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Physicians and public health care advocates protest outside a private health clinic, the Cambie Surgery Centre, in Vancouver on Aug. 20, 2012. The protesters are against the clinic’s extra-billing practices.

Rafal Gerszak/The Globe and Mail

Provincial and territorial health ministers will gather in Banff this week and advocates of Canada's public health-care system are urging them to protect medicare while they are there.

Dr. Vanessa Brcic of the B.C. Health Coalition said a lack of federal leadership on health care has led to a proliferation of private health-care services across the country, with British Columbia leading the way.

"In other provinces we don't see quite as much for-profit investment as we do in B.C.," Brcic said Monday at a news conference held outside the Cambie Surgery Clinic in Vancouver.

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"There's definitely a tremendous movement towards for-profit care, simply because the profit that you can make from illness and suffering is absolutely tremendous."

The B.C. government is in negotiations to resolve a long-running dispute with the private Cambie clinic, nestled on a tree-lined street near the sprawling Vancouver General Hospital complex in Vancouver.

A 2012 audit of a 30-day period at the clinic found patients were illegally charged for nearly $500,000 in services. Under the Canada Health Act, doctors may not bill patients privately for procedures that are publicly insured.

The audit found 205 incidents where the clinic billed patients for services covered by medicare. The Medical Services Commission ordered the clinic to stop its billing practice and threatened a court injunction.

But Dr. Brian Day, who founded the clinic about two decades ago, countered with a lawsuit against the B.C. health minister and the attorney general, arguing that the prohibition is a violation of the charter right to life, liberty and security.

A trial set to begin last month in B.C. Supreme Court was delayed until at least next March while the two parties try to reach an out-of-court settlement.

Officials at the Cambie clinic declined a request for an interview.

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Health Minister Terry Lake was not available for comment, but said in an email statement that the priority of his ministry is to uphold the provincial Medicare Protection Act.

"We expect and require these clinics to come into full compliance with the law," Lake said.

If that goal can be reached through a settlement, the province is willing to explore that. If not, the court will resolve the dispute, he said.

"Physicians who are practising at these clinics can bill the Medical Services Plan for medically necessary services, as long as they are complying with the Medicare Protection Act," Lake said, adding that he could add no further comment on a case before the courts.

The coalition supports a settlement but sent a letter last week to Lake, Attorney General Suzanne Anton and the chairman of the Medical Services Commission, urging them to send a strong message with any potential deal.

"We want to ensure that the B.C. government fully holds Dr. Day and his for-profit clinic to account and that the over-billing practices stop today, and that a full, extensive audit is called," said Edith MacHattie, co-chairwoman of the health coalition.

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The two groups want a full audit of the clinic and hefty penalties for billing patients privately for services covered under the public system. But they also support an out-of-court resolution.

"The number of taxpayer dollars that have already been spent on the case are tremendous and we want our tax dollars going toward the health-care system and not the legal battle," said Brcic.

Wait lists are unacceptably long in some cases, she said, but for-profit health care is not the answer.

"When you have a scarce resource like doctors and nurses and those are working only for the select few who can afford high-cost services, then everyone else ends up waiting longer."

Provincial and territorial health ministers are to meet Tuesday and will be joined Wednesday by Federal Health Minister Rona Ambrose.

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