Crucial medicare case reaches Supreme Court Canada

Main Category: Pain / Anesthetics
Article Date: 10 Jun 2004 - 19:00 PDT


Seven Supreme Court justices began diagnosing the health of Canada's medicare system June 8 in a case that has the potential to shake Canadian health care to its core. Although it was difficult to gauge the passions aroused by Chaoulli and Zeliotis v. Quebec inside the quiet courtroom, this wasn't the case outside. Not only did the "Raging Grannies" arrive to protest any move toward privatized medicine, but additional opponents also came in a double-decker bus to symbolize their opposition to "two-tier" health care.

In the case, Dr. Jacques Chaoulli and patient George Zeliotis are asking Canada's highest court to overturn two earlier judgements by Quebec courts that upheld provincial laws limiting the use of private medical services or medical insurance. They contended that their rights under the Canadian Charter of Rights and Freedoms were breached by these prohibitions; their targets were the governments of Quebec and Canada.

A long list of interveners represented all sides of the health care spectrum. In the middle were the CMA/Canadian Orthopaedic Association (COA) and a group of 10 senators led by Michael Kirby, which maintained that the status quo is unacceptable but that the system can still be fixed within its existing publicly funded structure. Also facing off were the Charter Committee on Poverty Issues and Canadian Health Coalition, which consider privatization anathema, and 14 private British Columbia clinics that maintain the introduction of a parallel private system in Canada would improve publicly funded medicare.

Chaoulli, a Montreal GP, provided a detailed history of medicare's development in Quebec. He argued that the Charter gives him the right to choose a private hospital over a public hospital if the former would provide better care, and that it is unconstitutional for governments to prohibit this.

Philippe Trudel, a lawyer for Zeliotis, said the justices must answer 2 questions:

-- Should Canadians be allowed to use their own money to buy care that the publicly funded system cannot provide? (Zeliotis helped launch the case 5 years ago because of delays in receiving hip-replacement surgery.)

-- Can the state prevent people from receiving the health care they need by buying it with their own money?

Trudel said Zeliotis' Charter rights were breached because of the pain he was forced to endure, which resulted in dependency on pain medication.

This article continues on this web page of the Canadian Medical Association

Written by Patrick Sullivan

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