While many British Colum-bians agree that the ongoing recession is making this summer uncomfortably hot, the downturn may not reign much longer as the West Coast’s top issue. And if that happens, the headlines will read: “It’s not the economy, stupid; it’s health care.”

That’s right, health care — specifically, the private vs public variety — is beginning to heat up as a primary issue in British Columbia. And it’s pushing the economy off page one for several reasons.

A lawsuit launched earlier this year by private health-care operators continues to move through the Supreme Court of B.C., with the next step the setting of a trial date. Essentially, it’s a constitutional challenge to the B.C. legislation (matched in other provinces) that limits patient access to treatments in private health-care clinics.

The Canadian Independent Medical Clinics Association and five private clinics — including Vancouver’s Cambie Surgery Centre, which is headed by former Canadian Medical Association president Dr. Brian Day — are claiming that B.C. residents should be able to buy private health insurance to use in private clinics if their care is not provided in a timely manner in the public system.

“Governments can’t have it both ways,” Day said when the suit was launched last January. “They cannot, on the one hand, promise access to health care and then fail to deliver it, and then deny Canadians the right to extricate themselves from waiting lists.”

“Oh, yes, we can,” the B.C. government effectively said in its statement of defence and countersuit launched last spring. The filing actually said: “There is no freestanding constitutional right to health care.”

In other words, according to B.C., the Charter of Rights and Freedoms does not protect patients against long waits for treatment.

In a landmark 2005 Supreme Court of Canada case, Dr. Jacques Chaoulli sued the Quebec government, eventually winning the right to treat a patient waiting for a hip replacement in Chaoulli’s private clinic. The case has reverberated through the public/private health-care issue ever since: last year, for instance, critics noted that a patient died in Chaoulli’s waiting room and that no effort was made to resuscitate him, as would have occurred in a public hospital.

In any event, the B.C. government contends that the Chaoulli decision does not apply in B.C. Its countersuit seeks court authority to enter Day’s Cambie Surgery Centre to examine its books. The government suspects those records will show examples of what it considers unlawful billing. Private clinics, which treat about 50,000 patients annually in B.C., must not collect fees for medically necessary procedures that are publicly funded by B.C.’s medical services plan.

Despite the legal challenge, the health-care issue took a back seat to the recession during the May 2009 election campaign, as cautious voters decided to stick with the devil they know and gave Gordon Campbell’s Liberals a third term. So, many were surprised when Campbell appointed controversial Transportation Minister Kevin Falcon to the health portfolio. Falcon had systematically used the “bull in a china shop” approach to push through transportation projects, such as the Sea-to-Sky Highway and the Port Mann Bridge, despite strong public opposition. Many speculate his move to health means B.C. is in for significant spending cuts and major changes in its health-care structure.

True to form, Falcon created controversy almost immediately. The new health minister said in June he thought that B.C. patients should be able to use their own money to buy expedited treatments in private medical clinics. “I don’t have any philosophical objections to it,” he told the Vancouver Sun.

Not surprisingly, the premier must have had some pretty strong political objections to that statement because the new health minister quickly had to “qualify” his remarks by saying that he was only referring to elective treatments such as plastic surgery.

Consequently, given the pending court case and a new, brash, shoot-from-the-lip health minister at the helm, health care in B.C. is on the critical issue list and may never be the same again. IE