Health Care

SUMMARY

The COVID pandemic exposed the limitations and fragility of our health care system and revealed to Quebecers the clear need for reform. With the aging of the population due to accelerate over the next ten years and Quebecers requiring more and more resources for care and accommodation, the system is headed straight for an implosion. Doing nothing about it will endanger the population. The CPQ is the only political party offering a credible road to reform, a solution employing a mixed system in which the private and the public join forces.

For decades now, Quebecers have endured the struggle of finding a family doctor and the frustration of languishing on long waiting lists for surgery. The pandemic has brought the system's lack both of resources and structural flexibility into sharp relief.

The current government has literally no credible proposals for Quebecers to increase funding, improve the quality of facilities, or solve the labour shortage in order to ameliorate our health care system in the future.

Due to ideological biases, the potential role of the private sector in the health care system has been neglected by successive governments, this despite the considerable benefits it could yield through its ingenuity and innovation. 40 years of successive reforms, restructurings, and reports have led to an endless string of failures; it is time to consider other more modern and innovative solutions.

Indeed, almost all developed countries allow parallel public and private health care systems that compete with each other, as well as the option of taking out supplementary insurance for medical and surgical procedures.

In the monopolistic system we have inherited in Quebec, cost reductions are achieved through the rationing of resources. In the rest of the world, things work very differently.

Countries with parallel systems include Switzerland, France, Germany, Sweden, Denmark, the Netherlands, and the United Kingdom. Their health care systems all achieve higher performance indices than Quebec's in terms of surgical waiting lists, specialized services, access to first line care and emergency room waiting times.

The CPQ is proposing that we draw inspiration from the best health care systems in the world in order to modernize our own system, maintaining universal health care coverage while making it more accessible by adding the talents and resources of private entrepreneurship. Quebecers should be able to exercise their freedom of choice.

DID YOU KNOW? 

  • Running Quebec's current health care system costs nearly $1 billion per week ($SO billion per year). This represents 45% of the province's total budget.
  • Quebec spends more than 13% of its GDP on health care, one of the highest percentages among developed countries.
  • Despite these huge expenditures, Quebec's health care performance is far from According to pre-pandemic data, the median waiting time for patients in Quebec emergency rooms was nearly 10 hours. In 2022, the average wait time will have increased to 17 hours. In the meantime, more than one in five Quebecers do not have a family doctor.
  • The scarcity of health care resources leads to postponements of planned operations at the risk of increasing hospital mortality rates, especially for cancer cases.
  • Quebec and the rest of Canada are the only places in the developed world that maintain a public monopoly on medical and surgical procedures. This is one of the causes of the resource shortage in our health care In France, 50% of all operations are performed in private hospitals.
  • Unlike almost all of its OECD peers, Quebec prohibits its physicians from mixing private and public practice, thus reducing the supply of work available to them.
  • At the organizational level, most transmission of health data in Quebec still takes place via fax machine, an obsolete practice long abandoned by other major Canadian provinces.

CONSERVATIVE VALUES

  • All Quebecers have the right to universal access to medically necessary.
  • Given the huge proportion of our taxes allocated to the health budget, Quebecers are entitled to a health care system as modern and innovative as those of many other developed countries.
  • All Quebecers must have real, full, and complete access to medical treatment and long-term care through appropriate insurance plans.
  • All Quebecers have the right to choose whether to be treated in the public or private sector.
  • Government should encourage healthy lifestyles by exempting youth sports activities from taxation.
  • Our elders have given us our cultural heritage. They deserve respect and the right to carry on their lives in dignity and with care appropriate to their needs, whether at home or in a specialized institution.
     

MAKING MORE ROOM IN HEALTH CARE FOR ENTREPRENEURS AND THE PRIVATE SECTOR

THE CPQ IS COMMITTED TO: 

  • Allowing physicians to maintain mixed public/private
  • Launching pilot projects to outsource the administrative management of some hospitals to experienced private
  • Launching a pilot project establishing a fully private
  • Encouraging local and foreign investors to build new health care infrastructure, with the goal of increasing funding for new resources and
  • Allowing for public insurance (RAMQ) to reimburse patients for private sector medical care when public sector waiting times have been deemed unreasonable in view of the level of urgency of the illness. Reimbursement should also be provided whenever the cost of private services proves less expensive than the equivalent care in the public
  • Allowing every citizen the option to purchase private supplementary insurance covering medical and surgical procedures.
  • Allowing access, through these private insurance regimes, to a range of additional services in order to meet the diverse needs of clients and to shorten waiting lists within the public system.
  • Allowing all citizens the freedom to choose to take advantage of the coverage offered by their private insurance plan, including for care already covered by the RAMQ. A PCQ government would continue to offer all the coverage that already exists to all those unwilling or unable to purchase private insurance, as well as for any care not covered by such private
  • Ensuring that the costs of any supplementary insurance would be borne by the patient. their employer, or their community.
  • Facilitating the emergence of this private insurance market using tax credits, among other things, to reduce the effective premiums paid for insurance. Eligibility for these tax credits will begin with the first dollar spent on private insurance premiums for medical and surgical care offered by the private sector.

CHANGING THE WAY HOSPITALS ARE FUNDED

THE CPQ IS COMMITTED TO:

  • Changing the way many Quebec hospitals are funded by ending the fixed budget system and instead allocating resources based on the number, and the nature, of cases treated in previous This will involve the use of payment scales per episode of care, based on the average costs of each medical intervention.
  • Over the last 30 or more years, almost all developed countries have adopted methods of financing their hospitals based on the services provided to patients. Quebec will finally join their ranks.
  • This approach allows the patient to become a source of revenue for the hospital. rather than a source of expense, and provides powerful incentives for health care providers to increase their responsiveness and efficiency. It promotes better patient experiences as well as competition between hospitals that will strengthen their focus on the customer.

DIGITIZING QUEBEC'S HEALTH CARE SYSTEM

It is well established that Quebec's health care system suffers from major shortcomings in the communication of medical results, and that this hampers its efficiency. Rapid transmission of information through digitization minimizes administrative inefficiencies and is essential to the provision of timely, high­ quality patient care.

THE CPQ IS COMMITTED TO: 

  • Building one of the world's most efficient computerized medical systems.  This will be accomplished using the Alberta Netcare Portal (ANP) system, among others. These will provide:
    • Interconnection between the diverse platforms used in the health care
    • Rigorous security for confidential patient
    • Access to data essential to changing the way hospitals are funded.

INCREASING THE SUPPLY OF HEALTH CARE SERVICES 

Quebec employs only 2.5 doctors per 1,000 inhabitants, a ratio less than half that of many OECD countries. Furthermore, the province counts fewer than 900 specialized nurse practitioners, compared with nearly 3,500 in Ontario. This situation shows that Quebec is failing to keep up with its peers in terms of the provision of health care services.

THE CPQ IS COMMITTED TO:

  • Increasing the number of medical school admissions to Quebec universities from 300 to 500 per year, while taking into account the capacity of each
  • Increasing the number of "super nurses" to achieve a ratio comparable to that of Ontario within its first term.
  • Expanding the scope of practice of many health care professionals including nurses, pharmacists, and
  • Accelerating the recognition of foreign diplomas and simplifying the requalification of health professionals with training equivalent to North American standards.
  • Participating in international recruitment campaigns in order to attract foreign professionals.

DECENTRALIZING THE HEALTH CARE SYSTEM

The current health crisis has highlighted the fact that the ponderous bureaucracy and hyper-centralization of the Quebec health care system do not allow for rapid, efficient. and fluid communication between health care providers and the senior administration. Our goal is to have decisions made as close as possible to the communities being served.

THE CPQ IS COMMITTED TO: 

  • Significantly reducing the number of deputy and assistant deputy ministers in the Ministry of Health and Social Services (MSSS).
  • Relocating the positions of Associate Executive Director (AED) of the CISSS and CIUSS to local health care institutions, with one AED per hospital centre and per CHSLD. They would have autonomy in the management of finances and logistics for their institutions and would be encouraged to experiment with newmanagement processes. Their funding would come directly from the MSSS, according to a funding method based on the services rendered to patients.
  • Relocating the position of Director of Professional Services (DPS) to each local health care facility. The DPS would report to the local AED.
  • Relocating the Council of Doctors, Dentists and Pharmacists to each local health care institution.
  • Allowing more flexibility and freedom to the different regions to create their own coordination agencies (CISSS and CIUSSS) in accordance with the specific needs of each region.

RESPECTING AND RECOGNIZING OUR SENIORS

  • The CPQ would take its inspiration from the long-term care management models used in the Netherlands, Japan, South Korea and Germany. Following reforms to their health care systems, these countries have achieved the most effective management systems for long-term care and chronic diseases. They have introduced universal long-term care insurance for everyone over the age of 65, in some cases with the option of taking out insurance from the age of 40.
  • This type of insurance also includes access to home care when less severe losses of autonomy occur, thus minimizing and postponing their coverage by more costly institutional resources.

THE CPQ IS COMMITTED TO:

Providing Quebecers with the same level of insurance coverage as the best­ performing countries for both home care and long-term care, through either public or private insurance.

REFORMING THE PUBLIC HEALTH ACT

  • During the recent health crisis, Quebecers were stripped of their civil rights and individual freedoms, often without scientific justification or democratic approval. Quebec must never slide in such a repressive and authoritarian direction again.
  • The pandemic brought to light the extraordinary powers the government has assumed by arrogating rights to itself without the consent of opposition parties, and with no regard for the principles of democracy with respect to civil liberties and the awarding of public contracts. Moreover, the lack of transparency in decision-making by government and health authorities has generated significant mistrust in a large portion of the population with respect to the measures taken during the pandemic.

THE CPQ IS COMMITTED TO: 

  • Reaffirming and protecting the civil rights of Quebecers by enshrining in the Public Health Act the primacy of the Quebec Charter of Rights and Freedoms over any other legislative.
  • Requiring the agreement of 80% of all members of the National Assembly if the government deems it necessary to extend a state of health emergency beyond 30 days. This commitment would have to be reconfirmed every 30 days.
  • Ensuring complete independence between the government and the National Director of Public Health (NDPA), upon whom the title of Deputy Minister could not be During a health emergency, all recommendations of the NDPA and expert advisors should be made public at each renewal of the state of health emergency, i.e., every 30 days.
  • Ensuring full transparency with respect to the awarding of untendered contracts. It would be mandatory to make these contracts public at each period of renewal of the state of health emergency.