Judicial Earthquake Shakes Canada’s Health System

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IT’S BEEN CALLED A “BOMBSHELL SUPREME COURT RULING” by no less than the Wall Street Journal. On June 9, 2005, the Supreme Court of Canada ruled that the province of Quebec cannot prevent individuals from purchasing private health insurance policies for healthcare procedures covered under the Canadian health plan, called medicare.

The case started in 1997 when Quebec resident George Zeliotis learned he would have to wait a full year for a hip replacement, despite his painful arthritic condition. His anger increased when he next learned that it was against the law for him to privately pay for his hip replacement. In collaboration with his physician, Jaques Chaoulli, the two filed a lawsuit. They had lost in two provincial courts before prevailing in the Supreme Court review of their case.

It is expected that this Canadian Supreme Court Ruling will open the door for private health insurance to be sold as an adjunct to the government health system. One consumer advocate noted that wait times are much shorter in many European countries where a private health system is allowed to operate alongside the government health system.

In an editorial, the Wall Street Journalobserved that:

The larger lesson here is that healthcare is not immune from the laws of economics. Politicians can’t wave a wand and provide equal coverage for all merely by declaring medical care to be a ‘right,’ in the word that is currently popular on the American Left.

There are only two ways to allocate any good or service: through prices, as is done in a market economy, or lines dictated by government, as in Canada’s system. The socialist claim is that a single-payer system is more equal than one based on prices [our italics], but last week’s court decision reveals that as an illusion. Or, to put it another way, Canadian healthcare is equal only in its shared scarcity.

Thoughtful lab executives and pathologists should consider these words as they watch political forces battle in Washington over both the design and funding of federal healthcare programs. Most health professionals I know recognize that the manner in which elected officials and bureaucrats handle the Medicare and Medicaid programs has done much to erode the quality of healthcare services in the United States during the past two decades. More market discipline in the U.S. healthcare system would be quite beneficial to physicians and patients alike.


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