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News of the Day ... In Perspective


Landmark victory for private medicine in Canada

The Supreme Court of Canada struck down a Quebec prohibition on private health insurance, saying it contravened Quebec’s Charter of Human Rights and Freedoms.

“Access to a waiting list is not access to health care,” said the Court.

The case was brought by Dr. Jacques Chaoulli, a family physician, on behalf of a patient who had to wait a year for hip surgery while prohibited from paying privately. Dr. Chaoulli had been forced to abandon his emergency house call business in 1997, even as his patients begged him not to give up, because of mounting government penalties for accepting private payment (Clifford Krause, NY Times , May 21, 2005).

Dr. Chaoulli served as his own lawyer and incurred more than half a million dollars in out-of-pocket legal expenses. Had he lost, he could have been held liable for the government’s defense costs.

“This is indeed a historic ruling that could substantially change the very foundations of medicare as we know it,” said Dr. Albert Schumacher, President of the Canadian Medical Association (Globe and Mail, June 9, 2005).

The decision could potentially “destroy” the public system, said Mike McBane, spokesman for the Canadian Health Coalition. It “could open the door to introduce a legal framework for private health insurance. It would be a constitutional coup d’état on medicare.”

However, Philippe Trudel, lawyer for the patient, said, “The issue at hand today can be boiled down to one question—can the state keep people from obtaining the medical services that they need?” (National Post, June 8, 2005).

While this decision only applies to Quebec, Dr. Chaoulli predicts that eventually the effect will be felt throughout Canada. “How can you imagine that Quebeckers may live,” he asked, “and the English Canadian has to die?” (NY Times, June 9, 2005).

Additional information:

“Fighting for Freedom of Contract in Canada” by Jacques Chaoulli, M.D., J Am Phys Surg, Spring 2004

“Canadian Medicare: A Road to Serfdom” by William Goodman, M.D., from AAPS annual meeting, 1990

“The Canadian Model: Could It Work Here?” by Willliam Goodman, M.D., from AAPS annual meeting, 1989

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