09-06-2005 20:20									#1
	Canadian Politics - Healthcare Get a bigger avatar today!

The story is just breaking now so I suspect we will have a better news article later but for now:

quote: Supreme Court strikes down Quebec law banning private health care Provided by: Canadian Press Jun. 9, 2005 OTTAWA (CP) - The Supreme Court of Canada has struck down a Quebec law banning private insurance for services covered under medicare. The high court ruled that the law violates Quebec's charter of rights. It split on the implications for other provinces. The Canadian Medical Association called it a "historic" ruling that could "fundamentally change the health-care system in Canada as we now know it." It said it needed time to study the decision before commenting further. Ad The case involved Quebec doctor Jacques Chaoulli and his patient George Zeliotis who argued that the ban on buying private insurance for health care infringed on Canada's Charter of Rights and Freedoms. They also argued that it violated the Quebec charter. Zeliotis said his year-long wait for a hip replacement in 1997 violated both charters. Chaoulli has long campaigned for the right to set up a private medical business, and once went on a hunger strike over the issue. Public opinion polls have shown strong support for single-tier health care, with service based on need rather than ability to pay. Pro-medicare groups such as the Canadian Health Coalition say pressure to strike down the rules of medicare came from health-care companies that want new market opportunities. But political figures such as Senator Michael Kirby have argued in favour of permitting a greater role for private care. Chaoulli and Zeliotis received support from for-profit clinics in the Vancouver area. Two Quebec courts had already ruled against Chaoulli.

Looks like yet another bad decision by the santas in Ottawa. Not only does this ruling make 'rights' inconsistant across the country, it throws a hot potato to the politicians in Ottawa.

Will the politicians now extend "two tier" across the country to conform with the law in Quebec (something they swore they would never do) or try to convince the ROC that this imbalance is OK?

	09-06-2005 20:53									#2
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Two tier healthcare - provided the public portion remains at least as good as it is now (or hopefully gets better)

	09-06-2005 20:55									#3
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But apparently only if you live in Quebec.

	09-06-2005 20:57									#4
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Forbidding any private practice of doctors (IIUC)

	09-06-2005 21:01									#5
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quote: Originally posted by Kontiki Two tier healthcare - provided the public portion remains at least as good as it is now (or hopefully gets better)

It won't. Once doctors can make more money in private health care, they will abandon the public health care sector in a tsumani, leaving your public health care system a wreck. This decision is a catastrophe for Canada's health care system. You better nip this in the bud.

	09-06-2005 21:10									#6
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quote: Originally posted by Kuciwalker Forbidding any private practice of doctors (IIUC)

Yep, we are in good company though. Cuba has the same policy.

	09-06-2005 21:14									#7
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quote: Originally posted by chegitz guevara It won't. Once doctors can make more money in private health care, they will abandon the public health care sector in a tsumani, leaving your public health care system a wreck. This decision is a catastrophe for Canada's health care system. You better nip this in the bud.

You make many assumptions there. How such a system is structured is critical. How does the rest of the world do it?

How to "nip this" is a better question. This is a SCC decision. I favour the decision as it applies to Quebec, but this gutless decision created two separate classes of Canadians. Should we all move to Quebec if our health starts failing and we can't get timely care in our home provinces? I assume you can see the problem.

	09-06-2005 21:19									#8
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quote: Originally posted by Kuciwalker Forbidding any private practice of doctors (IIUC)

We don't forbid private practices, we just don't let them set their own rates or handpick their patients.

	09-06-2005 21:50									#9
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quote: Zeliotis said his year-long wait for a hip replacement in 1997 violated both charters.

My father had a hip replacement on Tuesday. He waited about three weeks. If he had to wait a year he would have completely lost function in his hip and been in a wheelchair permanently.

	09-06-2005 21:54									#10
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quote: It won't. Once doctors can make more money in private health care, they will abandon the public health care sector in a tsumani, leaving your public health care system a wreck. This decision is a catastrophe for Canada's health care system. You better nip this in the bud.

Nah.

We've always had this in New Zealand. People who want additional insurance can buy it. It means that they don't have to wait as long for hip replacements. I think that taxes should be raised to get rid of such lists, but it's false to say that two tier healthcare has gutted the public system. If anything, it is the public's appetite for consumer spending rather than public spending, and the right wing nutbars who have exploited this, who have made public healthcare worse.

	09-06-2005 21:58									#11
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quote: Originally posted by Adam Smith My father had a hip replacement on Tuesday. He waited about three weeks. If he had to wait a year he would have completely lost function in his hip and been in a wheelchair permanently.

And if that were the case with this Zeliotis guy, he most likely wouldn't have waited a year. We have a needs-based system, though imperfect. My mother, unfortunately, has had a litany of health problems. There's been routine, quasi-surgical procedures that she's had done that while improving her comfort level, weren't going to seriously harm her if they were put off. She had to wait a while for these. Other times, she's had stuff that needed to be done right away, and she managed to get in a few days after being diagnosed.

	09-06-2005 22:02									#12
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Zeliotis according to the evidence was in considerable pain.

	10-06-2005 12:02									#13
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http://www.cbc.ca/story/canada/nati...alth050609.html

quote: Top court strikes down Quebec private health-care ban Last Updated Thu, 09 Jun 2005 21:33:36 EDT CBC News 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. In a 4-3 decision, the panel of seven justices said banning private insurance for a list of services ranging from MRI tests to cataract surgery was unconstitutional under the Quebec Charter of Rights, given that the public system has failed to guarantee patients access to those services in a timely way. As a result of delays in receiving tests and surgeries, patients have suffered and even died in some cases, justices Beverley McLachlin, Jack Major, Michel Bastarache and Marie Deschamps found for the majority. The Quebec government reacted by saying it would apply immediately for a stay of between six months and two years before the decision takes effect, given the chaos it could cause in the delivery of medical services in Quebec. Intergovernmental Affairs Minister Benoit Pelletier said the province would consider using the notwithstanding clause in Quebec's constitution as an alternative to abiding by the court's decision. The plaintiffs in the case – a Montreal patient and a doctor wanting to set up a private clinic – asked 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. Four of the seven justices ruled Thursday that 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. Waited year for hip replacement The two plaintiffs in the case had separate complaints, but the court decided to hear their court challenges together. 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. The 73-year-old Zeliotis 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. On Thursday, Chaoulli said the ruling can only improve the quality of the country's health care system by taking some of the burden off cash-strapped provincial governments. "The government cannot continue to raise taxes to pay for health care," Chaoulli said. "Too many Canadians are suffering." 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."

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

People in pain or dying is against the Quebec Charter, but not the Canadian? This had gotta take the cake.

	10-06-2005 12:36									#14
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So does anyone know why the Supreme Court ruled that banning private medicine violates the Quebec charter, but not the Canadian charter?

	10-06-2005 23:13									#15
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quote: Quebec Charter of Human Rights and Freedoms INTRODUCTION WHEREAS every human being possesses intrinsic rights and freedoms designed to ensure his protection and development, Whereas all human beings are equal in worth and dignity, and are entitled to equal protection of the law; Whereas respect for the dignity of the human being and recognition of his rights and freedoms constitute the foundation of justice and peace-, Whereas the rights and freedoms of the human person are inseparable from the rights and freedoms of others and from the common well-being-be-, Whereas it is expedient to solemnly declare the fundamental human rights and freedoms in a Charter, so that they may be guaranteed by the collective will and better protected against any violation; Therefore, Her Majesty, with the advice and consent of the National Assembly of Quebec, enacts as follows:

quote: CHAPTER I: GENERAL PROVISIONS 1 . Every human being has a right to life, and to personal security, inviolability and freedom. He also possesses juridical personality. 2. Every human being whose life is in peril has a right to assistance. Every person must come to the aid of anyone whose life is in peril, either personally or by calling for aid, by giving him the necessary and immediate physical assistance, unless it involves danger to himself or a third person, or he has another valid reason. 3. Every person is the possessor of the fundamental freedoms, including freedom of conscience, freedom of religion, freedom of opinion, freedom of expression, freedom of peaceful assembly and freedom of association. 4. Every person has a right to the safeguard of his dignity, honour and reputation. 5. Every person has a right to respect for his private life 6. Every person has a right to the peaceful enjoyment and free disposition of his property, except to the extent provided by law. 7. A person's home is inviolable. 8. No one may enter upon the property of another or take anything therefrom without his express or implied consent. 9. Every person has a right to non-disclosure of confidential information. No person bound to professional secrecy by law and no priest or other ministers of religion may, even in judicial proceedings, disclose confidential information revealed to him by reason of his position or profession, unless he is authorized to do so by the person who confided such information to him or by an express provision of law. The tribunal must, ex officio, ensure that professional secrecy is respected. 10. Every person has a right to full and equal recognition and exercise of his human rights and freedoms, without distinction, exclusion or preference based on race, colour, sex, sexual orientation, civil status, religion, political convictions, language, ethnic or national origin, social condition or the fact that he is a handicapped person or that he uses any means to palliate his handicap. Discrimination exists where such a distinction, exclusion or preference has the effect of nullifying or impairing such right. 11. No one may distribute, publish or publicly exhibit a notice, symbol or sign involving discrimination, or authorize anyone to do so. 12. No one may, through discrimination, refuse to make a juridical act concerning goods or services ordinarily offered to the public 13. No one may in a juridical act stipulate a clause involving discrimination. Such a clause is deemed without effect. 14. The prohibitions contemplated in sections 12 and 13 do not apply to the person who leases a room situated in a dwelling if the lessor or his family resides in such dwelling, leases only one room and does not advertise the room for lease by a notice or any other public means of solicitation. 15. No one may, through discrimination, inhibit the access of another to public transportation or a public place, such as a commercial establishment, hotel, restaurant, theatre, cinema, park, camping ground or trailer park, or his obtaining the goods and services available there. 16. No one may practice discrimination in respect of the hiring, apprenticeship, duration of the probationary period, vocational training, promotion, transfer, displacement, laying-off, suspension, dismissal or conditions of employment of a person or in the establishment of categories or classes of employment. 17. No one may practice discrimination in respect of the admission, enjoyment of benefits, suspension or expulsion of a person to, of or from an association of employers or employees or any professional corporation or association of persons carrying on the same occupation. 18. No employment bureau may practice discrimination in respect of the reception, classification or processing of a job application or in any document intended for submitting an application to a prospective employer. 19. Every employer must, without discrimination, grant equal salary or wages to the members of his personnel who perform equivalent work at the same place. A difference in salary or wages based on experience, seniority, years of service, merit, productivity or overtime is not considered discriminatory if such criteria are common to all members of the personnel. 20. A distinction, exclusion or preference based on the aptitudes or qualifications required in good faith for an employment, or justified by the charitable, philanthropic, religious, political or educational nature of a nonprofit institution or of an institution devoted exclusively to the well-being of an ethnic group, is deemed non-discriminatory.

	10-06-2005 23:15									#16
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quote: CHAPTER 11: POLITICAL RIGHTS 21. Every person has a right of petition to the National Assembly for the redress of grievances. 22. Every person legally capable and qualified has the right to be a candidate and to vote at an election.

quote: CHAPTER III: JUDICIAL RIGHTS 23. Every person has a right to a full and equal, public and fair hearing by an independent and impartial tribunal, for the determination of his rights and obligations or of the merits of any charge brought against him. The tribunal may decide to sit in camera, however, in the interests of morality or public order. It may also sit in camera in the interests of children, particularly in matters of divorce, separation from bed and board, marriage annulment or declaration or disavowal of paternity. 24. No one may be deprived of his liberty or of his rights except on grounds provided by law and in accordance with prescribed procedure. 25. Every person arrested or detained must be treated with humanity and with the respect due to the human person. 26. Every person confined to a house of detention has the right to separate treatment appropriate to his sex, his age and his physical or mental condition. 27. Every person confined to a house of detention while awaiting the outcome of his trial has the right to be kept apart, until final judgment, from prisoners serving sentence. 28. Every person arrested or detained has a right to be promptly informed, in a language he understands, of the grounds of his arrest or detention, 29. Every person arrested or detained has a right to immediately advise his next of kin thereof and to have recourse to the services of an advocate. 30. Every person arrested or detained must be brought promptly before the competent tribunal. 31. No person arrested or detained may be deprived without just cause of the right to be released on undertaking, with or without deposit or surety, to appear before the tribunal at the appointed time. 32. Every person deprived of his liberty has a right of recourse to habeas corpus. 33. Every accused person is presumed innocent until proven guilty according to law. 34. Every person has a right to be represented by an advocate or to be assisted by one before any tribunal. 35. Every accused person has a right to a full and complete defense and has the right to examine and cross-examine witnesses. 36. Every accused person has a right to be assisted free of charge by an interpreter if he does not understand the language used at the hearing. 37. No accused person may be held guilty on account of any act or omission which, at the time when it was committed, did not constitute a violation of the law. 38. No testimony may be used to incriminate the person who gives it if he does so under the protection of the tribunal, except in the case of perjury.

	10-06-2005 23:17									#17
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quote: CHAPTER IV: ECONOMIC AND SOCIAL RIGHTS 39. Every child has a right to the protection, security and attention that must be provided to him by his family or the persons acting in their stead. 40. Every person has a right, to the extent and according to the standards provided for by law, to free public education. 41. Parents or the persons acting in their stead have a right to require that, in the public educational establishments, their children receive a religious or moral education in conformity with their convictions, within the framework of the curricula provided for by law. 42. Parents or the persons acting in their stead have a right to choose private educational establishments for their children, provided such establishments comply with the standards prescribed or approved by virtue of the law. 43. Persons belonging to ethnic minorities have a right to maintain and develop their own cultural interests with the other members of their group. 44. Every person has a right to information to the extent provided by law. 45. Every person in need has a right, for himself and his family, to measures of financial assistance and to social measures provided for by law, susceptible of ensuring such person an acceptable standard of living. 46. Every person who works has a right, in accordance with the law, to fair and reasonable conditions of employment. 47. Husband and wife have, in the marriage, the same rights, obligations and responsibilities. Together they provide the moral guidance and material support of the family and the education of their common offspring. 48. Every aged person and every handicapped person has a right to protection against any form of exploitation. Such a person also has a right to the protection and security that must be provided to him by his family or the persons acting in their stead.

quote: CHAPTER V: SPECIAL AND INTERPRETATIVE PROVISIONS 49. Any unlawful interference with any right or freedom recognized by this Charter entities the victim to obtain the cessation of such interference and compensation for the moral or material prejudice resulting therefrom. In case of unlawful and intentional interference, the tribunal may, in addition, condemn the person guilty of it to exemplary damages. 50. The Charter shall not be so interpreted as to suppress or limit the enjoyment or exercise of any human right or freedom not enumerated herein. 51. The Charter shall not be so interpreted as to extend, limit or amend the scope of a provision of law except to the extent provided in section 52. 52. Sections 9 to 38 prevail over any provision of any subsequent act which may be inconsistent therewith unless such act expressly states that it applies despite the Charter. 53. If any doubt arises in the interpretation of a provision of the act, it shall be resolved in keeping with the intent of the Charter. 54. The Charter binds the Crown. 55. The Charter affects those matters that come under the legislative authority of Quebec. 56.(1) In sections 9, 23, 30, 31, 34 and 38, the word "Tribunal" includes a coroner, a fire investigation commissioner, an inquiry commission, and any person or agency exercising quasi-I . judicial functions. (2)In section 19, the words "salary" and "wages" include the compensations or benefits of pecuniary value connected with the employment. (3)In the Charter, the word "law" or "act" includes a regulation, a decree, an ordinance or an order in council made under the authority of any act.

	10-06-2005 23:25									#18
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quote: People in pain or dying is against the Quebec Charter, but not the Canadian? This had gotta take the cake.

Well, the right to not be in pain isn't included in the Canadian Charter of Rights and Freedoms. It's a minimalist document that concerns itself more with negative freedoms than with positive ones.

From an American perspective, the law has been struck down for left-wing reasons rather than right-wing ones. It's an interesting situation.

	11-06-2005 00:29									#19
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quote: Originally posted by St Leo quote: People in pain or dying is against the Quebec Charter, but not the Canadian? This had gotta take the cake. Well, the right to not be in pain isn't included in the Canadian Charter of Rights and Freedoms. It's a minimalist document that concerns itself more with negative freedoms than with positive ones. From an American perspective, the law has been struck down for left-wing reasons rather than right-wing ones. It's an interesting situation.

What do you mean by an American perspective?

	11-06-2005 00:34									#20
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Well, a Libertarian perspective anyways. Maybe a Republican one.

Libertarians don't believe in positive rights like the right to assistance in case of pain. Rather, they would argue that the single-tier healthcare law is unconscionable because it prohibits the right of selling whatever you want to sell (which is not in the Quebec charter, but is the foundation of Libertarian philosophy).

I apologize for misstating things.:P

	11-06-2005 00:52									#21
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quote: Originally posted by St Leo Well, a Libertarian perspective anyways. Maybe a Republican one. Libertarians don't believe in positive rights like the right to assistance in case of pain. Rather, they would argue that the single-tier healthcare law is unconscionable because it prohibits the right of selling whatever you want to sell (which is not in the Quebec charter, but is the foundation of Libertarian philosophy). I apologize for misstating things.:P

Oh, I thought you were refering to some specific American legislation.

But I understand what you mean now, although I wouldn't peg the issue with any particular party or group. There's no clear cut division on the issue of public vs private healthcare. And I think public opinion could change at any time.

This may sound weird but this whole issue, somehow, reminds me of the issue of ID and recent court cases surrounding it in parts of the US. I recently read a rather well written blog entry on it. For those who might be interested:

http://www.gnxp.com/MT2/archives/004054.html

	11-06-2005 01:40									#22
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quote: Originally posted by St Leo Well, a Libertarian perspective anyways. Maybe a Republican one. Libertarians don't believe in positive rights like the right to assistance in case of pain. Rather, they would argue that the single-tier healthcare law is unconscionable because it prohibits the right of selling whatever you want to sell (which is not in the Quebec charter, but is the foundation of Libertarian philosophy).

Or buying what you want to buy.

	11-06-2005 01:42									#23
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quote: 7. A person's home is inviolable.

WTF? How does Quebec arrest people?

	11-06-2005 01:47									#24
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Are all arrests in the US based on the police kicking down someone's door?

	11-06-2005 01:48									#25
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In Quebec, do the police wait for you to come outside before arresting you?

	11-06-2005 01:54									#26
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Frankly, I have no idea. But how is that a response to my question?

	11-06-2005 12:46									#27
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quote: Originally posted by St Leo quote: People in pain or dying is against the Quebec Charter, but not the Canadian? This had gotta take the cake. Well, the right to not be in pain isn't included in the Canadian Charter of Rights and Freedoms. It's a minimalist document that concerns itself more with negative freedoms than with positive ones. From an American perspective, the law has been struck down for left-wing reasons rather than right-wing ones. It's an interesting situation.

Except the case was based on arguments that the government's mishandling of healthcare, and the consequent waiting lists, are an infringement on our rights to 'life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.'

I would say that being left in agony for months until they get around to you qualifies as an infringement, as does being left to die on a waiting list.

	11-06-2005 12:48									#28
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quote: It's a minimalist document that concerns itself more with negative freedoms than with positive ones.

Where did you tear that from?

	11-06-2005 13:24									#29
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Thanks for the info, St. Leo. That info makes it easier to understand how the justices reached their decision.

	11-06-2005 20:12									#30
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quote: Libertarians don't believe in positive rights like the right to assistance in case of pain.

Interesting. Earlier you state the right in the negative, the right to be free from pain, and now you say it is a right to assistance in case of pain.

So which is it St. Leo? A positive or a negative right?

Secondly, the Charter has many positive rights, including the right for religious people to believe whatever they want to believe, even as it does not talk about their right to practice. I don't need the charter to protect my right to believe, I need a charter that explicitly protects the rights of religious people to practice.