Top court strikes down Quebec private health-care law

The Supreme Court of Canada ruled Thursday that the Quebec government cannot prevent people from paying for private insurance for health-care procedures covered under medicare.

The plaintiffs in the case are a Montreal patient and a doctor.

They wanted Canada's top court to strike down sections of the Quebec Hospital Insurance Act that prevent people from buying health insurance for medical procedures covered by the public health plan.

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In its ruling Thursday, the court said the provincial policy violates the Quebec charter. But they split 3 - 3 on whether it violated the Canadian Charter of Rights and Freedoms, meaning there is no immediate impact on the Canadian health-care system as a whole.

One justice gave no opinion on whether the laws violate the charter.

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But Alain Joduin of the Canadian Orthopedic Association said the decision is "truly an historic one that could fundamentally change the health-care system in Canada as we know it."

He said his group and the Canadian Medical Association would comment further on the ruling later in the day, after their experts had had a chance to pore over it.

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Sharon Sholzberg-Gray, president of the Canadian Healthcare Association., said although the decision applies to the Quebec act, it's clearly "a clone of all the other provincial acts, and they're all clones of the Canada Health Act."

She said her group would have to study the lengthy ruling before being able to discuss all the implications, but added that she doesn't see the entire medical system going to a private-payment plan.

"Just because someone might be able to pay $8,000 for a joint replacement doesn't mean all Canadians can pay $300,000 for a complex cancer treatment," she said.

Waited year for hip replacement

The two plaintiffs in the case had separate complaints, but the court decided to hear their court challenges together.

George Zeliotis waited a year for hip replacement surgery.

In 1996, Montreal businessman George Zeliotis waited a year for hip replacement surgery. While waiting, he asked whether he could purchase insurance that would allow him to skip the public queue and pay directly for the surgery.

When he learned it was against the law, he took his case to court.

Canadians can buy private health insurance for things outside of public medicare such as prescriptions, physiotherapy or private hospital rooms.

Zeliotis, 73, argued the year-long wait for surgery was unreasonable, endangered his life and infringed on the charter's guarantee of right to life, liberty and security.

The second plaintiff, Dr. Jacques Chaoulli, wanted the court to overturn a Quebec provision preventing doctors who don't operate within the medicare plan from charging for services in public hospitals.

Chaoulli, who had tried but failed to set up a private hospital, represented himself before the court.

Senator Michael Kirby, who chaired a Senate committee studying health care, recommended the provinces pay for private treatment if the patient isn't treated within a certain timeframe.

Lawyers for the federal government argued the court should not interfere with the health-care system, considered "one of Canada's finest achievements and a powerful symbol of the national identity."