Grant: Operating Grant

Across Canada laws protecting public Medicare are being subject to Charter challenges on the basis that a one-tier system causes Canadians to suffer wait-times. Likely the Supreme Court will rule upon one or more of these challenges, setting a new and uncharted course for Canadian Medicare. Precedent suggests that the Court will allow governments a brief window within which to respond with new laws that are more permissive of private finance. Applicants in the Charter challenges claim that Canada's restrictions on two-tier care are unconstitutional because other countries maintain viable universal schemes without prohibiting two-tier care. This oft-made claim rests on superficial analysis of foreign health care systems; in fact countries around the world employ various laws and policies to restrict two-tier care but very little is known about these approaches. Moreover, although the issue of wait times is at the heart of the Charter challenges to Medicare happening across the country, there is no comprehensive analysis of the relationship between laws and policies limiting two-tier care and wait times. Our proposed research serves two purposes. First, it will assist courts over the next few years as these challenges wind their way through the judicial system by providing a much stronger evidence base about how two-tier health care is regulated around the world and its relationship to wait times. Second, our research will help inform governments of alternative laws and policies, drawn from the experience of other OECD countries, which will meet Medicare's goals of equitable access to care within a reasonable time and survive scrutiny by the courts.