SPEECH BY DR. JACQUES CHAOULLI: DEFEATER OF CANADA'S MEDICAL SOVIET

Up to the end, most of the commentators thought I would fail. But on June 9, 2005, I won. Across Canada, the elite was astonished. The Dean of Canada's Osgoode Hall law school, Patrick Monahan, was quoted by Canada's National Post three days ago as saying, "I didn't expect a majority of the court to uphold Chaoulli's claim." A constitutional law professor from the same law school, Jamie Cameron, was quoted as being "surprised at the judges' activism.... It's a huge step for Section 7 [of the Canadian Charter of Rights and Freedoms}. I think that the constraints that used to apply to Section 7 have pretty much blown out of the water."

It is significant that I won against a number of lawyers and top expert witnesses representing the government side. For example, during the trial I cross-examined Professor Theodore Marmor from Yale University. Justice Deschamps, concurring with the majority, rejected his testimony, on paragraphs 63, 64 and 67 of the judgment.

For many years, in survey after survey, a majority of Canadians said that they were in favor of private health care alongside the public system. After my victory, ordinary people felt a sense of relief to hear that, for the first time ever, the highest court in the land condemned the Canadian single-payer health care system for causing situations in which patients suffered and died on waiting lists, in violation of the rights to life, liberty, and security protected by Section 7 of the Canadian Charter of Rights and Freedoms.

As a result of this historic judgment, Canadian legal scholars have now classified Canada's legal history about rights and freedoms into two distinct periods: before Chaoulli and after Chaoulli. For many years, I have been studying constitutional law, most of the time alone, and during a short period of time, in year 2000, as a full-time law student in Canada. As a law student, I argued against most of my Canadian professors of law, whose interpretation of the Canadian Charter of Rights and Freedoms was opposed to my own interpretation. Ironically, five years later, in 2005, the Canadian Supreme Court upheld my own interpretation of that Canadian Charter of Rights and Freedoms.

To my knowledge, it is the first time that a court has invalidated a government health care action that had effectively resulted in the suffering or deaths of individuals. The Canadian Supreme Court ruled that a state may not force an individual to endure poor quality health care services or unreasonable waiting times for medically required services, and it cannot prevent average individuals from getting access to private health insurance.

Opportunity for Private Health Care

This Canadian Supreme Court ruling was like the fall of a second Berlin Wall. It opens up a unique opportunity, in the United States and in several OECD countries, to counter what is called in the United States "liberal," and what I call "socialist," lobbies that are pushing their agenda for socialized medicine.

Some commentators believe that this ruling would apply only to Quebec and not to the rest of Canada. I respectfully disagree with their opinion. In my view, a proper reading of the judgment leads to the conclusion that similar legislation in other Canadian provinces may already be considered as violating Section 7 of the Canadian Charter of Rights and Freedoms, which protects the right to life, liberty, and security. For that reason, in my view, there is no need to launch additional legal challenges in other Canadian provinces.

About private hospitals, I was asking the court to declare my right to establish a private hospital in Montreal. The majority of the Canadian Supreme Court gave me the green light to go ahead in establishing a private hospital, when Justice Deschamps, concurring with the majority, ruled at paragraph 51 of the judgment that: "the Minister may not refuse to issue a permit solely because he or she wishes to slow down the development of private institutions that are not under agreement," and when at paragraph 54, she said: "Not only are the restrictions real but Mr. Chaoulli's situation shows clearly that they are."

Practically speaking, that ruling opens the door for a parallel private health care system in Canada running alongside the continuing socialized and compulsory Medicare program run by the "States" or "Provinces," as in other countries of Northern and Southern Europe, Australia, and New Zealand. Obviously, in terms of public health policy, such a result is not good enough. Those who are unable to pay twice, through general taxation and the additional cost of parallel private health care services, will continue to fall through the cracks of a deficient Medicare program.

For a long time, several experts have suggested that legislators should permit individuals to opt out of a state's compulsory Medicare program [In Australia they are allowed to -- to some degree]. But as you well know, legislators from around the world, including here in the United States, have to deal with a potato which is not only hot, but also burning!

Lessons for the U.S.

This victory is particularly important for American people, since they are facing important health policy issues, both at the federal level, regarding the Medicare program, and at the state level. The states of Vermont and California have engaged, or are engaging themselves, in the process of establishing a single-payer health care system which--there is no doubt in my mind--shall lead, like in Canada, to a situation whereby some patients will suffer and die on waiting lists.

I believe that, were it not for particular interest groups pushing for their own agenda, most people around the world would reject such a health care system that inevitably leads to suffering and to death. In 2002, particular interest groups thought they could introduce a single-payer health care system in Oregon, through the initiative and referendum called Measure 23. But three-quarters of the population of Oregon rejected that model. Then, legislators in Vermont passed a bill establishing a single-payer system. A few weeks ago, the Senate of California passed a bill that is even more extremist, in the sense that, like in Quebec, it bans private health insurance covering services already covered under a new California State Universal Medicare program. That bill is likely to pass the Assembly as well. Maybe the governor of California will use his veto power to block that bill, but such a veto would last only as long as that same governor would remain in power. What about the people of California if the bill is passed again and the next governor fails to the veto that bill?

In Canada, in the United States, and elsewhere, liberal groups should be confronted with the failure of socialized medicine, which the four majority justices exposed in the so-called Chaoulli judgment. Moreover, and even perhaps more importantly, they should be confronted with the terrifying opinion of the three dissenting justices. Although the dissenting justices acknowledged that some patients die as a result of the state monopoly, they went on to say that the state monopoly is necessary in order to avoid what they call an unfair situation, whereby those able to pay in a parallel private health care system would save their own life, while those unable to pay would have to wait in the public sector.

For the first time in Canada, a Supreme Court Justice criticized publicly a dissenting colleague sitting on the same bench. Justice Deschamps, about whom I have spoken, wrote at paragraph 16 of the judgment: "The debate about the effectiveness of public health care has become an emotional one.... The tone adopted by my colleagues Binnie and Lebel JJ. is indicative of this type of emotional reaction." Also, she clearly challenged the view of the three dissenting justices, when at paragraph 85, she said: "It must be possible to base the criteria for judicial intervention on legal principles and not on a socio-political discourse that is disconnected from reality."

But make no mistake about it. Although the Berlin Wall fell in 1989, many groups driven by a socialist ideology are still very active in all the OECD countries, including here in the United States, and they share the view of the three dissenting justices I have mentioned.

You might hear from the legislators of Vermont that the Chaoulli judgment is irrelevant to them since the bill they passed doesn't ban private health insurance. They would be right to say that their bill doesn't ban a parallel private health care system. Still, down the road, like in Canada, in the UK, and in several other OECD countries, I believe some patients from Vermont shall inevitably suffer and die on waiting lists if the single-payer health care system is to be implemented in that state. Justice Deschamps had it right when she wrote, at paragraph 96: "Given the tendency to focus the debate on a socio-political philosophy, it seems that governments have lost sight of the urgency of taking concrete action. The courts are therefore the last line of defence for citizens."

I suggest her comment applies as well to the United States and to many countries around the world. I suggest the time has come to take advantage of this historic judgment in order to inform people in Canada, in the United States, and elsewhere about the consequences in terms of human suffering from letting legislators adopt, or maintain, single-payer health care systems.

More here

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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