here in Canada with the news yesterday that the Supreme Court has struck down a Quebec medicare law that banned private insurance from covering treatments covered under medicare. The reaction has been all over the map – and has come from all over the globe as it strikes many that this is the thin edge of the wedge (not so thin, actually) to allowing a 2 tier health care system in Canada in place of the current universal system.

More importantly, though, I think this was a ruling against what they call, in the US, unfunded mandates. More than condemning the current single-payer system, the Supreme Court has said that theory is not enough – the system has to work in practice. So now the ball is (properly) in the governments’ court: fund the healthcare systems in Canada adequately or you will not be able to maintain the monopolistic single-payer system. You can’t just promise an adequate system – you have to deliver it.

This is a profound challenge to all 10 provincial governments and the Federal government, and one that will have far-reaching political and social implications from coast to coast to coast. We’ll see if they’re up to it – though I’m not optimistic.