what he considers the real issue.
After a September court ruling on whether or not it had the right to audit Brian Day's Cambie Surgeries Corp., the Medical Services Commission consulted with the Attorney General's ministry on how to proceed, a health ministry official said in an emailed statement.
"The commission has instructed legal counsel to seek a warrant under the Medicare Protection Act authorizing an inspector to enter Cambie Surgeries Corp. and Specialist Referral Clinic to conduct audits," the statement said. "It is the role of the Medical Services Commission to protect the integrity and sustainability of the health care system and uphold the Medicare Protection Act.
"We hope that the clinics will cooperate with the audits and allow both the audits and litigation to be resolved as quickly as possible," it said.
Health Services Minister Kevin Falcon was unavailable for an interview. A spokesperson for the ministry said the timing for seeking the warrant is so far undetermined and is likely a few weeks away.
Breaking a bad law: clinic owner Day
Brian Day, president and CEO of Cambie Surgeries Corp., said the government won't need a warrant to conduct an audit.
"Your source in the provincial health ministry is out of the loop, I'm afraid," he said. "Right now, we're in the process of negotiating a voluntary order to show we're not afraid of the audit."
The issue, however, is not about the audit, Day said.
There's no question his clinic is extra billing patients, and it's obvious what an audit will find, he said. You can phone the clinic and ask what it costs to have a knee operation done and they'll tell you, he said. A couple years ago the Vancouver Sun published the full details of what the clinic charges for various procedures.
Extra billing for services funded through medicare is illegal under the Canada Health Act, and the federal government has withheld portions of health transfer payments from B.C. and other provinces when they've allowed the practice.
"There's no need for them to seek an audit," Day said. "The truth is we're happy to submit to a voluntary audit... This is under negotiation right now. We have met with ministry officials, and discussions are going on about a voluntary audit."
Day said he and the clinics would like the courts to decide, in a case that's continuing, on whether British Columbians have the "right to avoid the pain and suffering" of being on a wait list for surgery. "We want the constitutional question put to the court. They want that delayed as long as possible."
He added, "It's very dishonest of them, I think."
Asked Day, "Does a B.C. resident have the same rights as a Quebec resident?"
He was referring to a Supreme Court of Canada ruling in 2005, that prohibiting people from buying private medical insurance while there are long wait times was a violation of the Quebec Charter of Rights and Freedoms.
He likened what his clinic is doing to having a car parked in a spot clearly marked no parking. He doesn't dispute that he's parked under a 'no parking' sign; what he disagrees with is the sign itself and the law that makes parking in that place illegal.
Government needs to enforce the law: NDP's Dix
It's disingenuous for Day to now say he welcomes being audited, said New Democratic Party health services critic Adrian Dix. "As I understand it, in the courts they've tried to avoid being audited."
In September, the B.C. Court of Appeal set aside an injunction that would have allowed Medical Services Commission auditors to enter clinics belonging to the Cambie Surgeries Corp. and examine records to see if they are billing patients for services that are also being billed to the government, The Tyee reported.
However, writing the reasons for judgment on behalf of the three judges who heard the case, Harvey Groberman said the MSC never needed an injunction in the first place. Instead he confirmed "the commission's right to apply for a warrant in properly constituted proceedings before a justice of the peace."
The clinics could also ask the Supreme Court to disallow the audits until the litigation is over, he said.
How Day feels about being audited is irrelevant, said Dix, who in the days following the court's September decision urged getting on with the audit. "It's like somebody saying they welcome any other law."
The law is clear that extra billing is illegal, Dix said. "The government's obligation is to see that the law is enforced," he said. "They've dragged reluctantly into following the law that they should have been following all along."
The audit needs to happen quickly, he said, adding he wonders why the government is waiting a few more weeks. "That will make it years and weeks of delay."
And while Day has been upfront that his clinics are extra billing, Dix said, the audit should discover the details and give a picture of how extensive it is at the clinic. "It will be interesting to see what's been going on with respect to facility fees and extra billing."
Cambie's Charter challenge against the government continues. ![]()




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G West
1 year ago
Have a look at the books
The put the SOB OUT of business.
Here, have a look at what the public system paid doctors from all over the province in the last fiscal year for which figures are available (2009/10):
http://www.health.gov.bc.ca/msp/legislation/pdf/bluebook2010.pdf
Are you feeling sorry for Dr Day and his buddies who can't seem to make a decent living working inside the system?
Camero409
1 year ago
What a Joke
This characters operations should have been shut down years ago. Instead this government lets him continue while pretending to investigate/shut him down with false threats. If the Gordocons were at all pursuing this, his clinic would have been out of business years ago.
Van Isle
1 year ago
I had an uncle (who is now
I had an uncle (who is now long been dead) who was a doctor and thought that the public health was such a wonderful idea cuz now he was being paid. Before public health he didn't know if he was going to be paid. He got paid in kind, like some acreage in some remote parts of BC (which you can't eat), or a chicken here or there. Before he died he thought the younger doctors were kinda stupid cuz they didn't know what it was like before; people went broke if they had a serious medical problem.
Amor de Cosmos
1 year ago
Nothing voluntary please
If they get a warrant, I certainly hope they will also be collecting all e-mail communication between Mr. Day, his cronies, and WorkSafeBC. Would be interesting to know how far their double-billing scam goes. [COMMENT REMOVED FOR LEGAL CONCERNS. -MODERATOR.]
DenisB
1 year ago
When your sick
all you want is to be healed and end the pain. You don't care where you have the procedure done. and lets face it the longer you wait the worse the outcome. My wife had to wait 3 years for her rotator cuff repair due to fighting between WCB and the Orthopaedic surgeons of BC. 10 years later and 3 surgeries later she's lost 25% use of the arm and WCB is paying her $1338.00 per month as a pension.
What we don't want is a system where the private sector only does procedures where they make 300% profit or more and leave the money losing procedures to the public system. This is what we have with the Private Labs like BC Bio and LifeLabs.
If you get your blood work done at the hospital all that profit would go into the hospitals general revenue. E.G. a CBC (complete blood count) costs $1.50 for a lab to do. MSP pays the lab $8.75.
If everyone in Farser Health got their blood work done at the hospital it would generate about $50million for the Health Authority.
You'd have to wait a little longer but eventually hospital management would get the hint and fund the labs accordingly. You can provide really good service at 700% profit.
kmdyson
1 year ago
Audit
The MSC should be independent of any government ideological influence however, it is clear they are being dictated to by this one. The Commission should simply go and do the audit as they are legally allowed to do and tell the government to quit interfering with the right of the people to health care delivery via our single payer system. If money was actually put into health care delivery instead of devising examples to undermine it there would not be any wait times...
MineSalkin
1 year ago
I used to serve that guy coffee
at the Bean where I worked for more than three years. He was always polite.
cboo44
1 year ago
Citizen's "Rights"
Does John Q. Public have the same medical "rights" as a WCB client? Does he have the same "rights" as an RCMP officer, off work due to injury?
Well, WCB and the RCMP BOTH pay the clinics EXTRA to get their people into surgery. Does John Q. have "the right" to pay extra? I would think so.
Adrian Dix would probably jump the cue, also.
offended
1 year ago
Work Safe BC
is allowed to use private clinics. Been to a private clinic twice for an on the job injury.
Now that it's reinjured, I am having surgery in hospital on Friday. After 6 months, instead of 2 weeks, which I could have paid for privately, but will not do.
Many of the private clinics will operate for cash up front. Day's not the only one.
Frank
1 year ago
What's good for the goose is good for the gander
"Day said he and the clinics would like the courts to decide on whether British Columbians have the "right to avoid the pain and suffering" of being on a wait list for surgery"
The courts should also decide at the same time if Canadians have the right to avoid pain and suffering if they don't have enough money.
Methinks that would put Dr Day out of business.
Skywalker
1 year ago
So he's polite when he buys coffee.
The guy is trying to undermine universal healthcare because of greed. It is all about money and more money. Maybe if he did some pro bono work I might have a higher opinion. While he threatens healthcare, I have no sympathy for him. I don't care if he is polite when he buys his coffee.
jnewcomb
1 year ago
Quebec vs BC - abortion clinics private too?
Interesting that some of the oldest medical clinics in Canada are Dr. Henry Morgentaler (Order of Canada) profitable abortion clinics in Quebec (first opened 1969). Are all abortions done in hospitals in BC, or are there also private abortion clinics at work?
DPL
1 year ago
The story I got from the
The story I got from the doctor, way back when he was working at the UBC Hospital was that he simply couldn't get enough operating room time and that wasn't a good thing. He sure must be getting lots of operating room time now, and the pay to show it.
There are too many exceptions to the standard medical waiting times. sure the work Safe folks want their clients to get the job done earlier as it might save them money as the client gets back to work. But what about the rest of us? we either come up with the money or wait.
realisticman
1 year ago
Under the Radar it's Everywhere - and increasingly accepted
http://www.theglobeandmail.com/life/health/private-health-care-slips-under-radar/article1220145/
Pick your malady:
http://www.findprivateclinics.ca/
Why wait when your doggie doesn't have to?
Conductor274
1 year ago
Right wing governments
There isn't a right wing government anywhere in north america that will shut down private for profit medical clinics. Two years ago there were already 130 or more private clinics operating across Canada and now I believe it's close to 300. All breaking the laws of our Canada Health Act. Governments are making protest noises about this but none have done anything about them This is a coordinated effort to get the public conditioned to accept them and it's been effective and successful. Now the clinics are going to challenge the law itself. With right wing governments ruling the vast majority of Canadian institutions it's just a matter of time before the law gets changed. The rich will be ok but the rest of us will be like the Americans and go broke if we ever need surgery to save our lives.
Frank
1 year ago
r'man
Unless your doggie has a bank account it has to rely on the charity of its human.
G West
1 year ago
IT"S EVERYWHERE? So are bedbugs!
So's lying cheating and chiseling. If the argument 'it's everywhere' had any relevance there would be no reason for any laws...Interesting that the people who shrug their shoulders and think queue jumping is a 'great' way to limit THEIR pain and suffering happen to be the ones with the extra scratch who also think that they shouldn't pay progressive taxes on their income.
The same guys who think socialism is fine and dandy for big corporations while insisting on the 'values' of free enterprise and dog eat dog competition for everyone else.
Doctors who bill MSP in BC made an 'average' of about $311,000.00 in 2009-10. The 'average' wage in 2008 for an individual woman was $30,200 and for a man $46,900.
Even if we assume an average wage of $50G in 2010 (something which is clearly a stretch in a province with the lowest minimum wage in the country) it's not difficult to see that the average doctor is getting at least 6 time what the average worker is.
What the fuck is wrong with this picture?
And why would anyone defend the idea of extra billing and screwing with what could be the best medical system in the world - for everyone?
Anyone who supports a vampire like Dr Day belongs in a hall of shame exhibit with [EDITED]. He should be ridden out of the medical profession on a rail by his colleagues.
frank2
1 year ago
What's the problem?
Presumably Day is being paid by the public as well as individual clients for a medically necessary service. If that's what the audit finds, let's hope there's a vigourous prosecution and penalties sufficient to cause Day (and any others) to take their hands out of the public till.
As for the RCMP and Workmens Compensation, these loopholes should never have been allowed in the first place--as this weakens the pressure for an efficient public system. But do they also receive funding from the general Medical Insurance system? If so, that should be stopped immediately.
Armed forces are a different situation: their separate system is required to meet special demands and is, I understand, fully paid by the employer, us, until retirement. which leads to another story in the headlines these days.
Katherine
1 year ago
The rich will be ok but the
The rich will be ok but the rest of us will be like the Americans and go broke if we ever need surgery to save our lives.
Why?
The average person is likely to prefer getting a medical procedure for free through public health care to paying for it at a private clinic. However, if people need to have some surgery done and the waiting list is very long, why shouldn't they be able to pay a private clinic to get it done?
Everyone benefits. The rich people who go to private clinics spend less time in pain; the waiting times for public health care become shorter because the rich aren't in line any more. The majority of people come to appreciate public health care even more than they do now, because they can get treated sooner. I don't see private clinics as a massive threat, given that public health care is immensely popular in Canada.
This guy is engaging in straightforward civil disobedience, which the left has long recognized as a legitimate tactic. He's accepting the consequences of breaking the law in hopes of causing people to see that the law should be changed. I don't believe that makes him a bad person.
Katherine
1 year ago
Whoops, the first line in my
Whoops, the first line in my post was meant to be formatted as a quote of Conducter274.
G West
1 year ago
Thanks Katherine
Clarification accepted... The suggestion that private vampires like Day will shorten lines for the non-paying public is patently absurd. In fact, his sort of scam creams off the simplest and most profitable procedures while doing few or none of the more difficult and costly operations.
Private clinics ARE a massive threat and should be stopped immediately. George Abbott knew this years ago when Day started his little chop shop and the Health ministry failed to shut him down forthwith.
Frank
1 year ago
Katherine
Where do the doctors and nurses that staff private clinics some from?
If private clinics didn't exist they'd be part of the public health system.
Which of course means everyone doesn't benefit when rich people can go to private clinics.
The mere existence of the private clinic means poorer people will have to wait longer.
Its not by accident that we have both longer waiting lists and more private clinics.
Frank
1 year ago
Katherine
And my first line should have read "come from" not "some from".
For a better world
1 year ago
Au contraire Katherine
"...if people need to have some surgery done and the waiting list is very long, why shouldn't they be able to pay a private clinic to get it done...".
This approach might be okay if all of the private clinic patients didn't have any side effects, or complications related to their surgery. However, when patients have adverse effects and need emergency treatment they go to a general hospital. That affects the wait times and it's called cherry picking.
Katherine
1 year ago
Responses
To "for a better world": that would be true if private clinics have a proven record of producing more side effects and complications of surgery than public hospitals. Is there evidence to that effect?
I have to say I don't understand how certain procedures are "profitable" for public health care, as people aren't charged for specific procedures - we pay for health insurance and get what we need (that's the point of having public health care, isn't it). I apologize if I'm being dense; I'm not versed in the debates on this issue.
As to the point that having private clinics means that the people in them aren't working for the public health care system: those people might not be working in public health care even if Canadian private clinics didn't exist. Many of our trained doctors emigrate to the US or other nations if they want to pursue a private practice. Allowing private clinics might keep some of those people in Canada, increasing our number of health care practitioners and decreasing total wait times.
greengreen
1 year ago
Progress
Well, we are making progress...this guy is pEDITED FOR LEGAL CONCERNS -- TYEE MODERATOR
Chris Keam
1 year ago
a reason to keep all healthcare public
"However, if people need to have some surgery done and the waiting list is very long, why shouldn't they be able to pay a private clinic to get it done? "
If 'rich' people can bypass the line, then they will support politicians who make it easier to bypass the line. If no one can bypass the line, wealthy people will support politicians who work to improve the system for everyone. That's a compelling reason in my book to disallow private surgeries, etc. For those who want (and can afford) private, immediate health care there are numerous options in other countries they can take advantage of. They should be free to do so if that's how they want to spend their money, but to my mind, creating two tiered health care is simply allowing people to buy additional rights that the rest of us can't afford. I don't think that's something we want to encourage as a society.
Frank
1 year ago
Katherine
"Allowing private clinics might keep some of those people in Canada, increasing our number of health care practitioners and decreasing total wait times."
Private clinics have been here for more than a decade and what you hoped would happen, didn't. The opposite occurred.
In the face of that will you change your conclusion about allowing private clinics?
Katherine
1 year ago
Chris Keam and Frank
Chris - Your argument is certainly the most compelling one against allowing private clinics. However, the vast majority of the Canadian people greatly value public health care (we did vote Tommy Douglas as "greatest Canadian"). I don't think that pressure on politicians to maintain a good public health care system is going to substantially decrease if a relatively small proportion of the population start using private health care.
Certainly, rich people have disproportionate political influence; but on the other hand, Canada has quite strong campaign finance laws (only $2300 per person), and the middle and lower classes, who make up the vast majority of Canada's population, also do vote. For example, Britain allows private health care, but it's still basically political suicide to attack the NHS - the the point that a UK Conservative budget that heavily cut almost every other department actually increased spending on health (or, if you account for inflation, left it pretty much flat).
Frank - In what respect are private, for-profit clinics already in existence in Canada? If the changes have already been made, why are there such vigorous political arguments about whether we should allow any of them?
CanadianLatitude
1 year ago
This characters operations
This characters operations should have been shut down years ago. Instead this government lets him continue while pretending to investigate/shut him down with false threats. If the Gordocons were at all pursuing this, his clinic would have been out of business years ago.
============
Gordo like Harper and the BC Libs saviour Dianne Watts are all low wage conservatives who only care about the bottom line of their business buddies. they could care less if you get healthcare or not or living under the bridge provided your out of site.
This country has gone down the drain and will only get worse. private Healthcare USA style is coming, just a matter of when because people keep electing twits like Gordo & Stevie...
Frank
1 year ago
Katherine
There's been hundreds of private clinics operating in Canada over the last decade. Dr Day set up his back when the NDP was in power back in 1996.
Many of us don't think they should be allowed but they've been here for as long as 15 years.
The evidence is available. They haven't shortened waiting lists, all they've done is remove doctors from the public system.
In order to reduce waiting lists you have to put money into the public system, Campbell has instead greatly reduced the amount of money per person in BC going into public healthcare.
Rather than fund surgeries at public hospitals the Liberals have reduced the time operating rooms are available and thus created a market for centres like Dr Day's.
Its not rocket science.
Frank
1 year ago
Katherine
In regards to your answer to Chris, public healthcare spending per capita declined compared to the rest of Canada.
To quote from Will McMartin's article on this subject :
"At the beginning of the decade, Victoria's health spending on a per capita basis was 9.7 per cent above the national average. By 2005 B.C. had slipped to slightly under the national average, and in 2010, we will be 4.1 per cent below the country as a whole."
and
"According to the CIHI, private-sector health expenditures represented 26.1 per cent of total health spending in B.C. when Gordon Campbell became premier in 2001. A decade later, the comparable figure is 29.2 per cent."
So almost 30% of our healthcare spending is private and we have fallen behind the rest of Canada in public spending on healthcare.
Whatever else you may want to believe the fact is private sector health has a history and its results can be measured and conclusions can be drawn.
We don't need to rely on a theory that says the private sector will save the public sector by removing rich patients from the queue. We know that doesn't help the rest of the population because doctors are removed in a greater ratio than patients.
nolanrh
1 year ago
Yes, different procedures
Yes, different procedures have different levels of "profit". Payments for certain procedures supplement the costs of others. If the "profitable" procedures are dealt with by new private clinics. That leaves the expensive stuff to be born by the public through insurance.
VivianLea Doubt
1 year ago
influence...
"Certainly, rich people have disproportionate political influence..."
Yes, they do, and what they cannot get through legitimate means they will often get through illegitimate means. Now this is not a matter of conjecture, but fact...and it is part of what the Basi/Virk trial was about. Perhaps we will never know the true extent of 'influencing' going on in government. In any event, the most compelling reason not to allow for-profit clinics is still Frank's: because pain and suffering afflicts the poor as well as the rich. Anyone who thinks it is okay for someone well-off to go to sleep pain-free, while that same option does not exist for a low/middle income person is probably deficient in the traits of temperant required for a civilized nation.
For a better world
1 year ago
Katherine re: Evidence
".....if private clinics have a proven record of producing more side effects and complications of surgery than public hospitals. Is there evidence to that effect?"
I have read several articles about the negative effects of hospital wait times. You will find some reports on the website of the The Canadian Centre of Policy Alternatives. See:
http://www.policyalternatives.ca/search/node/Hospital%20Wait%20Times
I also have some anecdotal evidence regarding neighbours. Two of them had primary surgical procedures at private clinics, which resulted in side effects. Both were admitted to general hospitals.
One young woman chose not to wait to have a cosmetic problem addressed, so she went to a private clinic to have the surgery performed. The end result was she had to have her side effects taken care of at the local hospital's emergency ward (twice).
These certainly imposed an undesirable impact to the local hospital that dealt with the follow-up treatment.
offended
1 year ago
The Canada Health Act
specifically states that no one should have to pay extra billing for medically necessary procedures.
Why shouldn't people be able to pay for private surgery?
Because it's illegal.
There is no reason that the government couldn't pay private clinics to do some surgeries and pay for them, without violating the Canada Health Act.
It's all about the money. Campbell and the Fiberals would rather give large companies large tax breaks (decreasing the amount of revenue collected by the government) than pay for necessary medical services in a timely fashion.
I sent a letter of complaint to Kevin Falcon's office about my long wait for knee surgery.
Included in the email I received back from Falcon's office:
"If you feel that your condition has deteriorated or warrants reassessment, I encourage you to bring your specific concerns to the attention of your surgeon. Additionally, your family physician may refer you to a surgeon with a shorter wait time, even if the surgeon is not in your geographic area. You may also enquire as to whether your surgeon has a cancellation list, and if you are available on short notice you may request to be added to this list."
Thanks for nothing, you arrogant *&^%$##@ Kevin.
BTW I already was on a cancellation list, with a surgeon who has one of the shortest waiting lists, and my surgery got bumped up by 4 months (this Friday).
vikanadian
1 year ago
need more fibre
ugh. such a bad taste in my mouth after reading about brian day and his B.S. again. i think a little bit of 'medicare schmedicare' just tried coming up my gullet. i was hoping that crap would finally stomach itself and go down the sewer where it belonged long ago.
zalm
1 year ago
It's a tough question
...with no simple answer.
Though Day's attitude sucks, he had some reason for it. Back in the early '90s, all hospitals started cutting ortho from their list of care - it was expensive to do, lots of complications, there was rarely a routine care plan to a good recovery, and often a lot of expensive equipment was needed.
Not much has changed. Arthroscopy has improved the lot of patients a bit, but the long list of joint replacements hasn't gone away by ignoring it. Yet Day claimed he could only get 4 hours of OR time a week at VGH (staff I know there claim it was closer to a day-and-a-half) and so the man who was trained for 16 years at public expense couldn't make a good living by doing what he was trained to do because of unofficial rationing.
By whom? Hospital boards, ultimately, each of whom decided that ortho programs were simply too expensive, and rationalized their services to less expensive, more productive cases. Big hospitals were the worst - with their 6-person "Business Case" departments, they informally decided what services the hospital would provide, and what they wouldn't, instead of spending those MBA salaries on actual care programs.
For this an many other reasons, the NDP started to get rid of hospital boards' autonomy, by funding them through Health Authorities, with a kind of Care Services contract. The Health ministry under the Fiberals has taken this further. This is not a bad thing, but as with all things, it's hard to micromanage policy to take into account every situation. Small hospitals that couldn't justify their operations through the care contract were shuttered, large hospitals that could snow bureaucrats with figures on programme spending managed to stay alive or expand.
In between, patients still fell betweent he cracks. And Day and other doctors got angrier and angrier. So when he became head of BCMA, I thought we would see a few changes in how medical fees are paid - for a long time it's been noted that difficult specialties such as ortho are not fee-paid at anything like the rate approaching their post-care difficulty, while specialties that have become nearly fully automatic, such as opthalmology, are paid grossly out of proportion to the difficulty and follow-up care required. I looked forward to seeing Day lead the charge on ophthalmologists fees being reduced - no chance.
Just look at the highest earners on the link GWest provided. Intensivists (internal medicine specialists) working 'in-service' 24/7 are very nearly the highest earners beaten out only by ophthalmologists, nearly all of whom go home at 5:00, take long weekends off to attend conferences in Geneva and Dubai, and run the computerized laser that does the work.
There's a lot wrong with the system, and Day is but one public face of it. I'm not sure if he's being selectively quoted or not, but he sure has an axe to grind at the existing rationing system, and I'm not sure it's entirely unjustified.
editingfool
1 year ago
is it my imagination?
is it my imagination, or do a lot of doctors from south africa open private clinics in canada?
why do you suppose they left south africa in the first place?
editingfool
1 year ago
my mistake
my mistake, he is not from south africa. he just acts like he is.