As lawmakers in Washington struggle to reform America's healthcare system, Canada is battling to preserve it's universal publicly funded program.

For forty years Canada's public health system has provided basic medical care for all on the simple premise that everyone be treated equally, regardless of financial status - a socialistic approach to medicine now under siege.
There's a shortage of doctors and patients are saturating the system resulting in long waits for some treatment-
Unless you're willing to pay.

Private for-profit clinics are popping up across the country offering services to patients who don't want to suffer in a long public line.

When Christine Crossman, an active, self-employed mother, injured her hip in an aerobics class she saw several physicians before being diagnosed and told she would need surgery. Told she could wait nine months to a year for the needed MRI, and longer for the operation, she decided to seek out a private clinic, paying several hundred dollars to get her MRI done within days.
"Any wait time was an enormous frustration for me and also pain. I just couldn't live my life the way I wanted to," Crossman explained. "No question- it was worth the money."

Health care delivery in Canada falls largely under provincial jurisdiction. Provinces and territories are responsible for implementing Canada's universal care principals and regulations vary across the country. For instance, a certain private for-profit clinic will be permitted in one province and not allowed in another.

Under the Canada Health Act- privately run facilities cannot charge citizens for services covered by government insurance but, a 2005 Canadian Supreme Court ruling in Quebec opened the door for patients facing unreasonable wait times to pay-out-of-pocket for private treatment. The Chaoulli case stems from a Montreal man's challenge to a long wait for hip replacement surgery. 73-year-old George Zeliotis tried to skip the public line and pay privately for surgery but discovered it was against the law. He and his physician, Dr. Jacques Chaoulli, argued the wait was unreasonable, infringing on his constitutional rights. After a long legal battle the Supreme Court agreed ruling "Access to a waiting list is not access to health care."

Luc Boulay is a partner in St. Joseph MRI- a private clinic in Quebec that charges around 700 dollars for most scans. He says when the clinic opened several years ago they were operating in a legal gray area. Today, the clinic accepts some overflow patients from the local public hospital.

"I think there is a fundamental shift in different parts of the country that's beginning to happen. I think people are beginning to realize that they should have a choice."

Public healthcare advocates fear a proliferation of private facilities will create a two-tiered system and undermine the very foundation of the country's healthcare system. Natalie Mehra, Director of the Ontario Health Coalition, believes private clinics violate the spirit of fairness inherent in Canada's policies.

"Private clinics don't produce one new doctor, nurse, or specialist. All they do it take the existing ones out of the public system, make wait times longer for everybody else while people who can pay more and more and more money jump the queue for health care services" Mehra argues.

Canada spends $3,600 per capita on healthcare - almost half of what is spent in the US, and while some in Washington looks north for ideas the Canadian system is still changing.

"One can understand that this is evolving and a mix of private and public seems to be favorable in some context," University of Ottawa professor, Dr. Michael Orsini said. "On the other hand, we need to be really careful that we're not treating health care the way we treat a value meal at McDonalds."

Driven by consumer demand for quick care, some fear the growth of a two-tiered system.
Provincial governments face the difficult job of finding a balance, reducing wait times and maintaining fair access without redefining the universal ideals at the core of Canada's health care system.