Montreal, June 4, 2015 – Ten years have passed since the Chaoulli decision, handed down by the Supreme Court of Canada in June 2005. This ruling hinted at major changes in the field of health care in Quebec, raising the hopes of many patients.
Yet very little has changed. The government remains incapable of offering access to care in a timely manner, all while maintaining a strict monopoly over the provision of medical treatments, according to a Viewpoint on “The Chaoulli Decision and Health Care Reform” published today by the MEI.
“It was a historic opportunity to reform Quebec’s health care system. But the government’s response has been very timid,” says Yanick Labrie, author of the study.
The Chaoulli decision stated then that when the government is unable to offer access to needed care within a reasonable time frame, the prohibition against purchasing private health insurance is a violation of the right to life and security of patients.
The law was indeed modified in order to allow Quebecers to purchase duplicate private insurance, at least in principle, but only for a limited number of medical and surgical treatments such as hip and knee replacements and cataract removals. As a result, no actual market for this kind of insurance developed, since the number of admissible surgeries remained too restricted to be of interest to individuals and employers.
The legislative change also authorized public hospitals to sign partnership agreements with clinics for the transfer of a certain volume of surgeries and treatments (covered by the public system). Yet very few agreements resulted. Still, three agreements of this type signed in recent years led to improved access in the public hospitals concerned.
Finally, the government set the maximum wait time for treatment at six months for hip, knee, and cataract surgery. However, nearly 20% of patients waiting for a hip or knee replacement are still not operated on within the prescribed timeframe.
“There has been no appreciable change in Quebec since the Chaoulli decision. The government chose to interpret the Supreme Court’s ruling narrowly, and the timid reforms adopted have not led to improved access for hip, knee, and cataract surgeries. Patients waiting for treatment still have very few options outside the public system,” says Yanick Labrie.
As of March 31, 2015, nearly 20,000 Quebecers had been waiting for surgery for more than six months in the public health care system.
“The Chaoulli decision was a missed opportunity,” adds Michel Kelly-Gagnon, President and CEO of the MEI. “We had a chance to reform the system and improve access to care for everyone. Indeed, there’s no justification for maintaining a strict government monopoly on the delivery of medical care, and it’s high time to adopt reforms modelled after Europe’s mixed universal systems, which are far more accessible to patients.”
The Viewpoint on “The Chaoulli Decision and Health Care Reform” was prepared by Yanick Labrie, economist at the MEI and holder of a master’s degree in economics from the Université de Montréal. This publication is available on our website.
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The Montreal Economic Institute is an independent, non-partisan, not-for-profit research and educational organization. Through its studies and its conferences, the MEI stimulates debate on public policies in Quebec and across Canada by proposing wealth-creating reforms based on market mechanisms.
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