OTTAWA — Canada's Supreme Court struck down a Quebec law banning private health insurance Thursday, a landmark decision that could jeopardize the nation's universal healthcare system, once regarded by some advocates as a model for the United States.
The high court ruled that the long delays for patients, lack of doctors and other problems have put Canadians' health at risk and that the government could not ban citizens from seeking private care if it could not guarantee treatment in a timely and reliable way. The decision will allow patients to seek private care outside the national system, stirring fears that doctors will leave the national plan to go into more lucrative private practice and create a two-tier system that benefits the rich.
The decision takes effect immediately, but the Quebec province's government said it planned to ask the high court to grant it a stay of up to two years to implement the new policy to avoid upsetting the delivery of medical services. The ruling may spark legal challenges to universal healthcare in other provinces, legal experts said.
Canada's free healthcare and low-cost drugs have bolstered the country's image as being different and superior to its neighbor to the south. During periodic attempts to revamp the U.S. healthcare system, which has left an estimated 45 million Americans uninsured, Canada has often been held up as a model.
Critics said the court's action threatened a widely popular program that is part of Canada's national identity. But delays have cost the system some of its luster, and some said Thursday that the Supreme Court ruling was a vindication for free-market healthcare.
Montreal physician Jacques Chaoulli, an advocate for private care, and a patient, 73-year-old businessman George Zeliotis, launched the legal challenge in 1997 after Zeliotis had waited a year for hip-replacement surgery. Two Quebec courts had upheld the prohibition on private insurance.
Chaoulli represented himself before the Supreme Court and argued that the province violated his patient's constitutional rights by denying him timely treatment and refusing him the option of private care. Patients who were willing to pay for expedited treatment were not legally allowed to do so.
After considering the case for a year, the Supreme Court largely agreed, noting in a 4-3 decision that patients had died because of the delays. But it stopped short of declaring that it was unconstitutional to ban private healthcare or that the universal healthcare system violated patients' rights to "liberty, safety and security" under the country's charter.
