Supreme Court Strikes Down Quebec Ban on Privately Purchased Medical Treatment

[dutchie]

Just saw this on the Global site:

http://www.canada.com/news/national/story.html?id=866c83e8-39d5-4cba-ad04-d8a090479098

OTTAWA (CP) - The country's top court has delivered a powerful blow to Canada's single-tier system of public health care, striking down a Quebec law that banned private insurance for medically necessary services. The federal government insisted there's nothing to worry about, but most experts predicted the decision will lead to a parallel private system.

The Supreme Court of Canada ruled Thursday that the Quebec ban on private insurance violates Quebec's charter of rights.

The Canadian Medical Association called it a "historic" ruling that could "fundamentally change the health-care system in Canada as we now know it."

In Quebec City, interim Parti Quebecois Leader Louise Harel said Quebec's public health system is threatened and she urged Premier Jean Charest to defend it.

But Prime Minister Paul Martin downplayed such concerns.

"We're not going to have a two-tier health-care system in this country," he said.

Martin said the extra $41 billion his government is investing in health care will improve the public system and protect it, especially by reducing wait times.

"Our purpose is to strengthen our universal public system and to provide timely access to medical services.

"So when we put in the $41 billion we also said we need proper benchmarks in place with all the province that will allow us to determine by how much waiting times must be reduced."

Justice Minister Irwin Cotler also insisted the ruling doesn't threaten medicare.

"On a first, quick reading . . . the importance, the validity and the integrity of the public health-care system has been affirmed.

"The issue is really, how do we enhance a system that is acknowledged ... to be a valid system? How do we enhance it in terms of equal access and waiting times and the like, rather than say that this is an issue where we can't enforce the Canada Health Act?"

Health Minister Ujjal Dosanjh argued that governments can prevent the rise of private health care is by strengthening the public system.

"We are already on the way to doing that. That is the crux and the thrust of our approach."

But many weren't buying it.

"This is the end of medicare as we know it," said John Williamson of the Canadian Taxpayers Federation.

"This is a breach in government monopoly health care in this country.

"It's going to open up litigation across the country in the other nine provinces as taxpayers there press for the same right which is the right to seek and buy insurance to cover private health care."

Charest had no immediate reaction, saying he wanted to read the judgment.

The case involved Quebec doctor Jacques Chaoulli and his patient George Zeliotis who argued that the ban on buying private insurance for health care infringed on Canada's Charter of Rights and Freedoms as well as the Quebec Charter of Rights.

Zeliotis said his year-long wait for a hip replacement in 1997 violated his right to life, liberty and security under the Canadian charter, and a similar guarantee in the Quebec charter.

The Supreme Court split on whether the law violated the Canadian charter, but four of the seven justices who considered the case ruled that it violated the Quebec charter.

Chaoulli has long campaigned for the right to set up a private medical business, and once went on a hunger strike over the issue.

Public opinion polls have shown strong support for single-tier health care, with service based on need rather than ability to pay.

Pro-medicare groups such as the Canadian Health Coalition say pressure to strike down the rules of medicare came from health-care companies that want new market opportunities.

But political figures such as Senator Michael Kirby have argued in favour of permitting a greater role for private care. Chaoulli and Zeliotis received support from for-profit clinics in the Vancouver area.

Two Quebec courts had already ruled against Chaoulli.

© The Canadian Press 2005



What do you guys think? Will this open the door to a 2-tiered system? If so, is that a bad thing?

 

[Horse_Soldier]

The comments by the politicians and the chattering classes are pretty much what you'd expect.  The irony is that a large chunk of our health care system is already two-tier - it just isn't acknowledged. 

I hope that this ruling will get the discussion about the future of health care onto a realistic track instead of more repetitions of the single-minded mantra we've been hearing from those who think throwing more money at the problem is the only acceptable solution.  Of course, it's quite possible that instead of opening up discussions of solutions other than the current costly and inefficient socialised system, our elites will find ways to stifle any attempt at rational discourse by creative legislation.  Notwithstanding clause, anyone?

 

[Infanteer]

I hope that this ruling will get the discussion about the future of health care onto a realistic track instead of more repetitions of the single-minded mantra we've been hearing from those who think throwing more money at the problem is the only acceptable solution.    Of course, it's quite possible that instead of opening up discussions of solutions other than the current costly and inefficient socialised system, our elites will find ways to stifle any attempt at rational discourse by creative legislation.   Notwithstanding clause, anyone?

+1 to that, Horse Soldier.

I was hoping that this is the ruling that would come down (the Supreme Court had to earn points with me after its ridiculous ruling on Quebec Language education).   I'm happy for it for 2 reasons:

1)   Canada, as a free and liberal democratic nation, should not be in the business of running Doctors - it should regulate and oversee the profession, but it should dictate how they shall run their business; there is a legitmate consumer/provider relationship in Health Care, and ideology won't make that go away.

2)   Perhaps it will start to dawn on Canadians that the ideas of delivery of service and health care coverage are two different concepts - this shouldn't make a difference (in a properly managed system of universal coverage) as people should be covered regardless of where they go.

 

[Brad Sallows]

The ruling and the resulting media attention just might be the tipping point to drive home the message to Canadians that private care has always been available in Canada, but only to those who can pay directly.  The issue is _insurance_.  The ability to buy private health insurance would place that private care in the realm of accessibility to the middle classes.  I suspect some of those who can afford private care are disgruntled that the common man might soon be showing up on the clinic doorstep, and driving up the price (greater demand).  As for the statists, there may be pressure from the grassroots to renegotiate the funding to take into account a greater use of private insurers, which would of course be a threat to the steady stream of tax revenues and associated "spillage".

 

[a_majoor]

Paul Martin must be relieved at this ruling; he won't have to give up his private doctor.

 

[Cloud Cover]

With all due respect, as Brad indicated, one could always purchase private health care services in Quebec, in fact the province already has the most extensive private health network in Canada. The decision struck down the ban on private health care insurance.... which opens the door for the average joe to purchase private insurance for health treatment. That is what is scaring the shit out of the proponents of an all public system. Once the average consumer feels the difference in quality between the two systems,   the impetus for more public spending will dry up as families redirect their taxes to private insurance. Given the opportunity, Canadians will vote with their cheque books when it comes to decent health care.

IMHO, this is a non-decision if you are already sick or disabled, because the common law and most statute law in Canada protects insurers from discrimination law suits for refusing to insure high risk clients.   Private insurance will be a real threat when the substantive law in that area changes ... which is not likely to happen since the Supreme Court has, time and again, upheld the validity of insurance industry discriminatory practices, with the exception of employer group health insurance.    

The state will always provide the bulk of health care services, and there will be no throw back to the pre- CHA era. At the risk of sounding arrogant, the bottom line is this: in virtually all respects, when an individual needs something done right, with quality and in a timely, efficient manner, the government is the last entity any educated, motivated and self reliant person would or should turn to for virtually anything of high personal importance.

Scarce public resources ought to be reserved for those who have choice removed because of their individual circumstances, especially the disabled and the working poor.

Cheers  

 

[Fishbone Jones]

Let me buy my own insurance and get the timely care I need (not that need it right now  ) I'm tired of Joe Blue Collar having to wait four years for bypass surgery, but a politico from the hill can get his chest cracked in a week if he wants it. We've always been two tiered, but the politicians refuse to acknowledge it. It's just another pie in the sky, bullshit lie, out of Ottawa.