OTTAWA — Roy Romanow says last week's Supreme Court ruling on private health insurance in Quebec may kill the Canada Health Act, the legal foundation of medicare.

The former Saskatchewan premier, who headed the 2002 royal commission on health care, has sharply stepped up his criticism of the ruling since it was first brought down. Last week he said the verdict would not have a major impact, but since then, he said, he has read it twice.

He now calls the ruling "confusing, contradictory and in many ways just not consistent with any of the evidence - in fact, it's based on no evidence."

By guaranteeing Quebecers the right to private insurance for medically necessary services, he said, the majority ruling implicitly undermines the Canada Health Act. The act requires insured services to be provided "on uniform terms and conditions."

"I would not be surprised if somebody would take the logic of the majority of the court and try to apply it to knock off the Canada Health Act. It may be knocked off now by virtue of the decision itself," he said

In a 4-3 ruling, the high court struck down Quebec's ban on private health insurance for medically necessary services, saying the ban violated guarantees of life and personal security under the Quebec Charter of Rights.

The majority ruled that plaintiff George Zeliotis had been forced to wait an unreasonable time for a hip replacement. Yet the court did not define what a reasonable wait would be, said Romanow.

Provincial health ministers and high-level officials held a conference call Thursday to discuss the ruling.

David Spencer, a spokesman for Ontario Health Minister George Smitherman, chairman of the meeting, described it as a highly productive discussion in which participants discussed efforts to reduce wait times.

An official from another province, who spoke on condition of anonmity, said nothing substantive came of the discussion.

In the Commons, Prime Minister Paul Martin said the federal government has already taken action to deal with long wait times through last year's $41-billion federal-provincial health accord.

"What we are doing is strengthening the public (system)," said Martin.

Health Minister Ujjal Dosanjh has said all provinces are working to shorten wait times and the Liberal government will fight all efforts to privatize health care.