End of Canada's single-tier healthcare !

[Bakunin]

Supreme Court strikes down Quebec law 

Dennis Bueckert 

Canadian Press

Thursday, June 09, 2005

OTTAWA -- 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.

Most experts, on either side of the debate, predicted the decision will lead to a parallel private system. But the federal government insisted there's nothing to worry about.

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 federal Justice Minister Irwin Cotler 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."

Prime Minister Paul Martin said the extra $41 billion his government is investing in health care will improve the public system.

Many disagreed.

"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.

Private healthcare is now oficially legal in quebec !

However its likly that the quebec government will have to freeze the supreme court decision at least until we have a real debate and a variety of law to regulate the privatisation the way we want it.

I guess its a matter of time for alberta to join us and then the rest of canada.

[I miss Reagan]

This is why I like you Quebecers, you have backbone. Good for you guys. Somebody needs to stand up to the "Dirty Ditherer" for the rest of us. It sure as hell isn't Klein. But I understand Quebec may use that spookey and taboo notwithstanding clause. Hope not.

[Bakunin]

This is why I like you Quebecers, you have backbone.  Good for you guys.  Somebody needs to stand up to the "Dirty Ditherer" for the rest of us.  It sure as hell isn't Klein.  But I understand Quebec may use that spookey and taboo notwithstanding clause.  Hope not.

<{POST_SNAPBACK}>

For now the quebec government is asking the supreme court for a delay. I guess they will watch what the population think about it before doing anything.

The last poll on the subject showed that 60% of quebecers where for a partial privatisation of healthcare.

[Hugo]

Call me cynical, but wouldn't it make sense for Quebec to have private clinics so that our politicians have somewhere to go when they don't feel like waiting in line for hours, weeks, months or years (depending on what's wrong) like the rest of us? Isn't that what they already do?

Anyway, this will turn out well for Quebec. As the rest of Canadian public healthcare slowly goes down the sewer, their private clinics will be increasingly in demand. Their increasing clientele will drive their prices down and their quality up, and I'm sure that Quebec will have a booming healthcare-tourism industry before too long.

[willy]

"We're not going to a have two-tier health-care system"

Guess who said this today.

And we wonder why we bother listening to PMPM talk at all. Can I call him a liar or would that be to strong, maybe it is just spin.

We have two-tier health-care already. In BC if you get hurt on the job you get to go straight past the line into a private clinic thanks to WCB insurance. If you need you eyes fixed you go to a private clinic. If you want an MRI in Alberta while you are still young you go to a private clinic. And if you have a soft tissue injury you find out treatment is not covered in any province but yet the PMPM still claims we don't have two-tier health-care.

The federal government’s great answer today has been that they are managing wait lines. While the next time I am sick I will feel better to know that the line is being managed.

Oh boy...

[Bakunin]

The federal government’s great answer today has been that they are managing wait lines.

No wonder we have to wait so long...

We would give them the ocean and they would manage to run out of water....

[I miss Reagan]

Can I call him a liar or would that be to strong, maybe it is just spin.

"Liar" is such an emotionally charged accuasation. I hate to call him a liar for the reason that I wouldn't want to appear like the fools who call Bush a liar just because of their irrational rage. Martin does use private healthcare, such as MRI's, to "jump the que". So in that sense he's a total hypocrite. I would say PM definitely fits the category of spineless with his decision making history and lack of sticking to principles, if he has any. And I guess we could say he's dishonest from evidence coming out in the sponsorship scandle. I would say is biggest character flaw is his inability to make decisions and how he's so easily swayed to make what ever decision will keep him up in the polls. It's pretty disappointing. I figured the Trudeau/Chretien era of corruption ended when Martin took over. I tried to give him the benefit of the doubt.

[Bakunin]

Quebec healthcare minister wants a european style system

[Argus]

The federal government’s great answer today has been that they are managing wait lines. While the next time I am sick I will feel better to know that the line is being managed.

Oh boy...

<{POST_SNAPBACK}>

The Ontario Liberals have addressed the problem of wait lines with their usual vigour. They are changing the reporting system so that the waiting times seem to be smaller. Right now, the wait time reported is the time from when your doctor gets you an appointment to see a specialist, to when your surgery is performed by that specialist. The new system will only identify the time from when you actually see the specialist (often six months down the road) to when the surgery is performed.

Presto! Smaller waiting times are just around the corner for Ontarians!

Boy! Aren't you glad you voted Liberal!

[mona]

regarding I miss Reagan and those who agree with this individual, is our health care system that seriously flawed? Canada is a nation with one of the highest life expectancies in the world due to our health care system. If our health care were to become privatized, we will become our neighbour to the south. If we all look at the United State's health care system we can see canada if we were to have two tiered health care. I look at the U.S and cringe. The two tier system may benefit those with the money and the influence to have the needed health care but what of the people who make up the majority of the population, those who can't afford it? because of our health care system they can get the care they need, even if they have to wait. I would rather wait it out then have to pay hundreds of thousands of dollars. Maybe you who disagree have the money but the majority of the people i know don't possess salaries that can accomodate that.

[Canuck E Stan]

All these years Ralph was the bad guy, with his "third way" idea. Maybe federal Health Minister Ujjal Dosanjh should have attended the international conference a couple of months back in Calgary instead of rejecting it. He might have gotten some ideas so the Libs could get a PLAN for health care. Oh I forgot, the PLAN is throw MORE MONEY at health care,that way they could delay dealing with the whole thing. Health care needs some new ideas...today. People need help now. Paul did his thing as finance minister, cutting it down to bare bones. Fourteen years to get it in order and all the Libs did was dither it into the mess it is today.Enough talk,show me the PLAN.

[willy]

highest life expectancies in the world due to our health care system.

Our system is focused on dealing with the sick and not preventing sickness. IMO we have a longer life expectancy because we are a developed G8 country with better than average, air, water, education and employment. These things add up to prevention. High cigarette taxes, sport programs and many other preventions may also help.

[Bakunin]

highest life expectancies in the world due to our health care system.

Our system is focused on dealing with the sick and not preventing sickness. IMO we have a longer life expectancy because we are a developed G8 country with better than average, air, water, education and employment. These things add up to prevention. High cigarette taxes, sport programs and many other preventions may also help.

<{POST_SNAPBACK}>

the canadian and american system are bad, evryone agree with that but why not look at the european style system ?

Ppl against privatisation always point out the united states instead of the other g8 members.

When we have the same system as the cuban and north korean one, we must ask ourself what is wrong with us ? why is evrybody freaking when we are talking about partial privatisation ? it is unrational fear. European country are alot more progressive and they don't have a soviet style system like us.

[PatM]

Don't expect Martin to actually do anything to "fix" our healthcare system. He joined Mulroney in the long-term goal of starving the system to death. Make it so unpalletable to the general public that we'd roll over and plead for privatization.

Our system isn't "broken", its chronically underfunded. The talking heads all use phrases like "throw money at it" to discount the idea that lack of money is the problem. Fact is, throwing more money at it is EXACTLY what is required.

Can't get enough doctors and nurses since nobody wants to work the massive overtime for the relatively low pay. What is the mainstream politician's solution? Bust Nurses union contracts, freeze doctor's pay, and generally tick off everyone in healthcare. They NEVER do this when recruiting management types - they offer HUGE salaries and massive severance packages. Yet when it comes to those delivering healthcare, pay and benefits cuts along with snide characterizations are used to lure more workers?

Wake up - healthcare is "failing" because that is what the Liberals and Conservatives WANT to happen. Martin, Mr. former Power Financial Corporation which just happens to own insurace companies that want to sell health insurance, would love for Paul Desmarais to become a major Canadian HMO supplier.

Wikipedia Entry on Martin and Power Corp

[Riverwind]

Our system isn't "broken", its chronically underfunded. The talking heads all use phrases like "throw money at it" to discount the idea that lack of money is the problem. Fact is, throwing more money at it is EXACTLY what is required.

Whenever a government must manage a complex system to meet the needs of a large number of people, the government must conduct a 'cost benefit analysis' to determine whether any specific expenditure will deliver a benefit to the group as a whole that outweighes its cost.

What this means is that the needs of some individuals will ALWAYS fall though the gaps in the system since sacrificing the lives of a 10% of the indviduals in the system is acceptable in the name of preserving the system for the 90%. The 'sacrifice' that the 10% is caused in many ways including restructions on new drugs and treatments, limits on access to diagnostic equipment, and waiting lists.

However, those people who falling into this 10% obviously would put a much higher price on the value of their own lives even if the government decides that society would not benefit enough to justify the expense. This is why it is absolutely necessary to allow participation of the private sector in healthcare because it allows individuals to make thier own choices about healthcare. This why the supreme court ruled the way it did.

Futhermore, I have read some human resources studies that show that the effect of money on the moral of workers is short term because within a few years the workers feel they 'deserve' the new pay levels and start complaining about the same things again and demand even higher pay. This is another reason why 'throwing money at the system' will not fix it in the long term.

[Argus]

regarding I miss Reagan and those who agree with this individual, is our health care system that seriously flawed? Canada is a nation with one of the highest life expectancies in the world due to our health care system. If our health care were to become privatized, we will become our neighbour to the south. If we all look at the United State's health care system we can see canada if we were to have two tiered health care. I look at the U.S and cringe.

Why? The US also has one of the best health care systems in the world, and one of the highest life expectancies in the world. In fact, if you eliminate the underclass of the inner cities (who get free health care btw) I bet the life expectancy of the US is the same as Canada.

In any event, your presumption that adding private health care makes us the same as the US ignores the fact that every nation on Earth except us, Cuba, and North Korea has private health care. We should try to emulate the Germans or Fins, rather than the Americans, but we should at the least, TRY to get a better system. Two years for a hip operation is unacceptable. Ten hours to get a bone set is unacceptable. Six months for an MRI is unacceptable. They don't have these waits in most European nations - OR in the United States. Why should we put up with it?

[Argus]

Our system isn't "broken", its chronically underfunded. The talking heads all use phrases like "throw money at it" to discount the idea that lack of money is the problem. Fact is, throwing more money at it is EXACTLY what is required.

I disagree. The system is funded well enough. What is needed are incentives for people to conserve resources - and for private orgnizations to help out. Namely, user fees. They don't have to be large. But they have to exist.

Can't get enough doctors and nurses since nobody wants to work the massive overtime for the relatively low pay.

Most doctors don't work any overtime unless it's voluntary. Nurses often do, and are well-rewarded for their time. Nurses are very well paid, and so are doctors. The shortages are due to government decisions to restrict the intake into nursing and medical schools.

[Guest eureka]

The United States ranks 37th. in world rankings of health care systems. It is an atrocious system.

The US spends about the same proportion of GDP as Switzerland which ranks as equal with France at the top though spending twice as much as France to get there.

Everywhere there is private healthcare, there are higher costs for, frequently poorer results. Public healthcare becomes the avenue of last resource and the only avenue for the lower half of society. The better off are also often able to use only the impoverished public systems, too, since private caregivers are often self restricted in what they offer. The do not want poor outcomes in serious cases.

[August1991]

The US spends about the same proportion of GDP as Switzerland which ranks as equal with France at the top though spending twice as much as France to get there.

These numbers are meaningless. Both Switzerland and the US "export" medical services because many foreigners go to those countries for treatment. This gives the impression that both countries "spend alot" on health care, as a portion of their GDP.

To compare, Canada "spends alot" of its GDP on electricity (because of our hydro resources) but we have no more illumination than other countries.

The United States ranks 37th. in world rankings of health care systems. It is an atrocious system.

I question that number - how can anyone say a country of 300 million is 37th in something - but that's not the issue here. No one is saying that Canada adopt the US health system.

eureka, the Supreme Court's decision did not fall from the sky. Like with other problems, many Canadians refuse to accept obvious facts and we have too many politicians who will happily tell lies to accomodate them.

[PatM]

What this means is that the needs of some individuals will ALWAYS fall though the gaps in the system since sacrificing the lives of a 10% of the indviduals in the system is acceptable in the name of preserving the system for the 90%. The 'sacrifice' that the 10% is caused in many ways including restructions on new drugs and treatments, limits on access to diagnostic equipment, and waiting lists.

However, those people who falling into this 10% obviously would put a much higher price on the value of their own lives even if the government decides that society would not benefit enough to justify the expense. This is why it is absolutely necessary to allow participation of the private sector in healthcare because it allows individuals to make thier own choices about healthcare. This why the supreme court ruled the way it did.

Futhermore, I have read some human resources studies that show that the effect of money on the moral of workers is short term because within a few years the workers feel they 'deserve' the new pay levels and start complaining about the same things again and demand even higher pay. This is another reason why 'throwing money at the system' will not fix it in the long term.

<{POST_SNAPBACK}>

Holy rationalizations batman. Its fine if 10% of the population croaks due to lack of healthcare and healthcare workers should just eat cake? Do you even realize what you are saying?

More money IS the cure, Martin has been stealth-nerfing healthcare funding all along. He'd announce extra money for healthcare then either not deliver OR deliver publically and remove money through other (unreported) cuts for a net decrease in funding.

[Riverwind]

What this means is that the needs of some individuals will ALWAYS fall though the gaps in the system since sacrificing the lives of a 10% of the indviduals in the system is acceptable in the name of preserving the system for the 90%. The 'sacrifice' that the 10% is caused in many ways including restructions on new drugs and treatments, limits on access to diagnostic equipment, and waiting lists.

More money IS the cure, Martin has been stealth-nerfing healthcare funding all along. He'd announce extra money for healthcare then either not deliver OR deliver publically and remove money through other (unreported) cuts for a net decrease in funding.

You miss the point entirely, Universal health cannot possibly meet the needs of 100% of the people 100% of the time since there is not an infinite amount of money. This problem comes from the nature of any large bureaucratic system. The best way to ensure that people do not slip through the cracks is to allow them to make their own decisions regarding healthcare: even if that means paying for a service themselves.

Healthcare spending is a beast that is growing faster than inflation and the economy. This speading is already squeezing out spending on important programs such as education and the environment. If you draw a line on a graph you would see that healthcare will eat up 100% of government revenue in a few decades.

In other words no amount of taxation will provide the system with enough money so we must rethink how we deliver and pay for care.

[Guest eureka]

Not much illumination in your response, either, August. The US is 37th. because it is an atrocius system and the ranking is done by the WHO.

Switzerland and the US spend a lot of money because they have basically private systems - no other reason. If they cater to foreigners, those foreigners pay the shot.

All investigations around the world have proven that private is both less efficacious and more expensive than public.

Sparrhawk, I do not think it is correvt to say the Healthcare costs are increasing faster than inflation or growth. The part of the system that is increasing faster is that related to drugs and new technology. All else may not be even as fast as inflation.

With a private system, those higher growth i cost items will be worse as profit is added.

[Argus]

The United States ranks 37th. in world rankings of health care systems. It is an atrocious system.

By whose reckoning? I don't see Americans dying at early ages, unless it's due to fat or bullets. Again, you need to leave out the urban underclass to get a true picture of American health care. If you do, their statistics are as good as ours.

And most of their people, covered by health insurance, don't have to wait two years for a hip operation.

[Bakunin]

The United States ranks 37th. in world rankings of health care systems. It is an atrocious system.

By whose reckoning? I don't see Americans dying at early ages, unless it's due to fat or bullets. Again, you need to leave out the urban underclass to get a true picture of American health care. If you do, their statistics are as good as ours.

And most of their people, covered by health insurance, don't have to wait two years for a hip operation.

<{POST_SNAPBACK}>

The first cause of bankrupt in usa is because of healthcare. Also there is the fact that its not your doctor who choose if you get opered its your insurance company. I think these are 2 good reason not to copy the usa system but to look more for an european style system where their is a public and a complementary private system, where you don't have to worry about your insurance company and where your doctor is the one who decide wheither you get opered or not.

[Riverwind]

Again, you need to leave out the urban underclass to get a true picture of American health care. If you do, their statistics are as good as ours.

And most of their people, covered by health insurance, don't have to wait two years for a hip operation.

In other words you are saying "the US system is great as long as you don't include anyone who will pull down the numbers". That is a creative way to manipulate statistics.

The US is the worst system in the developed world because it fails to provide anything better than 3rd world quality healthcare for a large percentage of its population. The fact that the rich and the upper middle class happen to enjoy top quality healthcare does not redeem the system.