By Beth Duff-Brown, Associated Press Writer | June 9, 2005
TORONTO --Canada's Supreme Court dealt a powerful blow to the state monopoly on health care Thursday, striking down a Quebec ban on private health insurance for services provided under the country's Medicare system of universal coverage.
Although the unanimous ruling applies only to Quebec, it is sure to bring similar cases in other Canadian provinces and give impetus to a growing movement pushing for public and private care.
Government leaders rushed to defend the current system, and Medicare supporters voiced fears the ruling will bring a two-tiered system favoring those with money and possibly hurting care for the poor. Proponents of change say it will improve care by offering more choices and cut waiting times for treatment.
The Supreme Court said Quebec's prohibition violated the province's charter of rights by threatening the lives of patients, and the justices noted other countries have successfully combined private and public care.
"The evidence in this case shows that delays in the public health-care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care," Chief Justice Beverley McLachlin wrote.
"The evidence also demonstrates that the prohibition against private health insurance and its consequence of denying people vital health care result in physical and psychological suffering ... ."
Medicare arose from a 1984 law that affirmed the federal government's commitment to provide mostly free health care for all, including the more than 200,000 immigrants arriving each year.
Most polls indicate that Canadians support the system despite the high taxes needed to finance health care, seeing it as a marker of egalitarianism and independent identity that sets their country apart from the United States, where some 45 million Americans lack health insurance.
But in recent years Medicare has been plagued by long waiting lists and a lack of doctors, nurses and state-of-the-art equipment. Some patients wait months for surgery, MRI machines are scarce and many Canadians travel to the United States for treatment.
Under the Canadian system, it is illegal to seek faster treatment and jump to the head of the line by paying out of pocket for public care. Private health clinics have sprouted up for Canadians willing to spend their own money for treatment. But they are technically illegal, though some provincial governments tend to look the other way, especially for more minor treatments.
Although unanimous in voiding Quebec's law, the court split 4-4, with one abstention, on whether the ban on private insurance was unconstitutional or violated the federal Charter of Rights and Freedom that guarantee "life, liberty and security of the person."
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