Anatole France, the famous French historian, in 1894 noted the irony that “The law, in its majestic equality, forbids the rich as well as the poor to sleep under bridges, to beg in the streets, and to steal bread.” Yesterday the Supreme Court of Canada offered us a similar bit of wisdom, ruling that all Canadians, rich and poor alike, have an equal right to use their own money to access health care in a timely manner.
In a narrow 4-3 ruling the Supreme Court, after a year-long deliberation, said that Quebec patients can buy private insurance to speed up their access to health services. The case overturns earlier court decisions that the collective right to health care on an equal basis is more important than individual rights to use their own money to obtain services more quickly than others.
The decision applies only in Quebec but will affect all Canadians as provinces move to bring their health systems into line with the Court ruling.
Despite what some are predicting, the Supreme Court ruling won’t support more timely access to health care by all Canadians. Ironically, one of the main plaintiffs in the case, 73-year old George Zeliotis, would not benefit from the decision if he didn’t have money. Seniors, most of whom earn less than $20,000 per year, would be unable to obtain private health insurance. For them, the court decision will not provide more timely access.
Studies do provide us with a hint of what may happen if governments do not act quickly to protect medicare. In countries that rely on private insurers and for-profit companies, the quality of care and the health status of citizens is compromised and the costs of care increase. Access to health care for middle class and poor people disappears or declines.
The Court's decision that "the prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver reasonable services" suggests that a resolution should be found in shoring up the public system. While health care budgets have grown, waiting lists remain a problem.
The people of Canada have consistently stated, in poll after poll, that medicare is their number one priority. Rather than open the door to more private health insurance, and a more American-style health care system, we need to make sure that the public system has the capacity to deliver the services needed by Canadians.
Colleen Fuller is the Chair of Pharmawatch and a research associate with the BC Office of the Canadian Centre for Policy Alternatives.
June 10, 2005
Offices: