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It’s a common mantra to claim that allowing enrolled doctors to bill patients privately would resolve the issue of wait times for all patients. In fact, it is through public innovations where real progress can be made. Canada has seen this first-hand, but we don’t always do a good job of spreading and scaling our successes.

For example, Rapid Access to Consultative Expertise (RACE) is a phone-based system available in much of B.C. that gives family physicians access to a rapid-access telephone consultation service with specialists. The pilot project found 80 per cent of calls were returned within 10 minutes, most consults were less than 15 minutes long, there were 50 per cent fewer referrals for face-to-face consults, and a reduction of emergency department visits by 24 per cent.

Do Canadians want equitable access to health care for all, or do they want preferential access for those who can pay while leaving those who can’t pay to wait even longer? This is ultimately what the trial is about.

The plaintiffs are challenging the central organizing principle of our public health-care system — that care should be provided on medical need and not the ability to pay. Should they succeed in their challenge, we will end up with a system that benefits the minority who can afford private payment but harms the majority of Canadians who can’t.

Dr. Rupinder Brar is a clinical assistant professor in the faculty of medicine at the University of B.C. and a family physician in Vancouver; Dr. Richard Klasa is a retired physician at the division of medical oncology, B.C. Cancer Agency, and the department of experimental therapeutics, B.C. Cancer Research Centre. Both are members of Canadian Doctors for Medicare’s board of directors.

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