For decades, Quebecers have had difficulty accessing a family doctor and have had to wait on waiting lists for surgery. The pandemic has highlighted a structural lack of resources and flexibility.
The current government has absolutely no perspective to offer Quebecers to increase funding, quality of facilities and human resources to do better in the future.
The current excesses of our health care system, despite the fact that it absorbs nearly $50 billion per year and 45% of the Quebec budget, require a different approach.
Quebec, along with the rest of Canada, is the only place in the developed world where there is a public monopoly on medical and surgical procedures. This is one of the causes of the inefficiency of our health care system that the Conservative Party of Quebec wants to address.
The Legault government and three other opposition parties do not question this public monopoly on health care.
The Conservative Party of Quebec voted at its last convention to propose ambitious and realistic reforms to Quebecers.
Much needs to be done. We will present just one of these reforms here.
Adding the private sector’s contribution
We propose to maintain universal health care coverage and make it more accessible by adding the talents and resources of private entrepreneurship.
Doctors could open private clinics and hospitals. We understand that they will have no difficulty borrowing the necessary funds and will act as responsible entrepreneurs. They will be innovative managers who will purchase advanced technologies that are too often absent.
By bringing this private initiative into play, there will be more clinics and hospital structures that are better distributed throughout Quebec.
With the monopolistic system that we have unfortunately inherited, cost reduction is achieved by rationing resources. In the rest of the world, it works differently.
The private health sector plays an important role in all countries where waiting lines are almost non-existent, as in Germany and Switzerland. In France, the private for-profit sector performs about one in two digestive tract surgeries, two in five heart surgeries, three in four cataract surgeries, and nearly three in ten deliveries. Private hospitals manage nearly 20 per cent of facilities with emergency departments.
In the immediate term, the government must encourage greater supply by allowing mixed private-public practice for specialist physicians. It is unacceptable that surgeons have access to only one day of surgery per week.
If the Quebec government would at least allow physicians to practice in the private sector once they have filled a quota of services in the public system, it is undeniable that more patients could be treated. Ignoring this reality to protect the current public monopoly is a dogmatic approach.
An improved insurance system
The cost of health services rendered in the private sector will be covered by Medicare, as for any care in the public system.
Quebecers already use private health insurance called complementary insurance. This insurance covers services that are not insured by the public system, such as drugs and dental care. Most Quebecers are covered by this type of insurance as part of their employment.
We propose to extend this type of insurance to medical and surgical consultations and care. Quebecers would therefore be invited, if they so wish, to take out duplicate insurance that will also cover what is offered by the public insurance plan. This private insurance plan will provide access to a range of additional benefits that will meet the diverse needs of clients and shorten the waiting lists of the public plan. The government will pay the cost normally assumed in the public system, with the remainder being assumed by private insurance for those who choose the private sector.
In order to facilitate the emergence of this private insurance market, the government will have to reduce the amount of premiums to be paid by the insured by using, among other things, tax credits. Currently, most Quebecers have to spend thousands of dollars at the dentist or for other health care services before getting a tax credit. The reform will allow eligibility for these tax credits from the first dollar spent on private insurance premiums for medical and surgical care provided by the private sector.
Several Leger polls have shown that a majority of Quebecers are in favour of opening up to the private sector while maintaining the public health care system.
A close examination of the Canada Health Act and the regulations in force in Quebec indicates that there are no major legal obstacles to the implementation of these proposals.
A major symposium on health
The Conservative Party of Quebec will soon be organizing a major public conference to clarify the steps and mechanisms for implementing the reforms described above.
This conference will be an opportunity to discuss other reforms that the PCQ considers essential, such as the decentralization of our health care system, which will give hospitals more budgetary autonomy.
Another important reform will propose that hospital funding be changed from a fixed amount to a budget based on the quantity and quality of services rendered in previous years. This is what is done elsewhere in the world and leads managers to listen to patient satisfaction.
President of the Political Committee
Quebec Conservative Party
Dr. Karim Elayoubi MD
Family Physician and Emergency Physician
Lecturer in the Department of Family Medicine and Emergency Medicine at the Université de Montréal
Dr. Roy Eappen MD
Endocrinologist at St. Mary’s Hospital Center
Assistant Professor of Medicine, McGill University