Canada sensibly embraces right to private health insurance

In an episode of the Simpsons, where the cartoon family travels to Toronto, Homer traipses across a busy Canadian road in a cavalier manner, nearly getting flattened. He admonishes his horrified wife not to worry, because, "In Canada, we have free healthcare!"

Universal healthcare is, along with winter, the chief identifying factor of Canada, both at home and abroad.

That might change because the Supreme Court of Canada last month struck down a Quebec provincial law that had made private health insurance illegal.

In 1997, Quebecer George Zeliotis was told he would be waiting a year for a hip replacement. There was no private medical option in Canada. And rather than do what some Canadians who can afford the time and money do - head for the US - he filed a lawsuit with Montreal Dr. Jacques Chaoulli, a longtime advocate for private medicine.

The case was twice shot down in Quebec courts before they brought it to the highest court.

The Supreme Court of Canada has ruled in favor of same-sex marriage and medical marijuana - hardly a gang of right-wing killjoys. Yet Chief Justice Beverley McLachlin and Justice John Major, in their ruling, concluded that "delays in the public health care system are widespread, and ... in some serious cases, patients die as a result of waiting lists for public health care." The court also emphasized the serious psychological suffering caused by prolonged denial of care.

The decision applies only to Quebec, but Canadians can fly or drive to Quebec. And, better yet, they can cite the ruling should a similar conflict arise in their own province.

Our socialized health-care system is idealized in the US by the likes of Hillary Clinton, Ted Kennedy, Michael Moore, and the California senate, which recently passed a bill guaranteeing publicly funded health coverage to every resident of the state.

Here at home, true believers hold the system as close to them as the flag. Any suggestion that the system is less than perfect, or that it may be beneficial for a private tier to coexist with the public, is bound to start arguments.

This, in spite of a US-Canada sponsored study on the state of healthcare that showed Canadians and uninsured Americans had quite similar levels of satisfaction when it came to healthcare. In the same report, more Americans overall (53 percent) than Canadians (44 percent) were said to be "very satisfied" with the state of their health care.

The day of the Supreme Court ruling, there was some hyperbole, with Prime Minister Paul Martin boldly asserting that "nobody" wanted two-tiers, and Saskatchewan's Premier Lorne Calvert declaring Canada was on its way to an American-style system.

"American-style health care," to your average Canadian, means a system where people routinely have to sell their homes to pay for treatments.

The relative truth of that assumption aside, what we appear to be headed for is European or Australian-style healthcare, in which private and public intermingle nicely.

As to the prime minister's statement, a June 2004 poll found a majority of Canadians - 51 percent - in favor of allowing a parallel private care system. Support was highest in Quebec, at 68 percent, and in Saskatchewan and Manitoba, at 57 percent.

Recently, I had orthopedic surgery. The biggest challenge for me was the desperate Yellow Pages search for a family doctor to refer me to a surgeon.

When that was accomplished, it was a three-month wait to see the surgeon, followed by three months more for the surgery.

I have no complaints about the care, the surgery, or the kindness showed to me by everyone from the family doctor to the hospital staff.

As someone who could not afford to pay for surgery, I'm grateful a surgeon was available to me.

But I also wouldn't mind if other Canadians opted out of our system. I'd assume that ultimately good things would trickle down to me in the form of - for starters - shorter waiting times and fewer doctors leaving Canada.

Americans who hold Canada's system up as a model should keep in mind that there are better models than equal access to something inadequate.

I take special note of an ad on Toronto's subway that tells me that if I am thinking of getting pregnant I should first talk to my "health-care provider" (newspeak for doctor) about it.

Right.

With the Supreme Court's ruling, there might even be a bed for me by the time the baby was born.

• Rondi Adamson is a Canadian writer.