Summing up the evening, Campion recalled that when the Sisters of St. Joseph opened St. Michael's Hospital in Toronto they offered care to whomever showed up at the door, regardless of their ability to pay. At the time, it was a revolutionary idea, Campion said.

"We have an ethical tradition supporting universal access to care," Campion said.

The preceding debate between a family doctor from Sioux Lookout, Ont., and a Toronto oil company executive with a PhD in economics largely revolved around whether allowing a parallel private system to compete with publicly funded hospital and physician care is consistent with the Catholic and Canadian tradition of free universal access.

Private clinics open to those who could pay, or who hold private insurance plans, "takes doctors and nurses out of an understaffed public service," said Chase. The former president of the Ontario College of Family Physicians argued that the more acute problems in Canada's health care system stem from a decision by provincial governments across Canada in the early to mid-1990s to cut the number of doctors. As graduation rates for young doctors return to traditional levels in the next three to five years, Canadians should notice improvements, Chase said.

"I don't see why it should be a problem if I want to pay to go to a private clinic," said Kyle, a transplanted American who taught economics at New York University before coming to Canada to work for Imperial Oil.

Kyle said he agreed with Canadians who do not want to adopt the American model of health care. Instead he urged Canadians to look at Sweden, France and Germany where privately delivered health care flourishes along with the public system. Competition could make Canada's public system more efficient, he said.

After listening to both sides, Peter Venton said he didn't think allowing those who could pay to opt out of the public system was really about choice or making the public system more efficient.

"The hidden agenda is that we cannot raise taxes," said Venton.

At the end of the day, said Venton, Canadians can have as good a public health system as they're willing to collectively pay for.

Kyle acknowledged that the private versus public debate has been going on for a long time in Canada, but he hoped dispassionate, objective research by the Canadian Catholic Bioethics Institute could push the country closer to a conclusion.

"I don't think those should be exclusively economic decisions (about the future of health care in Canada). There should be an ethical dimension," Kyle said.

The debate continues year after year, despite Canadians' preference for a public system in every opinion poll, because insurance companies which could make money from a private system won't let it go, said Chase.

"I don't think this debate will ever go away because there's too much money to be made," she said.

Chase has joined with other doctors to form Canadian Doctors for Medicare, a group that opposed the recent election of Dr. Brian Day as president of the Canadian Medical Association. Day runs a private clinic in Vancouver.