Guest column, Dr. Alieta Eck

30 Sep

Lessons from Canada about healthcare

When Dr. Jacques Chaoulli, a French trained physician, decided to emigrate to the New World in 1979, he made the decision to go to Canada, rather than the United States. He wanted to live in the country that was more compassionate. After all, any government that provides its citizens with health care must have its priorities straight, holding a kind regard for the poor.

Fifteen years later he found himself bucking the very system that had attracted him in the first place. In Quebec, he had developed a house call system employing six other doctors, where patients could be seen and cared for quickly. But the local medical association, having the monopoly to negotiate with the government, convinced the authorities to put him out of business. The other physicians left, and Dr. Chaoulli was forced to shut down. His patients begged him to continue, caught in a trap that the poor could not escape. Middle and upper class patients could save up and travel to the United States for more timely, higher quality medical care, but the poor had to wait or simply accept poorer quality care. They were forbidden by law to buy a catastrophic private health plan that covered the same services listed in the Quebec government Medicare plan. Furthermore, they were not allowed to contract privately with physicians for basic medical services. A willing provider could not give care to a patient willing to pay cash.

Dr. Chaoulli, single-handedly, sued the Canadian single-payer system and found himself facing the Canadian Supreme Court. He argued that the low quality of care imposed upon patients by government, long waiting lists for surgery, and the prohibition from purchasing a private health plan or medical care of one’s own choice, violated patients’ “constitutional right to life, liberty and security.”

In the end, the court agreed, saying that “access to a waiting list is not access to health care, and that a low quality of medical care could threaten a patient’s life.” While the Canadian system is still in place, cracks in the wall have begun to appear.

In 2008, when asked whether it was absurd that the government put itself in the business of telling doctors whom they can and cannot treat and whether people can purchase services, Dr. Chaoulli replied:

“We have to understand the historical roots. Historically, the government started to intervene a long time ago because the workers were suffering because they didn’t have access to health care. It was to protect those who were not able to pay. Today, the government is preventing those who are suffering from using their own money to get care, and it ends up in an infringement to the right to life, security and liberty of a person. This is another story here. It is a story where a government is, practically speaking, killing patients at random. This was on the front page of the National Post the day of my judgment–that the Supreme Court’s meaning is that government may not kill people.” (

Dr. Chaoulli came to speak at the annual meeting of the Association of American Physicians and Surgeons at Salt Lake City, Utah, in September of 2010. He sees the seeds of government coercion in ObamaCare and came to warn us that a government that tries to do too much becomes a heartless bureaucratic nightmare. He insists on the importance of challenging the constitutionality of the individual mandate for the coverage of doctor’s visits, the prohibition of purchasing a health plan limited to catastrophic coverage, and of statutes giving power to third party payers to deny payment based on their own determination of medical necessity.

The United States is heading in the wrong direction. Instead of encouraging free market solutions to our health care system, solutions that work in every other sector of the economy, ObamaCare is pushing us headlong into a top-down command and control health care system that will bankrupt the country and not end well. It must be repealed. That was the message that Dr. Jacques Chaoulli brought to the AAPS Doctors Tea Party at the Capitol Building in Salt Lake City. That was the message that we ought to heed.

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