Canadian Supreme Court ruling a step toward two-tiered care
Top court strikes down Quebec private health-care law
CBC News (Canada)
June 9, 2005
The Supreme Court of Canada ruled Thursday that the Quebec government cannot prevent people from paying for private insurance for health-care procedures covered under medicare.
The plaintiffs in the case are a Montreal patient and a doctor. They wanted Canada’s top court to strike down sections of the Quebec Hospital Insurance Act that prevent people from buying health insurance for medical procedures covered by the public health plan.
In its ruling Thursday, the court said the provincial policy violates the Quebec charter. But they split 3 - 3 on whether it violated the Canadian Charter of Rights and Freedoms, meaning there is no immediate impact on the Canadian health-care system as a whole.
http://montreal.cbc.ca/regional/servlet/View?filename=qc-health20050609
Comment: Private health insurance in Canada has been limited to care not covered by their medicare program. The citizens in Canada emphatically agree with the concept that parallel private insurance for medicare covered services should not be allowed because it would allow wealthier Canadians to buy their way to the front of the queue (waiting time for non-urgent services). They support the egalitarian view that their health care system should be shared by everyone.
At the same time, they are not pleased with the development of excess queues and believe that the government should fund adequate capacity in the system.
Prime Minister Paul Martin was reelected on the promise of increasing federal funding to the provincial health systems. That process has begun.
Today’s decision represents a collision of those views. Although the complex ruling is still under study, the Court did rule that, when queues are truly excessive, a patient should be able to bypass the queue through private payment and a physician should be able to provide those services under a private fee arrangement.
The great fear is that this decision will allow affluent Canadians to buy their way to the front of the queue, and, in so doing, diminish their support of public funding of the system. For the average Canadian, diminished funding would result in longer queues and other problems that can arise from chronic underfunding. Such policies would result in a two-tiered system: for the wealthy the best that money can buy, and for the rest, mediocrity or worse.
It will be interesting to see if Canadians will accept this shift from an egalitarian system to one more like ours in the United States: if you don’t have money, don’t get sick.