The goal of this project was to inform debate about introducing a parallel health insurance and health care system in Canada. The Montreal Economic Institute prepared a report in the wake of the Chaoulli case Supreme Court decision, which granted Canadian citizens limited access to private parallel health care. This Economic Note examines the economic impact of private health insurance provision alongside standard universal health insurance paid through taxes. It articulates concerns about the limits to the parallel system imposed by the Quebec government in the wake of the Chaoulli ruling. The report considers the insurance policy duplicating schemes used in various countries, including Australia, Ireland and New Zealand, and the kinds of regulations imposed on duplicate insurance in those countries. The project report recommends changes to Quebec’s health care access by allowing a broad scale, parallel health insurance and health care system to emerge alongside the publicly funded universal system.