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OTTAWAQuebec's ban on private insurance for health care services already provided by the province is unconstitutional, according to a split decision by the Supreme Court of Canada.
The 4-3 decision in Chaoulli vs. Quebec (Attorney General) found the prohibition on private insurance is an unjustified infringement on rights protected by federal and provincial laws. In its majority opinion, the court said the ban has the effect of allowing only the very rich, who can afford private health care without insurance, to secure private care and avoid delays in the public system.
"Given the prohibition, most Quebeckers have no choice but to accept any delays in the public health regime and the consequences this entails," the court said. "The evidence in this case shows that delays in the public health care system are widespread and that in some serious cases, patients die as a result of waiting for public health care."
In their dissent, the three judges argued that the prohibition is not arbitrary and is rationally connected to Quebec's objective of creating a health care system where access is governed by need rather than wealth or status.
While the decision technically only applies to Quebec, observers say it will have widespread implications for provinces with similar bans.
A patient with numerous health problems and a doctor seeking a license to operate an independent private hospital filed the case, challenging the prohibition because of the long wait times Canadians contend with when seeking public health care services. A Superior Court ruling in 2000 dismissed their motion for declaratory judgment, and the Quebec Court of Appeal affirmed that decision in 2002, leading to an appeal to the country's high court.