Access to Care, Access to Justice: The Legal Debate Over Private Health Insurance in Canada

K.V. Nagarajan is a professor of economics at Laurentian University.

On June 9, 2005, the Supreme Court of Canada ruled in Chaoulli v. Quebec
that prohibition of private insurance for publicly insured services in
Quebec was unconstitutional. This book of edited conference papers
delves deeply into the legal aspects of the case. Although the subtitle
includes the word “debate,” the collection mostly reflects views of
the opponents of the Supreme Court ruling. A couple of authors write in
favour of the landmark decision, but their support is feeble compared to
the overwhelming attack on the ruling by legal scholars, economists, and
policy analysts.

The ruling has been described variously as reflecting “class bias,”
as “an abomination of the most debilitating kind,” and as “naпve
and stupid.” The authors deploy both analytical and empirical
arguments to back their strong views. In a nutshell, they point out that
the majority arguments in favour of the ruling were based on
questionable legal principles, misreading of the presented evidence, and
ignorance of the dire consequences of their ruling for both the patients
and the health-care system. They persuasively argue that opening up
private insurance for publicly insured services will not improve the
system for most Canadians. Many of the authors recommend ignoring the
Chaoulli decision and getting on with the job of fixing the public
system.