Hearings have begun at the British Columbia Supreme Court in a long-anticipated legal challenge to the publicly funded Canadian health system. The plaintiffs -- led by Dr. Brian Day of Cambie Surgery Centre -- allege that medicare violates the Charter by forcing patients onto long wait lists for care.

By way of remedy, Day and his colleagues are not asking the government to reduce wait times for all patients. Too bad.

Instead, they are asking the court to overturn the law that stops the sale of private insurance covering medically necessary care. They are also asking the court to overturn the law against dual practice that requires doctors to choose whether to work for the public system or unenroll from medicare and work for the private sector. They also want to overturn prohibitions on extra-billing so that physicians can charge whatever they wish for the care they provide, whether in public hospitals or in private clinics.

In thinking through what this legal challenge could mean for ordinary Canadians, the standard investigative question, "who benefits?" is a good place to start.

The physicians spearheading these challenges certainly stand to benefit handsomely.

If the Cambie case succeeds, scores of private buyers will join the bargaining table, driving up prices for physician services.

Under the status quo, most physicians are locked into fee-for-service rates negotiated with the provinces. If the Cambie case succeeds, scores of private buyers will join the bargaining table, driving up prices for physician services and diverting resources to the highest bidder irrespective of medical need.

The physicians involved in the Cambie trial protest that they have only medicare's best interests at heart. They point to the many western "European" nations that have two-tier health systems which are purportedly the envy of the world. If only Canada would allow greater private payment, we are told, the invisible hand of the market would lead us to join their ranks.

Unfortunately, it's not that simple.

Proponents of the "European" model of health care never tell us if it's the French, Irish, English, Dutch, German or Italian model we are meant to be following -- they are all distinct.