Montréal, 2 mars 2006 – Contrary to assertions from several interest groups and media commentators, the proposed health care reform unveiled by the Alberta government earlier this week in no way violates the Canada Health Act, says the Montreal Economic Institute (MEI).
The MEI has studied this issue extensively in connection with the Chaoulli Supreme Court case and its repercussions on Quebec’s laws, and it considers that the federal government has no legal basis on which to contest the Klein government’s “third way” proposals.
The most controversial part of the Alberta plan would allow doctors to work in both the public and private sectors and permit patients to pay for faster access in private clinics to certain procedures, essentially elective surgeries. Critics contend that this would violate the accessibility clause of the Canada Health Act by allowing some patients to get faster treatment.
But MEI president Michel Kelly-Gagnon says the Act is very clear on this point: the accessibility clause applies to the public system only, not to an entirely parallel private system. What it does prevent is allowing some patients faster access where public funds are involved.
“It would be illegal to allow a patient to pay for faster access to obtain a service dispensed by the public sector,” Mr. Kelly-Gagnon explains. “Using public funds for partial financing of health care provided by a parallel private system would also present a legal problem. But getting faster treatment in a totally private parallel system is not a problem.”
It is already possible to obtain elective surgery in private clinics in Quebec for those who are prepared to pay the full cost of treatment. Provincial laws, not federal law, prohibit this happening elsewhere. As long as the public system continues to offer these services free of charge, this practice does not violate the conditions of the Health Act, Mr. Kelly-Gagnon states.
Referring to a document published by the think tank three years ago titled “Health care reforms: Just how far can we go?,” the MEI president says allowing doctors to work in both systems is not any more contentious. If such changes were implemented by the province, a participating doctor could invoice the government for a service provided in a hospital but would invoice a patient who is in a rush and is willing to pay for the same service in the doctor’s private office.
Proof of this has come from public debate on this issue in Quebec over the past several months as the provincial government prepared its official reaction to the Supreme Court ruling. Although Quebec Health Minister Philippe Couillard ended up deciding not to allow doctors to work in both sectors, no one believed that the court had ruled this unconstitutional, including those who opposed it.
Mr. Kelly-Gagnon adds: “If we want to have a rational debate over the future of our health care system, it is crucial not to pursue it on the basis of myths and misinformation. The Canada Health Act is not the all-encompassing mythical document that some believe, and provinces have no legal excuse not to go ahead with major reforms if they so choose.”
An MEI study on legal aspects of health care reform was written with legal advice from the Montreal law firm Trudel & Johnston, which was also involved in the Chaoulli-Zeliotis court case. The study was published in April 2003 and can be found on the Institute’s Website.
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Information and interview requests: Patrick Leblanc, Director of communications, Montreal Economic Institute, Tel.: (514) 273-0969 (office) / (514) 571-6400 (cell) / E-mail: email@example.com