2005/09/17

How much will Canadians pay for Supreme Court ruling on Medicare

The Canadian Press reports on a conference where academics are discussing the impact of the Supreme Court decision on medicare.Morris Barer of the Canadian Institutes of Health Research said the decision will undermine universal medicare, forcing people to pay for quality care. The views reported are scary. Has the Supreme Court gone beyond its mandate? Has it opened the door for private companies to pluck dollars from the well-to-do while the less well off are left to queue up for the public system? What we need is good quality one-tier healthcare. How do we get there? The politicians certainly don't seem to doing much to help. A year ago Martin promised he was fixing health care for a generation by giving the provinces more money but he didn't secure a set of standards and accountablity.

Cdns. will 'pay' for court medicare ruling

Dennis Bueckert
Canadian Press


Saturday, September 17, 2005


TORONTO -- Canadians will "pay, and pay, and pay" for an uninformed and irresponsible Supreme Court of Canada ruling that cleared the way for private health insurance in Quebec, a major academic conference heard Friday.

The ruling ignored research on the impact of private insurance in a public health-care system, Morris Barer of the Canadian Institutes of Health Research told the conference. Barer was one of several leading researchers who said the decision will undermine universal medicare, forcing people to pay for quality care.

He compared claims about the wonders of private health insurance are like zombies - impossible to kill even though disproven by research. He called the four judges who wrote the majority decision "servants of the zombie masters."

The Chaouilli decision, named after the Quebec doctor who initiated the case, struck down Quebec's ban on private insurance, saying it contradicted the provincial charter of rights.

The judges "showed no evidence that they understood the implications of opening up Canada to private insurance for core services in a world increasingly dominated by voracious international trade agreements," he said.

The argument is that once core medical services are opened to domestic corporations, the rules of NAFTA and other free-trade agreements will force them to be opened to foreign corporations.

"This is a one-way street," said Barer, founding director of the Centre for Health Services and Policy Research at the University of British Columbia. "It's likely to be practically and financially impossible to reverse direction once one starts down this road. In this, the majority (of judges) were, in my view, simply irresponsible.

"But they will not be held accountable for their errors in judgment. It's the rest of us who will pay, and pay and pay."

He added: "One of the most unsettling aspects of this judgment was the selective use, misuse and ignorance of researchers' evidence."

Roy Romanow, a former Saskatchewan premier who headed the 2002 royal commission on health care, said the Chaouilli decision runs counter to public opinion and expands judicial activism to a troubling level.

"The court basically said that the prohibition of private health insurance enacted by a democratically elected provincial government was bad public policy. This remarkable level of judicial activism troubles even many who are sympathetic to the end result."

He cited a June 2005 Statistics Canada report that said more than 80 per cent of Canadians are satisfied with the quality of care they receive.

In an interview, Romanow said he hopes politicians will respond vigorously to defend medicare, but so far there has been little more than silence.

Although the Chaouilli decision was based on the Quebec Charter of Rights, Romanow believes it also applies, by implication, to the Canadian Charter of Rights, which he helped negotiate during the 1980s.

But the drafters of the charter never intended it to protect economic claims such as the right to buy private insurance, he told the conference, sponsored by the University of Toronto Faculty of Law.

Stanley Hartt, who served as chief of staff to former prime minister Brian Mulroney and supervised extensive budget-cutting during that time, called himself "one of the zombie masters."

Hartt said politicians have been sleep-walking toward the Chaouilli decision for 20 years, and still have an opportunity to fix the health system by dealing with wait lists. If they don't, he said, medicare will be lost.

"In other words, if you can't deliver the goods, stop pretending that you can. Get out of the way. You can't say, 'We have a system, it's a wonderful system, it's the best on the face of the Earth, we will never have two-tier health care,' and the Supreme Court tells you people are dying on waiting lists. There's a disconnect there of some kind."

Allan Hutchinson, associate dean at Osgoode Hall Law School, said the Charter of Rights has become a political weapon used to benefit vested interests.

"The Supreme Court is not suggesting that as a matter of politics maybe we should revisit health care. They're suggesting that as a matter of constitutional law, the interest of private and affluent individuals should be given precedence in this debate."

The conference attracted such strong interest it had to be moved from the university campus to the Toronto Convention Centre. Three other conferences on the Chaouilli case are said to be in the works before the end of the year.

© The Canadian Press 2005

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