Health minister reacts to Castonguay report
QUEBEC CITY- The health minister is brushing aside many of the major recommendations made in a long-awaited report on the future of funding for health care in Quebec, drawn up by the father of the province's medicare system. Still, Philippe Couillard is promising it won't be shelved.
Unless serious action is taken, former Health Minister Claude Castonguay is warning the cost of health care in Quebec will spiral out of control.
Castonguay is proposing measures including an incease of up to 1 per centage point in the province's sales tax to fund health care, as well as charging patients a deductible that would be based on their income and on the number of visits they made to a doctor.
Couillard says increasing taxes is out of the question, and says charging patients is not something he's prepared to go ahead with- at least not yet.
"We want this idea to be discussed and debated," says Couillard. "But I can see some difficulties applying it."
The minister is also rejecting Castonguay's call for the right to private health insurance coverage to be extended beyond hip and knee replacements, or cataract surgeries. He is also ruling out the idea of allowing doctors to practice both in the public and private sectors, citing a shortage of staff in the health care sector.
But, Couillard says there will be major "changes in culture" in the health care system. The minister says he agrees with Castonguay's call for improved productivity, and is promising to put in place pilot projects to give Regional Health Agencies more autonomy, and even provide hospitals with funding on the basis of the number and type of patients treated.
"To make the patient a source of income for the hospital, rather than an expense," says Couillard.
Though he says the government has no immediate plans, the minister says he is not opposed to testing out a recommendation that private companies be brought in to manage public hospitals.
Action Democratique critic Eric Caire called the report "audacious, and lucid." He says the recommendations echo the ADQ's call for a bigger role for the private sector, promising to push the government to adopt its recommendations, including what he says is a user fee for patients.
However, Caire rejects the idea of increasing the sales tax.
Parti Quebecois critic Bernad Drainville says the results of the report confim that the government should have increased its sales tax to make up for last month's cut in the federal Goods and Services Tax.
But, he rejects a bigger role for the private sector.
"The way to resolve (the problems) is to work within the public sector, and make it work better," he says.
Even before the report was tabled, public sector unions were calling on the government to shelve it, calling its recommendations a violation of the principle of universal health care.
Patient's rights advocate Paul Brunet says he welcomes the emphasis on the need to improve access to health care, especially front line services.
But, he expressed reserves about the idea of charging patients a fee.
"We're going to have to be prudent to make sure that.. whatever your financial means you'll always have access to health care."
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