DJP 6-9-2005 AMA Update - Historic ruling: Supreme Ct in Canada AND book on stress in litigation

Two quick items as I am finishing my final AMA tour on the road.  This week: Princeton, San Jose, CA, and now South Dakota Med.  Many memories flash back in the beautiful state of South Dakota as this is where I spent my military time.

 

Both of the items below are important.  Hope you find them of value.

 

Donald J. Palmisano, MD, JD

AMA Immediate Past-President

 

 

ITEM ONE: Historic ruling Supreme Ct in Canada

See Grace-Marie Turner note below and note this comment by the court:

"Access to a waiting list is not access to health care,"

 

Galen Institute
Health Policy Matters^®
June 9, 2005

 

The Wall Tumbles
 

The equivalent of the Berlin Wall came tumbling down in Montreal today as the Supreme Court of Canada struck down a Quebec law that had banned private health insurance for services covered under medicare, Canada's socialized health care program.

"This is indeed a historic ruling that could substantially change the very foundations of medicare as we know it," Canadian Medical Association president Dr. Albert Schumacher said after the ruling. The ruling means that Quebec residents can pay privately for medical services, even if the services also are available in the provincial health care system.

"Access to a waiting list is not access to health care," the court said in its ruling.

We featured a New York Times article about the case in a recent newsletter, explaining that a courageous Canadian doctor, Jacques Chaoulli, was challenging the constitutionality of the Canadian ban on private payment. He argued that long waiting times for surgery contradict the country's constitutional guarantees of "life, liberty, and the security of the person."

He was joined in the case by his patient, Montreal businessman George Zeliotis, who waited a year for hip replacement surgery. Zeliotis, 73, tried to skip the public queue to pay privately for the surgery but learned that was against the law. He argued that the wait was unreasonable, endangered his life, and infringed on his constitutional rights. The court agreed!

The case involved the Quebec Hospital Insurance Act and technically only applies to that province, but it will shake up the system in all of the other provinces, where private insurance also is banned. The court split 3-3 over whether the ban on private insurance violates the Canadian Charter of Rights and Freedoms (like our Bill of Rights). Clearly this was a difficult decision since the court delayed a year in issuing its verdict.

The United States has been a safety valve for Canadians unwilling or unable to tolerate the long waits for medical care in their country. Now, the Canadian government must face the music about the long waiting lines, lack of diagnostic equipment, and restrictions on access to the latest therapies, including new medicines.

In an almost laughable defense, "Lawyers for the federal government argued the court should not interfere with the health-care system, considered 'one of Canada's finest achievements and a powerful symbol of the national identity,'" according to the Canadian Broadcasting Corp. Dr. Chaoulli had persevered in spite of two lower court rulings against him that had ruled the limitation on individual rights was justifiable in order to prevent the emergence of a two-tier health care system.

Supporters of the prohibition against private contracting in Medicare in the United States should take note because our own law has the same effect, making it almost impossible for Medicare recipients to pay privately for services covered by the program.

We already had invited Dr. Chaoulli to Washington on June 21 for a meeting and are organizing a public event to give you a chance to hear from him directly. We will alert you to the time and place of the event in our next newsletter.

Grace-Marie Turner

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The views expressed in this newsletter are the opinions of the authors and do not necessarily reflect the views of the Galen Institute or its directors.

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ITEM TWO:  More on stress to physicians and their families from ligitation from Dr. Sara Charles!

Many of you know the wonderful Dr. Sara Charles from her work in the House of Delegates and The National Patient Safety Foundation over the years.  She has co-authored a book on the stress of litigation.

We all know the harmful effects of the broken liability system and here is more evidence.