Dr. Chaoulli came upon a patient who was waiting to undergo hip-replacement surgery. Already suffering from the painful immobility that his illness entailed, the patient had his plight exacerbated by his country’s oppressive blanket of regulations: With private clinics prohibited from performing hip-replacement surgeries, and private insurance companies banned from paying for such services, the patient had no choice but to take a place in the public-health-rationing line. He would have to endure his crippling condition for an indefinite period, until the state decided it could fit him into its schedule. To make matters even worse, there were concerns about the quality of the prosthetic hip replacement that awaited Dr. Chaoulli’s patient at the end of the line. It is in the nature of universal-public-health provision that quality must often take a back seat to quantity: Any cash-strapped government that tries to provide free prosthetics to all needy recipients will tend to purchase the cheapest units possible. This was exactly the situation in Canada, Chaoulli says, and patients were given no further choice about it: To guard against special treatment for “the rich,” public-health patients were prohibited from chipping in some extra cash of their own to upgrade their prosthetics.
The conclusion of the article neatly crystallizes the mainstream -- and scary -- thinking in Canada.