EFL:TORONTO, June 9 - The Supreme Court on Thursday struck down a Quebec law banning private medical insurance in a decision that represents an acute blow to the publicly financed national health care system. The high court stopped short of striking down the constitutionality of the country's Patrick Monahan, dean of the Osgoode Hall Law School of York University in Toronto and a well-known critic of the national health care system, was even more emphatic about the import of the decision. "They are going to have to change the fundamental design of the system," he said. "They will have to build in an element of timely care or otherwise allow the development of a private medical system."
The Canadian health care system provides free doctor's services that are paid for by taxes. The system has generally been strongly supported by
But in recent years patients have been forced to wait longer for diagnostic tests and elective surgery, while the wealthy and well connected either sought care in the United States or used influence to jump medical lines.
The court ruled that the waiting lists had become so long that they violated patients' "life and personal security, inviolability and freedom" under the Quebec charter of human rights and freedoms, which covers about one-quarter of Canada's population. "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 lists for public health care," the Supreme Court ruled. "In sum, the prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver reasonable services."
The case was brought to the Supreme Court by Jacques Chaoulli, a Montreal family doctor who argued his own case through the courts, and George Zeliotis, a chemical salesman who was forced to wait a year for a hip replacement while he was prohibited from paying privately for surgery. Dr. Chaoulli and Mr. Zeliotis lost in two Quebec provincial courts before the Supreme Court decided to take their appeal. In a news conference, Dr. Chaoulli declared a victory and predicted that the decision would eventually apply to all Canada. "How could you imagine that Quebecers may live," he asked, "and the English Canadian has to die?"