The Aftermath of Chaoulli: Quebec's Bill 33 Opens the Door in a Limited Way to Private Healthcare Initiatives

By: Cassels Brock

Provided by World Services Group


The Aftermath of Chaoulli: Quebec's Bill 33 Opens the Door in a Limited Way to Private Healthcare Initiatives

   Published November 16, 2006 - Ontario, Canada

In June 2005, the Supreme Court of Canada released its decision in the case of Chaoulli v. Quebec (Attorney General). In that case, Dr. Jacques Chaoulli challenged the provisions of Quebec's health care legislation which prohibited the purchase of private insurance for insured services. A four-member majority of the Supreme Court held that these provisions violated the Quebec Charter of Human Rights and Freedoms (the "Quebec Charter"). Three justices of the Supreme Court also held that this prohibition violated the Canadian Charter of Rights and Freedoms, and that this violation was not justified in a free and democratic society.
Bill 33


In its written judgment, the Supreme Court gave the government of Quebec one year to amend the province's healthcare legislation in order to rectify the violation of the Quebec Charter. In response, on June 15, 2006, Bill 33 was tabled, setting out proposed amendments to Quebec's healthcare legislation. The changes set out in this bill reflect the Quebec government's intent to open the door to private health insurance, but only to a limited extent. Among other things, under the proposed changes:

the organizational plan of a hospital must provide for a central mechanism to manage access to specialized and super-specialized services and identify the person responsible for the central access management mechanism;
the Minister may take any measure necessary to implement alternative access mechanisms if he considers that the waiting time for a specialized service is unreasonable or about to become so;
patients would be provided with guaranteed access to certain procedures, currently limited to total hip or knee replacement and cataract surgery;
insurers and persons administering employee benefit plans would be permitted to enter into or maintain insurance contracts or establish and maintain employee benefit plans which provide insurance for those services for which guaranteed access is stipulated (initially proposed to be total hip or knee replacements and cataract surgeries), as long as: (i) the insurance contract or employee benefit plan does not cover any other service other than those determined by law or regulation; (ii) the insurance contract or employee benefit plan covers the entire cost of the service; and (iii) the procedure is performed in a specialized medical centre where only non-participating doctors practice.



For more information, please contact Megan Evans at 416 860 2949 or David Cameron at 416 869 5987.


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This article is not intended to provide legal advice as individual situations will differ and should be discussed with a lawyer.


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