The Canadian health care system is at a crossroads. Litigation building on the Supreme Court of Canada’s decision in Chaoulli that could lead to the establishment of a parallel private tier is underway in several provinces. For example, in a challenge set to proceed to trial this fall, Dr. Brian Day and six patient plaintiffs are challenging several British Columbia laws that restrict parallel private care. Provincial governments across Canada employ various laws to protect public Medicare, including bans on private insurance for publicly insured services, limits on dual practice by physicians (i.e. prohibiting those who are paid through the public insurance plan from also being paid from the public purse), and bans on extra-billing for insured services (i.e. preventing physicians from topping up public payments by charging patients more). Plaintiffs in the upcoming cases allege that the combination of long wait times in the public system and limits on private care infringe their Charter rights to life and security of the person. As judges evaluate these claims, a key consideration will be whether restrictions on private care are essential to preserving quality, efficiency, and accessibility within Canada’s public health care system. In assessing the impact of liberalizing these laws, courts will rely on the comparative experience of countries that also have universal public health insurance, but that allow parallel private care. However, too often, the subtleties of foreign countries’ experiences with two-tier care and contextual differences between health care systems are downplayed or ignored, in favour of simplistic conclusions. For example, in Chaoulli, Chief Justice McLachlin accepted a “common sense” argument that prohibiting private health insurance was not related to the provision of quality public health care, given the experiences of several western democracies with “medical services that are superior to and more affordable than the services that are presently available in Canada,” without addressing the differences that exist between Canada and these countries. This paper draws lessons for Canada from New Zealand’s health care system, which permits two-tier health care. After briefly comparing the two systems, we address the claim that New Zealand’s shorter wait lists coupled with its permissive approach to a parallel private system suggest that Canada should loosen its own restrictions on privatization. We argue that not only are there concerns with the reliability of New Zealand’s wait list data, but that its method of organizing wait lists and its permissiveness of dual practice raise serious concerns with equitable access, quality of care, and physician conflicts of interest. We conclude by arguing that the uncertainty inherent in adapting comparative health policy literature to the Canadian context necessitates judicial deference to policy-makers in the upcoming constitutional challenges.