CMA moves to reassure patients following "historic" medicare ruling
By Patrick Sullivan
CMA President Albert Schumacher acted quickly today to reassure patients about the future of Canada's medicare system in the wake of a "historic" ruling by the Supreme Court of Canada.
"I want to send a message to my patients and to other Canadians," Schumacher told reporters shortly after the decision was released this morning. "My fellow doctors and I took an oath to do our best for our patients and we will abide by those principles - no one who needs care will be turned away."
He made the comments after the court struck down a Quebec prohibition that banned the use of private health insurance and private financing of hospital services to provide medically necessary services. Although the ruling applies only in Quebec, since the prohibition was found to violate Quebec's Charter of Human Rights and Freedoms, it could open the door to similar litigation in other provinces.
Schumacher didn't pull his punches in responding to the judgment. "This represents a stinging indictment of the failure of governments to respond to the mountains of studies and years of research with real action [regarding wait times]," he said. "In essence, the court has agreed with our fundamental position that Canadians have the right to timely access to health services."
He was referring to the arguments the CMA and Canadian Orthopaedic Association presented when the court heard the case June 8, 2004. Today's momentous ruling by a split (four-three) court didn't come as a complete surprise because the court took much longer than expected - 366 days - to render its decision. This pointed to both the case's complexity and the deep divisions among the seven judges who heard it.
The case centred on the constitutionality of provincial legislation prohibiting the use of private insurance to cover necessary publicly insured services available within the medicare system. The Quebecers making the appeal - Dr. Jacques Chaoulli and George Zeliotis - contended that such insurance could be used to provide quick access to surgery, thus avoiding long queues within the public system. They also challenged legislation preventing physicians from providing private surgical and emergency services in publicly funded hospitals. Their arguments had been rejected by two Quebec courts before arriving at the Supreme Court of Canada.
Schumacher noted that last June the CMA had asked the court to delay the effective date for any remedy it imposed in order to give governments time to work with physicians to honour patients' right to timely access to care. "We are not surprised about the outcome," he said, "but we are surprised that the decision takes effect immediately."
He said the next step is now clear. "This is a clear call to the federal, provincial and territorial governments to immediately sit down with health care providers to lay out a roadmap that will provide Canadians with timely access to quality health care - the clock is now ticking."
Schumacher said work on this roadmap is already being drawn thanks to initiatives such as the Wait Time Alliance of Canada, of which the CMA and COA are both participants. "It has already made significant progress in developing a consensus on wait-time benchmarks," he said.
The majority decision said the court had no choice but to overturn the original rulings made in lower courts. "For many years the government has failed to act; the situation continues to deteriorate. This is not a case in which missing scientific data would allow for a more informed decision to be made. . . . While the government has the power to decide what measures to adopt, it cannot choose to do nothing in the face of a violation of Quebeckers' right to security."
© Canadian Medical Association or its licensors 2005
