and I’m glad you did Rob.

Introducing private health care would allow those with the means quicker access but I can’t see it saving anybody any money.

Yeah, because actually living long enough to get the health care is more expensive than dying while waiting in line.

This reeks of the vehicle insurance crock that the “competitive market” forced canadians into. They were prepared to generalize vehicle insurance through the state. I would have been cheaper and more inclusive for the people. But US insurance companies sued, saying it was unfair business practice that destroyed their ability to compete. They were prepared to allow the state to provide auto insurance, but only if they were reimbursed the money they would lose without competition. Good for the people : bad for the corporations.

Hehe, don’t take me too seriously, I’m only poking fun…

Hi, I’m Carl B. (Keep it simple) and I oppose Anything that you guys seem to like… Not because I have an argument against it, but because I would rather be partisan than agree with the likes of you.

And I don’t mind being a hypocrite and lying to be a partisan hack either!!!

Since you seem to know your stuff, Colleen, what is this story all about? What did the Supreme Court rule exactly about private health insurance?

Most provinces, including Quebec, provide physician and hospital insurance for “medically necessary” services and procedures. I’m not sure how Medicare in the US functions, but I think our provincial insurance plans may be similar (but universal and more comprehensive). Like Quebec, all provinces prohibit the sale of private insurance in competition with the public system. This is to ensure that health insurance is available “on uniform terms and conditions” to all residents of Canada.

Some years ago a case was brought to the Quebec Supreme Court by a physician, Jacques Chaoulli, and his patient, George Zeliotos. They said that the restrictions in Quebec’s health insurance laws violated Mr Zeliotis’ charter rights when he was forced to wait a year for hip surgery (a medically necessary procedure). If he had been able to obtain private insurance, he said, he would have been allowed to jump the queue and obtain the surgery more quickly (not coincidentally, in Dr Chaoulli’s private surgery clinic). However, the Supreme Court ruled against him at that time. Dr Chaoulli and Mr Zeliotis appealed the ruling and lost again. The next time, they appealed the case to the Supreme Court of Canada.

The SCOC narrowly ruled (4-3) that the prohibition on the sale, purchase and insurance of health services covered by the provincial health insurance system violated Section 1 of the Quebec Charter of Human Rights and Freedoms which states that “every human being has a right to life, and to personal security, inviolability and freedom”. More specifically, the justices said that the denial of the patient’s rights to purchase more speedy medical care than the provincial system could offer, and the denial of Dr Chaoulli’s right to provide it, violated Mr Zeliotis’ rights to security under S.1. It also narrowly ruled (4-3) that the prohibition did not violate Canada’s Charter of Rights and Freedoms which says that such freedoms must be subject to the principles of “fundamental justice”. I’m not a lawyer and the interpretation of this decision are still being argued. However, one thing does seem to be clear: the justices provided an awkward caveat which is that patients may obtain private insurance only when the waiting times for medically necessary care are “unreasonable”.

The Supreme Court also didn’t address the question of whether or not Mr Zeliotis, at some 80-plus years of age, would be able to obtain private health insurance. Under the Human Rights Act of Canada, insurance companies can deny coverage based on age, sex, disability and health status if they can demonstrate it would adversely affect the bottom line. Most people have agreed that Mr Zeliotis could only obtain private care if he could afford to pay for it directly out of pocket.

The application of the decision is limited to Quebec. Ironically, the wait times which caused Mr Zeliotis to wait a year for hip surgery have been substantially lowered, not just in Quebec but nationally as well. No one would agree that surgery should be delivered on a same-day basis, but certainly waiting times for cataract and hip or knee surgery were too long. The reasons for this are intensely debated: is it the system or is it the doctors? Is it because doctors are inducing demand or is it technological innovation? Are doctors channeling patients to their moonlighting operations in private clinics or is the public system incapable of performing better simply because it’s public and not private?

These are the questions that have always been debated and the SCOC decision has only intensified that. Hopefully, it will contribute to solutions rather than just talk. I don’t believe private health insurance is the solution but better management of waiting times certainly is.

Sorry for this long-winded explanation.

CF

Re Quebec doesn’t allow private insurance.

This simply is not the case. According to the Canadian Life and Health Insurance Association (which represents private life and health insurers), in 2004 about 5.5 million Quebeckers had private health insurance, and about 2.3 million had dental coverage. The companies who sell health policies there earned nearly $5 billion in premiums. In all provinces, including Quebec, the cost of premiums is subsidized by the tax system (that is, the premiums are tax deductible).

CF

I’ve often wondered how some of these celebrities get away with calling themselves certain things. Like Sting, for instance. You gotta have some pretty big cojones to go up to your friends one day and say, “Don’t call me Nigel any more. From now on…I’m sting.” That’s the equivalent of me doing a post one day asking all of you to start calling me “Turbo” or “Man-stud” from now on.

Self-deprecating nicknames, of course, are another matter.