Last June, the Supreme Court of Canada ruled that legal restriction of private health care services and insurance violate the Quebec Charter of Human Rights and Freedoms. The high court upheld the constitutional challenge brought by Dr. Jacques Chaoulli to laws forbidding Quebec residents from purchasing a full range of private medical services and private medical insurance.

Federal Health Minister Tony Clement is urging provinces to establish wait-time benchmarks and care guarantees. Minister Clement is concerned if provinces do not act, Canada's health policy will be litigation-driven and "Chaoulli-based."

What Minister Clement is hoping to avoid by establishing the benchmarks and guarantees is more court rulings like the Chaoulli decision affecting provinces other than Quebec. He's right to worry.

A wait-time benchmark is an agreed upon timeframe for when a certain type of medical procedure should be completed. If the wait-time benchmark cannot be achieved, a care guarantee would see the patient seek treatment in another jurisdiction or a private clinic with the patient's home province footing the bill.

Currently, there are only five areas were medically acceptable wait-times have been set: joint replacement, cataracts, cardiac care, cancer care and diagnostic imaging.

At the Canadian Medical Association's general council meeting, Minister Clement stated, "Establishing benchmarks is only the beginning. To mean something for Canadians, our health-care system must provide patients with recourse if medically specified wait-times can't be met." This is true, but what if the "medically specified wait-times" established by bureaucrats, are not suitable to the patient

As the Supreme Court noted, "many western democracies that do not impose a monopoly on the delivery of health care have successfully delivered to their citizens medical services that are superior to and more affordable than the services that are presently available in Canada. This demonstrates that a monopoly is not necessary or even related to the provision of quality public health care." Saving medicare means permitting private services to flourish.

There are many countries in Europe such as; Germany, France and Britain, where publicly funded medicare and private medicine co-exist. In many countries, the public medical system pays for all or part of the costs of services provided by private service providers.

Alberta, like Britain, allows for joint replacements such as hip or knee procedures to be done at private clinics. This contracting out has resulted in wait-time reductions.

The Chaoulli decision also opened the door for Quebec residents to purchase a full range of private medical insurance. (That said, the Quebec government continues to drag their feet on implementing this part of the court decision.) The private health care insurance would be voluntary and complement the coverage provided under the province's existing universal health care insurance.

Think of it as complementary or extended warranty insurance. The universal insurance system would still be there, but the complementary health insurance could provide choice for patients who may be unsatisfied with the service and treatment options available in the existing system. Choice for health care insurance should be adopted by all provinces.

Ottawa should embrace the Chaoulli ruling rather than fear it. To fully respect patients' rights means the government must remove the barriers to private health care. Minister Clement is correct in his assertion that litigation is a costly and time consuming route. But if governments continue to limit patient choice, don't be surprised if fed-up patients see litigation as their only route.