NCPA - National Center for Policy Analysis


February 20, 2008

The architect of Quebec's now-overburdened public health care system is proposing a strong and controversial remedy that includes further privatization and user fees of up to C$100 (about U.S. $98) for people to see their family doctor.

In a 338-page report, former provincial Liberal health minister Claude Castonguay concluded that Quebec can no longer sustain the annual growth in health care costs.  The province currently spends about C$24 billion (about U.S. $23.6 billion) annually on health care, or about 40 per cent of its budget.

Other recommendations include:

  • A new tax, including a "health care deductible" based on income and the number of visits made to a doctor's office or hospital in a calendar year. Low-income families and children would be exempt.
  • Encouraging private-sector involvement in the management of hospitals and medical clinics.
  • Lifting a ban that prevents doctors from practicing both in the public system and privately.
  • Raising the provincial sales tax by up to one percentage point.

In the report, provocatively titled "Getting Our Money's Worth," the working group headed by Castonguay also recommends an overhaul of the Canada Health Act, which "sooner or later must be adapted to today's realities."

"If nothing is done, at one point we will reach a crisis point ... this is why we say it is urgent to act," Castonguay said.  "There's no miracle solution, there is no simple solution."

Source: Sean Gordon, "More private health care urged: Report for Quebec government proposes fees, health act changes to help overburdened system," Toronto Star, February 20, 2008.

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