Chaoulli v Quebec (AG) [2005] 1 S.C.R. 791, 2005 SCC 35, was a decision by the Supreme Court of Canada of which the Court ruled that the Quebec Health Insurance Act and the Hospital Insurance Act prohibiting private medical insurance in the face of long wait times, up to 9 months, violated the Quebec Charter of Human Rights and Freedoms. In a 4 to 3 decision, the Court found the Acts violated Quebecers' right to life and security of person under the Quebec Charter. The ruling is binding only in Quebec. Three of the seven judges also found that the laws violated section seven of the Canadian Charter of Rights and Freedoms. One judge did not rule on the Canadian Charter. The result was a 3–3 tie on the question of the Canadian Charter, so Chaoulli decision does not apply to any other province.

Having suffered in the past from numerous health problems including a hip replacement, 73-year-old salesman George Zeliotis became an advocate for reducing waiting times for patients in Quebec hospitals.

Jacques Chaoulli is a doctor who provided home appointments to patients. He attempted to get a licence to offer his services as an independent private hospital but was rejected due to provincial legislation prohibiting private health insurance.

Together, the two men sought a declaratory judgment to contest the prohibition.

Three separate opinions were written. The first is by Deschamps who found a violation of the Quebec Charter, but stated there was no necessity for her to rule on the Canadian Charter. A second opinion was written by McLachlin C.J. and Major J., with Bastarache J. concurring, on the violation of section seven. A dissenting opinion was given by Binnie and LeBel JJ. with Fish J. concurring in dissent. .

The appeal court's characterization of the issue as an infringement of an economic right is rejected by Deschamps. She goes on to note that the long waits at hospitals can result in deaths and that private health care prohibited by the Quebec Acts would likely have saved those lives. The wait lists, she claims, are an implicit form of rationing, and it is the government's rationing policy that is being challenged here as a violation of the right to "security of person" (per Canadian Charter) and "personal inviolability" (per Quebec Charter).

Deschamps sides with the trial judge, who found a violation of section 7 of the Canadian Charter, but she interprets it as being more of a violation of the similar section 1 of the Quebec Charter. She adopts a broad interpretation, citing R. v. Morgentaler among others as examples of delay in medical treatment as a violation of security of person. She further rejects the dissenters' suggestion that a patient could seek medical treatment outside of the province as too extreme and case-specific.

Turning to the requisite analysis to justify the violation, Deschamps points to the "minimal impairment" expectation to be the one of the most interest. Expert and witness testimony was examined of which she found it to be not particularly credible or useful. She then examines other provinces' health legislation, finding the lack of prohibitory legislation allows her to conclude that the Quebec Acts are not necessary to preserve the public health plan. Studies on public health programs in other countries examined by Deschamps support this claim.

The issue of deference to government is considered. "When the courts are given the tools they need to make a decision, they should not hesitate to assume their responsibilities,"^[1] she states, claiming that social policies developed by the government should not be shied away from by the courts. Deference should be given only with a justification consistent with democratic values and sufficiently necessary to maintain public order.

In concluding, Deschamp points her finger squarely at the government and suggests the need for change:

For many years, the government has failed to act; the situation continues to deteriorate. This is not a case in which missing scientific data would allow for a more informed decision to be made. The principle of prudence that is so popular in matters relating to the environment and to medical research cannot be transposed to this case. Under the Quebec plan, the government can control its human resources in various ways, whether by using the time of professionals who have already reached the maximum for payment by the state, by applying the provision that authorizes it to compel even nonparticipating physicians to provide services (s. 30 HEIA) or by implementing less restrictive measures, like those adopted in the four Canadian provinces that do not prohibit private insurance or in the other OECD countries. While the government has the power to decide what measures to adopt, it cannot choose to do nothing in the face of the violation of Quebecers' right to security. The government has not given reasons for its failure to act. Inertia cannot be used as an argument to justify deference.^[2]

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The decision proved to be highly contentious by its political nature and its conflict with the present government's policy on health. There are those,^[9] who argue that this decision could potentially lead to the dismantling of the Canadian Medicare system, while others suggest that this could be a much-needed wake-up call to repair the ailing system.

This ruling could have a direct effect on most provinces that currently have laws that are designed to discourage the private sector, in particular Ontario, Manitoba, British Columbia, Alberta, and Prince Edward Island, which all have legislation very similar to the impugned laws in Quebec.

After the Supreme Court rendered its judgment, the Attorney General of Quebec asked the Court to stay (suspend) its judgment for 18 months. The Court granted the stay for only 12 months; it therefore expired on June 8, 2006.^[10]

In August 2005, delegates to the Canadian Medical Association adopted a motion supporting access to private-sector health services and private medical insurance in circumstances where patients cannot obtain timely access to care through the single-payer health care system.^[11]

In November 2005, a Quebec provincial white paper on limited private reforms was leaked to the media. The paper proposed allowing the purchase of private medical insurance. To prevent doctors from abandoning the public system, the paper would force doctors to perform a minimum amount of work in the public sector before they would be allowed to perform in the private sector.

• Healthcare in Canada
• List of Supreme Court of Canada cases (McLachlin Court)
• fr:Jacques Chaoulli (in French)
• Shona Holmes health care incident