I would agree that lower tuition and poorer career options would encourage more Canadians to apply. One of the reasons that the schools up there are cheap is that outside of McGill, Toronto, Western Ontario and UBC, there is very little research coming out of Canada. They run most of their medical schools like LECOM. Job 1 is pumping out clinicians.
I disagree that their system functions better. I know someone in Wisconsin who was deemed to be in need of a hip replacement two weeks ago. She is scheduled for surgery in 10 days. My cousin in Ontario was put on the hip replacement waiting list two years ago. He's still waiting. He takes 10 naproxin per day. I hope that stuff doesn't kill him.
If you think the Canadian healthcare system is so great, look at the decision of the Canadian Supreme Court related to Quebec's prohibition of the sale of private health insurance.
CanLII - 2005 SCC 35 (CanLII)
Here are the juicy parts of the opinion:
"The Superior Court judge stated [translation] “that there [are] serious problems in certain sectors of the health care system” (p. 823). The evidence supports that assertion. After meticulously analysing the evidence, she found that the right to life and liberty protected by
s. 7 of the
Canadian Charter had been infringed. As I mentioned above, the right to life and liberty protected by the
Quebec Charter is the same as the right protected by the
Canadian Charter. Quebec society is no different from Canadian society when it comes to respect for these two fundamental rights. Accordingly, the trial judge’s findings of fact concerning the infringement of the right to life and liberty protected by
s. 7 of the
Canadian Charter apply to the right protected by
s. 1 of the
Quebec Charter.
39 Not only is it common knowledge that health care in Quebec is subject to waiting times, but a number of witnesses acknowledged that the demand for health care is potentially unlimited and that waiting lists are a more or less implicit form of rationing (report by J.‑L. Denis,
Un avenir pour le système public de santé (1998), at p. 13; report by Y. Brunelle,
Aspects critiques d’un rationnement planifié (1993), at p. 21). Waiting lists are therefore real and intentional. The witnesses also commented on the consequences of waiting times.
40 Dr. Daniel Doyle, a cardiovascular surgeon, testified that when a person is diagnosed with cardiovascular disease, he or she is [translation] “always sitting on a bomb” and can die at any moment. In such cases, it is inevitable that some patients will die if they have to wait for an operation. Dr. Doyle testified that the risk of mortality rises by 0.45 percent per month. The right to life is therefore affected by the delays that are the necessary result of waiting lists.
41 The
Quebec Charter also protects the right to personal inviolability. This is a very broad right. The meaning of “inviolability” is broader than the meaning of the word “security” used in
s. 7 of the
Canadian Charter. In civil liability cases, it has long been recognized in Quebec that personal inviolability includes both physical inviolability and mental or psychological inviolability. This was stated clearly in
Quebec (Public Curator) v. Syndicat national des employés de l’hôpital St‑Ferdinand,
1996 CanLII 172 (SCC), [1996] 3 S.C.R. 211, at para. 95:
Section 1 of the
Charter guarantees the right to personal “inviolability”. The majority of the Court of Appeal was of the opinion, contrary to the trial judge’s interpretation, that the protection afforded by
s. 1 of the
Charter extends beyond physical inviolability. I agree. The statutory amendment enacted in 1982 (see
An Act to amend the Charter of Human Rights and Freedoms, S.Q. 1982, c. 61, in force at the time this cause of action arose) which,
inter alia, deleted the adjective “
physique”, in the French version, which had previously qualified the expression “
intégrité” (inviolability), clearly indicates that s. 1 refers inclusively to physical, psychological, moral and social inviolability.
Furthermore, arts. 1457 and 1458 of the
Civil Code of Québec, S.Q. 1991, c. 64, refer expressly to “moral” injury.
42 In the instant case, Dr. Eric Lenczner, an orthopaedic surgeon, testified that the usual waiting time of one year for patients who require orthopaedic surgery increases the risk that their injuries will become irreparable. Clearly, not everyone on a waiting list is in danger of dying before being treated. According to Dr. Edwin Coffey, people may face a wide variety of problems while waiting. For example, a person with chronic arthritis who is waiting for a hip replacement may experience considerable pain. Dr. Lenczner also stated that many patients on non‑urgent waiting lists for orthopaedic surgery are in pain and cannot walk or enjoy any real quality of life.
43 Canadian jurisprudence shows support for interpreting the right to security of the person generously in relation to delays. In
R. v. Morgentaler,
1988 CanLII 90 (SCC), [1988] 1 S.C.R. 30, at p. 59, Dickson C.J. found, based on the consequences of delays, that the procedure then provided for in s. 251 of the
Criminal Code, R.S.C. 1970, c. C‑34, jeopardized the right to security of the person. Beetz J., at pp. 105-6, with Estey J. concurring, was of the opinion that the delay created an additional risk to health and constituted a violation of the right to security of the person. Likewise, in
Rodriguez v. British Columbia (Attorney General),
1993 CanLII 75 (SCC), [1993] 3 S.C.R. 519, at p. 589, Sopinka J. found that the suffering imposed by the state impinged on the right to security of the person. See also
New Brunswick (Minister of Health and Community Services) v. G. (J.),
1999 CanLII 653 (SCC), [1999] 3 S.C.R. 46, and
Blencoe v. British Columbia (Human Rights Commission), [2000] 2 S.C.R. 307,
2000 SCC 44 (CanLII), with respect to mental suffering. If the evidence establishes that the right to security of the person has been infringed, it supports,
a fortiori, the finding that the right to the inviolability of the person has been infringed.
44 In the opinion of my colleagues Binnie and LeBel JJ., there is an internal mechanism that safeguards the public health system. According to them, Quebeckers may go outside the province for treatment where services are not available in Quebec. This possibility is clearly not a solution for the system’s deficiencies. The evidence did not bring to light any administrative mechanism that would permit Quebeckers suffering as a result of waiting times to obtain care outside the province. The possibility of obtaining care outside Quebec is case‑specific and is limited to crisis situations.
45 I find that the trial judge did not err in finding that the prohibition on insurance for health care already insured by the state constitutes an infringement of the right to life and security. This finding is no less true in the context of
s. 1 of the
Quebec Charter. Quebeckers are denied a solution that would permit them to avoid waiting lists, which are used as a tool to manage the public plan. I will now consider the justification advanced under
s. 9.1 of the
Quebec Charter.
