The Supreme Court of Canada has been reluctant to find a "positive" right to health care under section 7 of the Charter of Rights and Freedoms (the right to "life, liberty and security of the person").  However, the court has recognized a "negative" right to access health care privately, overturning a Quebec law banning duplicative private health insurance for core health services covered by public medicare. The Court found that an individual’s right to life and security, if jeopardized by wait times, is sufficiently linked to the right to buy private health insurance to trigger a constitutional claim. The subsequent, pro-privatization health rights litigation threatens to roll back the progressivity of one of Canada’s greatest social programs: a grave challenge to the assumption that rights litigation is a positive, progressive force. While some have suggested that these court challenges will spur government efforts to respond, in "dialogue" with the courts, to improve the public system, this chapter demonstrates why such gains are unlikely, given the realpolitik of redistributive politics against a backdrop of inequality.