For his part, Dr. Day has filed a B.C. version of the landmark Chaoulli case that opened the way for residents of Quebec to buy health insurance for private delivery of medically necessary procedures. "If we win, it will be the best thing that ever happened to medicare, because medicare is going bankrupt," Dr. Day said.
Critics despair at his prescription for the future, however, arguing that he plays fast and loose with facts and medicare is not doing nearly as poorly as he suggests.
Mr. Lewis agrees that medicare needs to improve its delivery of services, but the answer is not to allow someone to pay for something others can't afford. "That's not fair," he said. "The solution is to make the public system good enough, so we don't have facilities like Dr. Day's clinic cherry-picking low-risk, high-volume, lucrative services."
No one should be too surprised by Dr. Day's incessant punching away at Canada's health-care system. He comes by it honestly. A schoolmate of Paul and George of the Beatles, Dr. Day was raised in the rough, impoverished Liverpool district of Toxteth, He was a promising young boxer, until he stopped growing at 5 foot 4. He retains a scar from a one-sided knife fight when he was 10.
His pharmacist father was gunned down by a couple of thugs looking for drugs during the Toxteth riots in 1981. Several years later, his mother died at 61, a victim of misdiagnosis.
It's a background that has doubtlessly helped forge Dr. Day's combativeness and determination to stay the course. "There is nothing unethical about spending your own money on your own health care, and no one will ever convince me that it is," he declared.
The pros and cons of private-versus-public meant little, however, to Dennis Geidt, willing to pay to stop pain so severe he couldn't pick up a jug of milk or sleep at night. He just wanted the hurting to stop.
That night, in a downtown Vancouver hotel, Mr. Geidt, who travelled from his Rocky Mountain home in Revelstoke, B.C., for the operation, had his first pain-free, restful sleep in months.
"It was damned expensive," he said. "But when you're my age, who cares?"