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Maxed Out: B.C.’s new health-care bill is a shameful travesty

'Let them know you trust your health-care providers more than you trust them.'
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What could go wrong?

There’s this phenomena, frequently called a law, of unintended consequences. Unintended consequences are outcomes caused by an action that were unforeseen by the perpetrator of the action. Unintended consequences can be good. Aspirin is often cited as a positive unintended consequence for its ability to relieve headaches—intended—and prevent heart attacks, unintended.

But those aren’t nearly as interesting as the adverse unintended consequences. The example that always captured my whimsy is the introduction of South American cane toads into Australia. There’s about a million things in Oz that’ll kill you. There are lots of insects you don’t want to meet up with. And some of them ravaged the country’s sugar cane industry before the advent of chemicals to deal with them.

So in 1935, someone decided to bring cane toads over to deal with the pests. Problem was, there were no natural predators in the country to deal with the cane toads. Bigger problem was cane toads secrete toxins that’ll kill things that try to eat them. Pretty soon, cane toads were a bigger problem than the one they had in the sugar cane fields. Oops.

Bad unintended consequences are the reason things like drugs generally go through long trial periods before being approved.

Unfortunately, there are no long trial periods for laws passed by well-meaning legislative bodies. To cite just one example of laws that had serious unintended consequences, think prohibition in the United States. Designed to sober up the growing country, prohibition not only led to more drinking and general disregard for the law, but also supercharged organized crime.

And prohibition was really a pretty simple piece of legislation.

Unlike B.C.’s Bill 36, Health Professions and Occupations Act. Passed late last year, the bill was designed to replace the existing Health Professions Act to modernize it and, “prioritize protection of the public and to facilitate good governance by regulators.”

Sounds good, eh?

Problem is—more accurately, problems are—Bill 36 is an enormous omnibus bill, containing 645 clauses. It is a shotgun approach that affects every aspect of the delivery of health-care in the province.

One might argue it makes sense to deal with all aspects of health-care at one time. Perhaps that’s true. But the devil is in the details.

We elect MLAs to, among other things, make law. Bill 36 is a law. Given that making law is fundamental to government, it would be nice to think our elected lawmakers know and understand the laws they’re creating. We may forgive unintended consequences, but we’d like to think they at least understand the intended ones. Clearly it takes some time, a lot of time, to carefully consider and debate a law with more than 600 clauses, any one of which may carry the seeds of unintended consequences. And with so many clauses, the probability of such consequences approaches 100 per cent.

There are 87 MLAs in the provincial legislature. The governing NDP has 57 of them. If you polled all 87, you’d be lucky to find a dozen who read all 645 clauses of Bill 36. But even if all of them had read all of it, you wouldn’t be able to find a single one who had the opportunity to raise objections, ask for clarification, propose amendments or otherwise debate the merits of more than the first 223 clauses.

That’s because after a couple of hours, the NDP imposed closure and called for a vote... the outcome of which was a foregone conclusion given the party’s majority.

So what’s the problem with our legislators passing a bill so large in scope with so little debate? I mean, what could go wrong?

As related by one MLA, the government allowed two or three amendments to the bill because of “errors or unintended consequences” discovered during the scrutiny of those 223 clauses. Such authorized amendments to proposed legislation is, according to that source, unusual, in fact almost unheard of.

So if our elected MLAs could ferret out enough oopsies in the first third of the bill to warrant amendment, and much of the meat is contained in the later clauses, what might have been uncovered had they been able to perform their due diligence—in other words, perform the very function for which we elected them—in the remainder of the bill?

We’ll never know.

What we do know is a significant section of health-care providers are seriously concerned about this law’s overreach and the unprecedented powers it gives to the Public Health Office and health ministry. Don’t like an edict from the PHO? Don’t speak out about it. Such boldness can trigger ex parte proceedings—administrative proceedings without notice—that’ll shut you down, seize your assets and quite possibly lead to licence revocation or worse.

Beyond that outstanding example—and when have we recently seen health-care workers speak out against PHO edicts?—the law is vague to the point of opaque about what, exactly, might set the wheels in motion to steamroll those who fall under its myriad rules.

The bill wants to “streamline” the various professional “colleges” that oversee professional conduct. It goes without saying health-care colleges—professional bodies like the College of Physicians and Surgeons—have generally been more inclined to protect health-care workers than they have to ferret out quacks. Nonetheless, they’ve operated independently.

Bill 36 will eventually replace the 15 colleges with six, aggregating various professions and operating under the auspices of the Provincial Regulatory Oversight Superintendent who will operate a discipline tribunal to deal with those who run afoul of one of the many clauses. Oh, and it’ll be appointed by the government.

What could go wrong?

Well, your health-care records could be seized by the government, something they can’t do currently, if they’ve got an issue with something your doc/physio/nurse, etc., told you. Your health-care provider could be shut down for criticizing the health ministry or PHO. Or for suggesting an alternative course of treatment based on your particular health issues.

Or, as so many have hinted, they could simply leave the profession or province. Hey, it’s not like we don’t have docs we can spare. What? We don’t? Well that would certainly be an unwanted unintended consequence, eh?

Bill 36 and the shameful way it was passed is a travesty. At this point, the best we can do, and don’t imagine it doesn’t have any impact, is let the two heavy hitters in this debacle know you don’t think this is the way government should work or laws should be made. And it’s as easy as sending them an email: premier@gov.bc.ca—that would be David Eby, premier of all B.C.—and HLTH.Minister@gov.bc.ca—that would be Adrian Dix.

Let them know you believe MLAs should be able to do the job for which we elected them. Let them know you trust your health-care providers more than you trust them.

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