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Good morning! It’s James Keller.

Brian Day has been fighting a legal odyssey against the monopoly of public health care.

Dr. Day’s Vancouver-based Cambie Surgery Centre has for years allowed patients to pay for surgeries out of pocket, apparently flouting provincial health laws that prohibit the practice, known as “extra billing.” Dr. Day has argued that preventing patients from paying to access care privately, rather than languishing on wait lists in the public system, is unconstitutional and cruel.

The legal fight has dragged on for 13 years already. The first major decision came out nearly two years ago, when the B.C. Supreme Court ruled against Dr. Day and sided with the B.C. and federal governments. He appealed, and on Friday lost for the second time as three judges at the B.C. Court of Appeal concluded the province’s medicare laws – which are mirrored in provinces across Canada – do not contravene the Charter of Rights and Freedoms.

While the justices did find that the medicare laws do offend sections of the Charter, such as the right to life and security of the person, they ultimately concluded that those problems did not outweigh the benefits of maintaining a fully public system that is sustainable.

Dr. Day says he and the other plaintiffs in the case will appeal to the Supreme Court of Canada, arguing that the Appeal Court justices made “many errors” in their ruling. He noted that the justices did find that the public health care law did breach certain sections of the Charter, which he sees as a positive. His legal team, he said, will narrow in on that and suggested they will argue that those violations cannot be justified.

The B.C. and federal governments both welcomed the ruling, which they said affirmed the need to protect the public health care system.

Health care advocates also celebrated, even as they acknowledged that long wait times remain a serious problem in the public system and must be addressed.

The issue is a constant focus of complaints from Canada’s premiers, who have repeatedly pointed to wait times to press for more money from Ottawa. In fact, they reiterated those demands just days before Friday’s court ruling at a premiers’ meeting in B.C.

Our health columnist, André Picard, writes that while the court affirmed the principles of Canada’s health-care system, there are few reasons to celebrate a health-care system that remains plagued by long wait times that are only growing worse.

“ Politicians, policymakers and medicare boosters have no business celebrating this court ruling. All their energies should be put into fixing medicare, to shoring up a publicly funded health system that seems to be collapsing around us.”

For more on the court ruling and the legal issues at play, read our explainer.

This is the weekly Western Canada newsletter written by B.C. Editor Wendy Cox and Alberta Bureau Chief James Keller. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here.