Canada Healthcare Lesson

(National Review Online)  This column was written by Grace-Marie Turner.

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The supreme court of Canada struck down a Quebec law on Thursday that had banned private health insurance for services covered under medicare, Canada's socialized health-care program.

"This is indeed a historic ruling that could substantially change the very foundations of medicare as we know it," Canadian Medical Association president Dr. Albert Schumacher said after the ruling. The ruling means that Quebec residents can pay privately for medical services, even if the services also are available in the provincial health care system.

"Access to a waiting list is not access to health care," the court said in its ruling.

A courageous Canadian doctor, Jacques Chaoulli, challenged the constitutionality of the Canadian ban on private payment. He argued that long waiting times for surgery contradict the country's constitutional guarantees of "life, liberty, and the security of the person."

He was joined in the case by his patient, Montreal businessman George Zeliotis, who waited a year for hip-replacement surgery. Zeliotis, 73, tried to skip the public queue to pay privately for the surgery but learned that was against the law. He argued that the wait was unreasonable, endangered his life, and infringed on his constitutional rights. The court agreed.

The case involved the Quebec Hospital Insurance Act and technically only applies to that province -- but it will surely shake up all the other provinces, where private insurance is also banned. The court split 3-3 over whether the ban on private insurance violates the Canadian Charter of Rights and Freedoms (the Canadian equivalent of our Bill of Rights). Clearly this was a difficult decision since the court delayed a year in issuing its verdict.

The United States has been a safety valve for Canadians unwilling or unable to tolerate the long waits for medical care in their country. Now, the Canadian government must face the music about the long waiting lines, lack of diagnostic equipment, and restrictions on access to the latest therapies, including new medicines.

According to the Canadian Broadcasting Corp., in an almost laughable defense, "Lawyers for the federal government argued the court should not interfere with the health-care system, considered 'one of Canada's finest achievements and a powerful symbol of the national identity.'" Dr. Chaoulli had persevered in spite of two lower court-rulings against him that had ruled that the limitation on individual rights was justifiable in order to prevent the emergence of a two-tier healthcare system.

Supporters of the prohibition against private contracting in Medicare in the United States should take note because our own law has the same effect, making it almost impossible for Medicare recipients to pay privately for services covered by the program.


Grace-Marie Turner is the president of the Galen Institute.


By Grace-Marie Turner
Reprinted with permission from National Review Online