Privatization in the provinces

Québec

In 2005, by a narrow majority, the Supreme Court of Canada found that Quebec’s ban on private insurance for insured health services violates the Quebec Charter of Human Rights and Freedoms. The plaintiffs in the case – George Zeliotis, a Montreal patient, and Jacques Chaoulli, a doctor seeking to set up a private clinic – had asked Canada’s top court to strike down sections of the Quebec Hospital Insurance Act that prevent people from buying health insurance for procedures covered by medicare. The decision was lauded by privatization proponents as striking a powerful blow to Canada’s health care “monopoly” even though the decision affects only Quebec.

In response to the Supreme Court’s Chaoulli decision, Quebec Health Minister Philippe Couillard tabled Bill 33, a proposal to use public money to fund for-profit health clinics. Public health care advocates were concerned that this plan would drain resources from the public health care system, despite a proposed ceiling on the number of doctors allowed to practice in the for-profit sector. The Quebec government passed Bill 33 in December 2006. It came into force in 2008.

Quebec has been known to be a hotbed for private clinics. Even before Bill 33 was passed, private clinics offered health care for a price. Rockland MD Clinic, for example, is a clinic that offers medically necessary MRI services to patients who pay out-of-pocket. The clinic accepts payments from Quebec’s provincial insurance plan, in addition to charging extra fees directly to people who go there.
Bill 33 also included a provision allowing access to private insurance for higher quality medical treatments, which threatens to create a two-tier health care system in Quebec.

In May 2007, Finance Minister Monique Jérôme-Forget announced the creation of a task force headed by Claude Castonguay who has lobbied hard in recent years for user fees to finance the growing cost of health-care services. According to The Globe and Mail, the task force was mandated to define the role the private sector can play in health care delivery as well as "study changes that might have to be made to the Canada Health Act."

Released in Feb. 2008, the results of the report clearly favoured health care privatization, calling for an increased role for private insurance, the introduction of user fees that require all citizens to pay money when they see a doctor, and a provision to allow doctors to practice in both the public and private sectors. These are all clear breaches of the letter and spirit of the Canada Health Act.

The Council of Canadians believes the Quebec government should be promoting public health care for everyone – not just those who can afford to pay their way to the front of the line. There are public solutions to wait times that do not require public money being paid to private, for-profit clinics or private insurance companies.

Resources:

• Article: 10 things you should know about the Supreme Court decision on health care, Canadian Perspectives, Autumn 2005
• Letter: Clinique Rockland MD : Plutôt une pente glissante qu’une zone grise, February 2, 2007
• Brief: Garantir l’accès ? Une perspective canadienne, Brief to Quebec’s Commission on Social Affairs, March 24, 2006
• Media: Quebec headed in the wrong direction on health care, says Council, Council of Canadians, February 16, 2006