VANCOUVER — A framed iconic photo in Dr. Brian Day’s office shows Muhammad Ali raising a triumphant gloved hand as he stares down at his opponent splayed on the mat after a first-round boxing knockout less than two minutes into the fight.
Day, 72, will step into a courtroom on Monday as final arguments begin in the culmination of a battle he launched a decade ago against the British Columbia government based on a constitutional challenge saying patients have a right to pay for private care if the public system leaves them waiting too long.
“I stayed up to listen to the fight on the radio,” Day said of the legendary spectacle between Ali and Sonny Liston in 1965, adding he stopped boxing in his native Liverpool, England, at age 11 as his peers began outgrowing him.
He took on the provincial government, and in effect the “myth” of Canada’s single-tier universal health-care system, in 2009 and the case landed in B.C. Supreme Court in 2016 with support from four patients.
Other countries, including Switzerland, Germany and England, that offer a parallel public-private system of care have managed to shorten wait lists, he said.
“We’re the only jurisdiction on Earth where private health insurance for medically necessary care is unlawful, unless you’re an injured worker,” Day said after doing knee surgery on a 61-year-old patient from Alberta, the first of his eight procedures that day, some involving people whose costs would be covered by B.C.’s workers’ compensation agency.
That’s unfair to children and others needing surgery because they must choose to either pay for private clinics or suffer through delays in public hospitals, he said.
“One of the witnesses in our trial was a welder who had previously undergone surgery for a knee ligament injury on one knee and came back a few years later with the same injury in the other knee but he hurt it in sports on one knee and got an MRI quickly and on the other side was told it was going to be 18 months.”
However, government lawyers say in written closing arguments that Day’s claims of the plaintiff patients having been deprived of life, liberty and security of the person under Section 7 of the charter are problematic because those protections apply to issues of justice, not health care.
Rather than a constitutional challenge, the government alleges Day’s case amounts to “political theatre” and an attempt to force change on the health-care system for the financial benefit of doctors who earn more money from wealthy patients going to private clinics.
The province also says Day’s lawyers have failed to establish that patients any suffer harm by waiting for services.
Day said he illegally opened the Cambie Surgery Centre in 1996 in order to create more operating-room time for surgeons who couldn’t get it in public hospitals and profit was never a motive.
In 2018, Health Minister Adrian Dix announced the government would begin to fine doctors $10,000 for a first offence and $20,000 for a second violation of its Medicare Protection Act if they charged patients for publicly available services. He said the ‘Don’t ask, don’t tell’ approach, which allowed private-clinic surgeries and diagnostic tests to continue because provisions of the law had not been enforced, would come to an end.
However, Day successfully sought an injunction that prompted B.C. Supreme Court Justice Janet Winteringham to order the government not to enforce sections of the act until their validity could be established at trial, which is expected to conclude Dec. 6 with the trial judge.
Days before the start of closing arguments, the surgeon said the injunction order was a positive sign he would prevail in his court battle because Winteringham recognized patients would “suffer serious physical and/or psychological harm while waiting for health services” if they couldn’t turn to private clinics.
Winteringham’s words apply generally to the “nonsense” of an inadequate universal health-care system that doesn’t meet patients’ needs, said Day, a former president of the Canadian Medical Association.
“It’s unconstitutional. You cannot have it both ways. You cannot promise health care, then not deliver it in a timely way, then outlaw the patients’ ability to access it independently,” he said.
“I’m confident that the evidence is in that major harm is being done to patients by the health system as it operates.”
The federal government is an intervener in his trial, along with Canadian Doctors for Medicare, the B.C. Nurses’ Union and the B.C. Health Coalition.
Dr. Danyaal Raza, board chair of Canadian Doctors for Medicare, said the delivery of health care is being reorganized around the country and some changes are based on a model in Richmond, B.C., where a hospital reduced wait times for hip and knee surgeries through efficiencies such as booking surgeries centrally.
“It’s a model that Alberta has also pursued and now in Ontario we’re learning from the experience of B.C. and Alberta and we’re learning from that experience how to approach back pain,” the family doctor said from Toronto.
“I think the pace of change needs to speed up,” he said. “If we go down the road that Dr. Day wants to take us, wait lists are not going to get better, they’re going to get worse. So, we really have to decide when we make changes to the health-care system, do we want changes that are going to benefit everyone or do we want to make changes that prioritize those who can pay?”
He said a parallel public-private system has not worked in some countries, including Australia and Scotland.
Day said his case has so far cost $6 million, with much of the money raised by the Canadian Constitution Foundation, but the province has refused to divulge how much it has paid in taxpayers’ dollars since 2009.
Derek From, a lawyer with the foundation, said the Office of the Information and Privacy Commissioner ordered the government to release the amount at the foundation’s request but the government won an appeal of the decision in court though his group is in the process of filing an appeal of that ruling.
This report by The Canadian Press was first published Nov. 17, 2019
— Follow @CamilleBains1 on Twitter.
Camille Bains, The Canadian Press
@repost Spousal Maintenance Agreement
Democrats hold on to Louisiana governor’s seat despite Trump
BATON ROUGE, La. (AP) — Louisiana Gov. John Bel Edwards has stunned Republicans again, narrowly winning a second term Saturday as the Deep South’s only Democratic governor and handing Donald Trump another gubernatorial loss this year.
In the heart of Trump country, the moderate Edwards cobbled together enough cross-party support with his focus on bipartisan, state-specific issues to defeat Republican businessman Eddie Rispone, getting about 51% of the vote.
Coming after a defeat in the Kentucky governor’s race and sizable losses in Virginia’s legislative races, the Louisiana result seems certain to rattle Republicans as they head into the 2020 presidential election. Trump fought to return the seat to the GOP, making three trips to Louisiana to rally against Edwards.
In a victory rally of his own late Saturday, Edwards thanked supporters who danced, sang and cheered in celebration, while he declared, “How sweet it is!”
He added, “And as for the president, God bless his heart” — a phrase often used by genteel Southerners to politely deprecate someone.
Testimony ties president closer to pressure on Ukraine
WASHINGTON (AP) — Gordon Sondland, President Donald Trump’s emissary to the European Union, had a message when he met with a top Ukrainian official.
Sondland said vital U.S. military assistance to Ukraine might be freed up if the country’s top prosecutor “would go to the mike and announce that he was opening the Burisma investigation,” a U.S. official told lawmakers. Burisma is the gas company in Ukraine where Democrat Joe Biden’s son Hunter served on the board.
Sondland relayed the exchange moments later to Tim Morrison, then a National Security Council aide. In his private testimony to impeachment investigators made public Saturday, Morrison recounted that Sondland also told him he was discussing the Ukraine matters directly with Trump.
Morrison’s testimony ties Trump more closely to the central charge from Democrats pursuing impeachment: that Trump held up U.S. military aid to Ukraine in exchange for investigations into Democrats and Biden’s family. Morrison’s testimony also contradicts much of what Sondland told congressional investigators during his own closed-door deposition, which the ambassador later amended.
Both Morrison and Sondland are scheduled to testify publicly next week as part of the historic, high-stakes impeachment proceedings into the nation’s 45th president. Democrats charge that Trump abused his office for personal political gain, while the president and his allies argue that the process is politically motivated and that nothing in the testimony so far meets the bar for impeachment.
Migrants thrust by US officials into the arms of the cartels
NUEVO LAREDO, Mexico (AP) — The gangsters trawling Nuevo Laredo know just what they’re looking for: men and women missing their shoelaces.
Those are migrants who made it to the United States to ask for asylum, only to be taken into custody and stripped of their laces — to keep them from hurting themselves. And then they were thrust into danger, sent back to the lawless border state of Tamaulipas.
In years past, migrants moved quickly through this violent territory on their way to the United States. Now, due to Trump administration policies, they remain there for weeks and sometimes months as they await their U.S. court dates, often in the hands of the gangsters who hold the area in a vise-like grip.
Here, migrants in limbo are prey, and a boon to smugglers.
Warren pushes back on critics of her health care plan
WAVERLY, Iowa (AP) — Elizabeth Warren pushed back against critics of her newly released plan to phase in implementation of a single-payer health care system, insisting Saturday that she is “fully committed” to Medicare for All and that she plans to first build on existing health care programs because “people need help right now.”
“My commitment to Medicare for All is all the way,” Warren told reporters, responding to critics who’ve questioned the timing behind the release of her implementation plan.
On Friday, the Massachusetts Democrat released a plan outlining how she would transition to a full Medicare for All program, first by using executive action to bring down drug and health care prices and by pushing Congress to pass a bill giving Americans the option to buy in to an expanded government-run Medicare plan. Warren says she’ll then work with Congress to pass pieces of a universal coverage proposal more gradually, with the whole thing being ready “no later than” her third year in office.
The transition plan drew criticism from opposing campaigns, with a spokeswoman for Joe Biden accusing Warren of “muddying the waters” on health care and South Bend, Indiana, Mayor Pete Buttigieg’s campaign calling it “transparently political.”
Several Democratic candidates, including Biden and Buttigieg, have proposed plans similar to the first phase of Warren’s health care plan, which would allow Americans to buy into a public option. Asked about the difference between her plan and Buttigieg’s, Warren said that “mine is about actually giving people Medicare for All that is going to be full health care coverage,” and outlined ways in which she says her public option would offer more expansive health care coverage than those proposed by Buttigieg or Biden.
Alleged gunman, victim among 6 charged after game shooting
Six men have been charged after a shooting at a New Jersey high school football game that critically wounded a 10-year-old boy and sent players and the packed crowd fleeing in panic.
Ibn Abdullah, 27, was the target of the Friday night shooting and was charged because a gun was found on him when emergency responders went to his aid, authorities said. He is in stable condition and will be undergoing surgery.
The 10-year-old remained in critical condition Saturday. A 15-year-old boy was treated for a graze wound.
The shooting happened in the stands of a Friday night playoff game between the Camden Panthers and the Pleasantville Greyhounds. Authorities said it did not appear that any of the men charged had any connection to the game.
“Our community will not be held hostage by a few idiots intent on jeopardizing our safety and the safety of our children,” Atlantic County Prosecutor Damon Tyner said in a news release.
Big study casts doubt on need for many heart procedures
PHILADELPHIA (AP) — People with severe but stable heart disease from clogged arteries may have less chest pain if they get a procedure to improve blood flow rather than just giving medicines a chance to help, but it won’t cut their risk of having a heart attack or dying over the following few years, a big federally funded study found.
The results challenge medical dogma and call into question some of the most common practices in heart care. They are the strongest evidence yet that tens of thousands of costly stent procedures and bypass operations each year are unnecessary or premature for people with stable disease.
That’s a different situation than a heart attack, when a procedure is needed right away to restore blood flow.
For non-emergency cases, the study shows “there’s no need to rush” into invasive tests and procedures, said New York University’s Dr. Judith Hochman.
There might even be harm: To doctors’ surprise, study participants who had a procedure were more likely to suffer a heart problem or die over the next year than those treated with medicines alone.
White House: Trump undergoes exam at Walter Reed
BETHESDA, Md. (AP) — President Donald Trump spent more than two hours at Walter Reed National Medical Center on Saturday for what the White House said were medical tests as part of his annual physical.
The appointment wasn’t on Trump’s weekend public schedule, and his last physical was in February. Press secretary Stephanie Grisham said the 73-year-old president was “anticipating a very busy 2020” and wanted to take advantage of “a free weekend” in Washington to begin portions of his routine checkup.
She did not specify which tests he’d received or explain why the visit had not been disclosed in advance. Trump’s 2018 and 2019 physicals were both announced ahead of time and appeared on his public schedule.
Grisham said after the visit that the president had had “a quick exam and labs” and assured he remains in good health.
“The President remains healthy and energetic without complaints, as demonstrated by his repeated vigorous rally performances in front of thousands of Americans several times a week,” she said.
Sanders stars with Biden, Warren absent at California forum
LONG BEACH, Calif. (AP) — Bernie Sanders was greeted with booming cheers at a gathering of California Democrats Saturday, underscoring his popularity with the party’s liberal base as he looks to capture the biggest prize in the presidential primary season next year.
The decisions by Joe Biden and Elizabeth Warren to skip a weekend gathering of the California Democratic Party less than three months before voting begins gave rival candidates an opportunity to make inroads with the party’s most devoted activists, and Sanders’ reception made clear he remains among the favourites. Three years ago, the Vermont senator won 46 per cent of the vote in California’s 2016 Democratic primary in a losing bid against Hillary Clinton.
He assured the crowd he was in good health, just months after suffering a heart attack, and rose from a chair to his feet to apparently emphasize the point during a candidate forum hosted by Univision, the Spanish-language television station. He earned cheers when fending off suggestions that his agenda was pulling the party too far to the political left. “I don’t think so, I honestly don’t,” he said.
After the forum concluded, dozens of Sanders supporters staged an impromptu rally in the lobby of the convention centre, unfurling banners and chanting his slogan, “Not me, us.”
The convention stage gave candidates a chance to address devoted Democrats who are the backbone of the party and are coveted for their votes as well as potential volunteers and donors. Mail-in ballots for California’s primary will begin going out to voters on Feb. 3, the same day as the Iowa caucuses.
AP FACT CHECK: Impeachment hearings and that Trump tweet
WASHINGTON (AP) — President Donald Trump said he was just exercising his right to free speech. Democrats said he was intimidating a witness.
Whichever is the case, Trump’s Twitter assault on an ex-ambassador’s record came with a heavy dose of distortion.
He portrayed her, in a few choice words, as a wrecking ball in every country where she served U.S. interests in a long diplomatic career that has spanned danger zones and emerging democracies.
The tweet jolted impeachment hearings where Marie Yovanovitch was already testifying to the personal threat she has been feeling from the president.
Over two days, the hearings by the House Intelligence Committee featured a variety of statements at odds with the known facts.
Last minute-audible: Kaepernick workout moves to high school
RIVERDALE, Ga. (AP) — Colin Kaepernick’s saga took another surreal turn Saturday — a last-minute audible to nix an NFL-arranged workout and a quick dash 60 miles to the other side of metro Atlanta, where the exiled quarterback staged his own impromptu passing display on a high school field in dwindling light as hundreds of fans cheered him on from behind a chain-link fence.
Kaepernick threw passes for about 40 minutes at Charles Drew High School and spent nearly that long signing autographs for a crowd that steadily grew as word spread that a quarterback who led the San Francisco 49ers to the Super Bowl appearance and sparked a wave of protests and divisive debate by kneeling during the national anthem was in the neighbourhood.
Kaepernick declared again that he’s ready to play in the NFL.
If anyone will just give him a chance.
“I’ve been ready for three years,” he said. “I’ve been denied for three years. We all know why. I came out here today and showed it in front of everybody. We have nothing to hide. We’re waiting for the 32 owners, the 32 teams, (Commissioner) Roger Goodell, all of them to stop running, stop running from the truth, stop running from the people.”
The Associated Press
@repost Child Support Arrears
SAN DIEGO — The Latest on a shooting in San Diego (all times local):
San Diego police believe the deaths of three young boys and their parents were the result of a domestic dispute involving a husband and wife who were apparently going through a divorce.
Police Chief David Nisleit told a news conference Saturday afternoon that the couple had split up some time ago and that the 29-year-old mother had recently obtained a restraining order against the 31-year-old father. No names were disclosed.
Police Lt. Matt Dobbs says officers were summoned to the home shortly before 7 a.m. Saturday by someone who made a 911 call from the residence.
They arrived to see a boy inside the home covered in blood and found others severely wounded when they broke in.
The man, woman and three of the children have died.
Police say another young boy is hospitalized in critical condition.
Authorities say all were the victims of gunshot wounds.
This story has been updated to remove reference to the surviving child’s age after new information from authorities.
Five members of a family, including three young boys, have died and another boy was hospitalized with injuries in an apparent murder-suicide in San Diego.
Lt. Matt Dobbs said officers responded to a report of arguing and what sounded like a nail gun being fired inside a house in the Paradise Hills neighbourhood Saturday morning.
He said when officers arrived, they found a 3-year-old boy, a 29-year-old woman and a 31-year-old man dead inside. A 5-year-old boy and 9-year-old boy were taken to the hospital where they were pronounced dead.
An 11-year-old boy was also taken to the hospital to undergo surgery. His condition has not been released.
Dobbs said investigators found a gun in the house. Police believe the shooter was one of the deceased.
The Associated Press
@repost Top Divorce Lawyers
A community in Scarborough gathered on Saturday afternoon to mourn the loss of a young girl who died after being hit by an air conditioning unit that fell off the side of a city-owned apartment building last week.
“She was our little angel,” relative Qasem Afzali said, holding back tears while speaking to CTV News Toronto. “She was always smiling. She was very sweet, very loving.”
Friends and family of Crystal Mirogho huddled around the makeshift memorial for the little girl where members of the community had left flowers, stuffed animals and pictures of the two year old.
Police were called to the apartment complex on Lawrence Avenue East, near Mossbank Drive, just before 4 p.m. on Monday for a report of an injured child.
When emergency crews arrived on the scene, they located a child who had sustained life-threatening injuries and rushed her to a trauma centre. The child later succumbed to her injuries in hospital.
In a statement released Tuesday, the family said they are struggling to cope with the tragedy.
“Our family has lost our precious baby girl Crystal. We are devastated,” the statement from Slavko Ristich, the lawyer representing Crystal’s family, reads.
“We would ask that through this difficult time, we be given the opportunity to grieve our loss privately. We wanted to thank the public for the outpouring of support for our family while we are struggling to cope this is [sic] tragedy,”
Police said that Crystal’s two siblings, aged five and seven, witnessed the incident.
Window air conditioners pose ‘serious safety risk’: report
In 2007, a report commissioned by the Toronto Community Housing Corporation (TCHC) on replacing window air conditioner units inside city-owned buildings was released.
The report notes that of the more than 400 TCHC buildings with window air conditioners, many of the units are not properly installed and “pose a serious safety risk”.
“For the most part, the air conditioners inspected were not properly installed, which has two impacts: The air conditioners are not properly sealed around the edges resulting in energy loss, and there is a safety issue as the air conditioners could potentially fall out of windows.”
On Tuesday, a TCHC spokesperson said that in 2018 tenants could swap out their window-mounted units for floor models for free.
“It’s a safety issue,” TCHC spokesperson Bruce Malloch said, speaking to The Canadian Press. “A floor model will not fall out of a window and (they) are also more energy-efficient and that has a safety component as well – not to overload the wires.”
Speaking to CTV News Toronto, the family’s lawyer Slavko Ristich said he and his legal team have already discovered a lot of “interesting materials” in the early stages of their investigation.
“It doesn’t appear that they did anything since 2007. It looks like they revisited the issue again in 2017, and again, it doesn’t appear that anything was done.”
“If we find that the TCHC was negligent in terms of how they maintained these, how they installed them and how they supervised the building, then they could ultimately be responsible for any damages that the family may be entitled to.”
With files from the Canadian Press.
@repost Legal Separation Attorney
NUEVO LAREDO, Mexico — The gangsters trawling Nuevo Laredo know just what they’re looking for: men and women missing their shoelaces.
Those are migrants who made it to the United States to ask for asylum, only to be taken into custody and stripped of their laces — to keep them from hurting themselves. And then they were thrust into danger, sent back to the lawless border state of Tamaulipas.
Due to Trump administration policies, they remain there for weeks and sometimes months as they await their U.S. court dates, often in the hands of the gangsters who hold the area in a vise-like grip.
This story is part of an occasional series, “Outsourcing Migrants,” produced with the support of the Pulitzer Center on Crisis Reporting.
Migrants recount harrowing stories of robbery, extortion by criminals and crooked officials, and kidnappings by competing cartels. They tell of being captured by armed bandits who demand a ransom: They can pay for illegal passage to the border, or merely for their freedom, but either way they must pay.
And then they might be nabbed again by another gang. Or, desperate not to return to the homes they fled in the first place, they might willingly pay smugglers once more.
That’s what a 32-year-old Honduran accountant was contemplating. She had twice paid coyotes to help her cross into the U.S. only to be returned. Most recently, in September, she was sent back across the bridge from Brownsville to Matamoros.
Now, biding her time with her daughter in the city of Monterrey, she said one thing is for sure: “We are a little gold mine for the criminals.”
Tamaulipas’ dangers are well known. The U.S. has warned its citizens to stay away, assigning it the same alert level as war-torn countries such as Afghanistan and Syria.
Whenever possible, migrants heading north typically have immediately crossed the river to Texas or presented themselves at a U.S. port of entry to file an asylum claim, which would allow them to stay in the U.S. while their cases played out.
But the U.S. has set severe limits on applicants for asylum. The policy known colloquially as “Remain in Mexico” has meant the return of more than 55,000 asylum-seekers to the country while their requests meander through backlogged courts.
The Mexican government is ill-prepared to handle the influx along the border, especially in Tamaulipas, where it has been arranging bus rides south to the relative safety of the northern city of Monterrey or all the way to the Guatemala border, citing security concerns — tacit acknowledgement, some analysts say, of the state of anarchy.
A spokesperson for the Mexican foreign affairs secretary declined comment.
U.S. Border Patrol officials said they are continuing to send asylum seekers back over the border, including Nuevo Laredo.
Brian Hastings, Border Patrol chief of law enforcement operations, told AP officials didn’t see a “threat to that population” in Tamaulipas and “there was basically a small war between the cartel and the state police” there.
But the danger is real.
As of August, Human Rights First had tabulated 100 violent crimes against returnees. By October, that had more than tripled to 340. Most involved kidnapping and extortion. Kennji Kizuka, a researcher for the group, said the danger is even greater; the numbers are based solely on accounts his organization or reporters have been able to document.
Of dozens of people interviewed by AP who said they had been victimized in Nuevo Laredo, Reynosa, Matamoros and Monterrey, just one had filed a police report.
The story of Yohan and his family is typical. A 31-year-old Nicaraguan security guard, Yohan trudged back across the border bridge from Laredo, Texas, in July with his wife and two children in tow, clutching a plastic case full of documents including one with a court date to return and make their asylum claim to a U.S. immigration judge two months later.
They had left Esteli in northwestern Nicaragua over three months earlier after armed, government-aligned civilian militias learned that Yohan had witnessed the killing of a government opponent, he said. They followed him and painted death threats on the walls of their home.
In Nuevo Laredo, two strange men stopped Yohan while another group grabbed his loved ones. At least one of them had a gun. They were hustled into a van, relieved of their belongings and told they had a choice: Pay thousands of dollars for freedom, or for another illegal crossing.
They were was held in a series of what appeared to be private homes or offices, along with a family from El Salvador, two Cubans and two Mexicans. Everyone slept on the floor.
Initially the captors demanded $16,000. But Yohan’s family was able to scrape together just $3,000, and that angered the gangsters.
“I’m going to give you to the cartel,” one shouted.
Then Yohan’s son came down with the mumps. The captors provided a bit of extra milk for him in exchange for his sister’s little gold ring, but the boy wasn’t getting better and they abruptly released the family.
“They told us that the cartel doesn’t allow them to hold sick children,” Yohan said.
After 14 days captive and before leaving the safe house, Yohan was given a code phrase: “We already passed through the office, checking.” Only hours later they would need to use it. Arriving at the bus station, a group of strange men tried to grab them. Yohan spoke the six words in Spanish, and they were let go.
On Sept. 22, Yohan’s family returned for their court date, bringing with them a report on the family’s kidnapping. Though U.S. law allows at-risk people to stay, they were sent back to the parking lot of a Mexican immigration facility, surrounded by seedy cantinas and watching eyes.
They made their way to Monterrey, where they are being sheltered by a non-profit as they wait for their turn to plead for asylum.
Peter Orsi in Mexico City and Colleen Long in Washington contributed to this report.
Maria Verza, The Associated Press
@repost Custody Evaluation