Canadian Politics - Healthcare

[Wezil]

The story is just breaking now so I suspect we will have a better news article later but for now:

Supreme Court strikes down Quebec law banning private health care

Provided by: Canadian Press
Jun. 9, 2005


OTTAWA (CP) - The Supreme Court of Canada has struck down a Quebec law banning private insurance for services covered under medicare.

The high court ruled that the law violates Quebec's charter of rights.

It split on the implications for other provinces.

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

It said it needed time to study the decision before commenting further.


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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.

They also argued that it violated the Quebec charter.

Zeliotis said his year-long wait for a hip replacement in 1997 violated both charters.

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.

Looks like yet another bad decision by the santas in Ottawa. Not only does this ruling make 'rights' inconsistant across the country, it throws a hot potato to the politicians in Ottawa.

Will the politicians now extend "two tier" across the country to conform with the law in Quebec (something they swore they would never do) or try to convince the ROC that this imbalance is OK?

[Kontiki]

Two tier healthcare - provided the public portion remains at least as good as it is now (or hopefully gets better)

[Wezil]

But apparently only if you live in Quebec.

[Kuciwalker]

Forbidding any private practice of doctors (IIUC)

[chequita guevara]

Originally posted by Kontiki
Two tier healthcare - provided the public portion remains at least as good as it is now (or hopefully gets better)

It won't. Once doctors can make more money in private health care, they will abandon the public health care sector in a tsumani, leaving your public health care system a wreck. This decision is a catastrophe for Canada's health care system. You better nip this in the bud.

[Wezil]

Originally posted by Kuciwalker
Forbidding any private practice of doctors (IIUC)

Yep, we are in good company though. Cuba has the same policy.

[Wezil]

Originally posted by chegitz guevara


It won't. Once doctors can make more money in private health care, they will abandon the public health care sector in a tsumani, leaving your public health care system a wreck. This decision is a catastrophe for Canada's health care system. You better nip this in the bud.

You make many assumptions there. How such a system is structured is critical. How does the rest of the world do it?

How to "nip this" is a better question. This is a SCC decision. I favour the decision as it applies to Quebec, but this gutless decision created two separate classes of Canadians. Should we all move to Quebec if our health starts failing and we can't get timely care in our home provinces? I assume you can see the problem.

[Kontiki]

Originally posted by Kuciwalker
Forbidding any private practice of doctors (IIUC)

We don't forbid private practices, we just don't let them set their own rates or handpick their patients.

[Adam Smith]

Zeliotis said his year-long wait for a hip replacement in 1997 violated both charters.

My father had a hip replacement on Tuesday. He waited about three weeks. If he had to wait a year he would have completely lost function in his hip and been in a wheelchair permanently.

[Agathon]

It won't. Once doctors can make more money in private health care, they will abandon the public health care sector in a tsumani, leaving your public health care system a wreck. This decision is a catastrophe for Canada's health care system. You better nip this in the bud.

Nah.

We've always had this in New Zealand. People who want additional insurance can buy it. It means that they don't have to wait as long for hip replacements. I think that taxes should be raised to get rid of such lists, but it's false to say that two tier healthcare has gutted the public system. If anything, it is the public's appetite for consumer spending rather than public spending, and the right wing nutbars who have exploited this, who have made public healthcare worse.

[Kontiki]

Originally posted by Adam Smith

My father had a hip replacement on Tuesday. He waited about three weeks. If he had to wait a year he would have completely lost function in his hip and been in a wheelchair permanently.

And if that were the case with this Zeliotis guy, he most likely wouldn't have waited a year. We have a needs-based system, though imperfect. My mother, unfortunately, has had a litany of health problems. There's been routine, quasi-surgical procedures that she's had done that while improving her comfort level, weren't going to seriously harm her if they were put off. She had to wait a while for these. Other times, she's had stuff that needed to be done right away, and she managed to get in a few days after being diagnosed.

[Wezil]

Zeliotis according to the evidence was in considerable pain.

[notyoueither]

http://www.cbc.ca/story/canada/national/2005/06/09/newscoc-health050609.html

Top court strikes down Quebec private health-care ban
Last Updated Thu, 09 Jun 2005 21:33:36 EDT
CBC News
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.

In a 4-3 decision, the panel of seven justices said banning private insurance for a list of services ranging from MRI tests to cataract surgery was unconstitutional under the Quebec Charter of Rights, given that the public system has failed to guarantee patients access to those services in a timely way.

As a result of delays in receiving tests and surgeries, patients have suffered and even died in some cases, justices Beverley McLachlin, Jack Major, Michel Bastarache and Marie Deschamps found for the majority.

The Quebec government reacted by saying it would apply immediately for a stay of between six months and two years before the decision takes effect, given the chaos it could cause in the delivery of medical services in Quebec.

Intergovernmental Affairs Minister Benoit Pelletier said the province would consider using the notwithstanding clause in Quebec's constitution as an alternative to abiding by the court's decision.

The plaintiffs in the case – a Montreal patient and a doctor wanting to set up a private clinic – asked 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.

Four of the seven justices ruled Thursday that 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.

One justice gave no opinion on whether the laws violate the charter.

Waited year for hip replacement

The two plaintiffs in the case had separate complaints, but the court decided to hear their court challenges together.

In 1996, Montreal businessman George Zeliotis waited a year for hip replacement surgery. While waiting, he asked whether he could purchase insurance that would allow him to skip the public queue and pay directly for the surgery.

When he learned it was against the law, he took his case to court.

Canadians can buy private health insurance for things outside of public medicare such as prescriptions, physiotherapy or private hospital rooms.

The 73-year-old Zeliotis argued the year-long wait for surgery was unreasonable, endangered his life and infringed on the charter's guarantee of right to life, liberty and security.

The second plaintiff, Dr. Jacques Chaoulli, wanted the court to overturn a Quebec provision preventing doctors who don't operate within the medicare plan from charging for services in public hospitals.

Chaoulli, who had tried but failed to set up a private hospital, represented himself before the court.

On Thursday, Chaoulli said the ruling can only improve the quality of the country's health care system by taking some of the burden off cash-strapped provincial governments.

"The government cannot continue to raise taxes to pay for health care," Chaoulli said. "Too many Canadians are suffering."

Senator Michael Kirby, who chaired a Senate committee studying health care, recommended the provinces pay for private treatment if the patient isn't treated within a certain timeframe.

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."

One justice gave no opinion on whether the laws violate the charter.

People in pain or dying is against the Quebec Charter, but not the Canadian? This had gotta take the cake.

[Tingkai]

So does anyone know why the Supreme Court ruled that banning private medicine violates the Quebec charter, but not the Canadian charter?

[St Leo]

Quebec Charter of Human Rights and Freedoms

INTRODUCTION

WHEREAS every human being possesses intrinsic rights and freedoms designed to ensure his protection and development,

Whereas all human beings are equal in worth and dignity, and are entitled to equal protection of the law;

Whereas respect for the dignity of the human being and recognition of his rights and freedoms constitute the foundation of justice and peace-,

Whereas the rights and freedoms of the human person are inseparable from the rights and freedoms of others and from the common well-being-be-,

Whereas it is expedient to solemnly declare the fundamental human rights and freedoms in a Charter, so that they may be guaranteed by the collective will and better protected against any violation;

Therefore, Her Majesty, with the advice and consent of the National Assembly of Quebec, enacts as follows:

CHAPTER I: GENERAL PROVISIONS

1 . Every human being has a right to life, and to personal security, inviolability and freedom.

He also possesses juridical personality.

2. Every human being whose life is in peril has a right to assistance.

Every person must come to the aid of anyone whose life is in peril, either personally or by calling for aid, by giving him the necessary and immediate physical assistance, unless it involves danger to himself or a third person, or he has another valid reason.

3. Every person is the possessor of the fundamental freedoms, including freedom of conscience, freedom of religion, freedom of opinion, freedom of expression, freedom of peaceful assembly and freedom of association.

4. Every person has a right to the safeguard of his dignity, honour and reputation.

5. Every person has a right to respect for his private life

6. Every person has a right to the peaceful enjoyment and free disposition of his property, except to the extent provided by law.

7. A person's home is inviolable.

8. No one may enter upon the property of another or take anything therefrom without his express or implied consent.

9. Every person has a right to non-disclosure of confidential information.

No person bound to professional secrecy by law and no priest or other ministers of religion may, even in judicial proceedings, disclose confidential information revealed to him by reason of his position or profession, unless he is authorized to do so by the person who confided such information to him or by an express provision of law.

The tribunal must, ex officio, ensure that professional secrecy is respected.

10. Every person has a right to full and equal recognition and exercise of his human rights and freedoms, without distinction, exclusion or preference based on race, colour, sex, sexual orientation, civil status, religion, political convictions, language, ethnic or national origin, social condition or the fact that he is a handicapped person or that he uses any means to palliate his handicap.

Discrimination exists where such a distinction, exclusion or preference has the effect of nullifying or impairing such right.

11. No one may distribute, publish or publicly exhibit a notice, symbol or sign involving discrimination, or authorize anyone to do so.

12. No one may, through discrimination, refuse to make a juridical act
concerning goods or services ordinarily offered to the public

13. No one may in a juridical act stipulate a clause involving discrimination.

Such a clause is deemed without effect.

14. The prohibitions contemplated in sections 12 and 13 do not apply to the person who leases a room situated in a dwelling if the lessor or his family resides in such dwelling, leases only one room and does not advertise the room for lease by a notice or any other public means of solicitation.

15. No one may, through discrimination, inhibit the access of another to public transportation or a public place, such as a commercial establishment, hotel, restaurant, theatre, cinema, park, camping ground or trailer park, or his obtaining the goods and services available there.

16. No one may practice discrimination in respect of the hiring, apprenticeship, duration of the probationary period, vocational training, promotion, transfer, displacement, laying-off, suspension, dismissal or conditions of employment of a person or in the establishment of categories or classes of employment.

17. No one may practice discrimination in respect of the admission, enjoyment of benefits, suspension or expulsion of a person to, of or from an association of employers or employees or any professional corporation or association of persons carrying on the same occupation.

18. No employment bureau may practice discrimination in respect of the reception, classification or processing of a job application or in any document intended for submitting an application to a prospective employer.

19. Every employer must, without discrimination, grant equal salary or wages to the members of his personnel who perform equivalent work at the same place.

A difference in salary or wages based on experience, seniority, years of service, merit, productivity or overtime is not considered discriminatory if such criteria are common to all members of the personnel.

20. A distinction, exclusion or preference based on the aptitudes or qualifications required in good faith for an employment, or justified by the charitable, philanthropic, religious, political or educational nature of a nonprofit institution or of an institution devoted exclusively to the well-being of an ethnic group, is deemed non-discriminatory.