Interesting that the Federal Govt. is ignoring Quebec violations of the Canada Health Act. Both the Federal govt. and the Quebec provincial govt. want more private involvement and cost shifting to the private pocket all of which benefits the rich and investors.
Friday » February 22 » 2008
Our march toward private health care
Governments and parties are pushing Quebecers into the private sector by starving the public one
JOSEE LEGAULT
The Gazette
Friday, February 22, 2008
CREDIT: MARCOS TOWNSEND THE GAZETTE
Claude Castonguay produced a report suggesting user fees and more private-sector involvement.
Here's my hypothesis on why Jean Charest ordered a report on health-care financing only to have his health minister shoot it down like an enemy plane.
The report was ordered in June 2007. Charest's minority government was facing Mario Dumont, who had just become leader of the official opposition and was seen as the premier-in-waiting. The media were full of musings on voters shifting to the right.
This created what I called the "adéquisation"of Quebec politics, with Charest cozying up to Action démocratique policies. So it was no surprise when the premier called on Claude Castonguay, an advocate of user fees and private health-care services and insurance. He was a shoo-in to produce an ADQ-clone report. Predictably enough, Dumont just called the report the best thing since sliced bread.
But things have changed since 2007. The ADQ is in trouble and Charest is in better shape. This pro-business report was too hot to handle. Health Minister Philippe Couillard was thus sent out to sound like he was shredding it. But did he really?
The fact is that private health care has been on the rise in Quebec for a decade and nobody's stopping it. The Parti Québécois created the conditions for it when it weakened public health-care with its zero-deficit policy. Since 2003, the Liberal government has turned a blind eye to the growing number of privately paid-for services and tests.
Result: Quebec is now the province with the highest rate of private health-care spending, at 30 per cent. The Gazette's Aaron Derfel also reported that while the public sector is short 800 family doctors and 650 specialists, the number of doctors who have gone private has tripled in the past 10 years. Meanwhile, Ontario stopped allowing doctors to opt out of medicare in 2004.
Who hasn't been told by a doctor to get a test done in a privately run clinic where you pay out of pocket or through private insurance? Some family doctors ask first-time patients for a battery of tests to be done privately for $500 to $1,000 before they'll even see them.
Yesterday's Globe and Mail reported that Quebec, in violation of the Canada Health Act, refuses to give Ottawa its data on extra-billing or user fees. Ottawa has turned its own blind eye by refusing to penalize the province for this. Like the three monkeys, nobody sees, hears or says anything. It is no wonder private care flourishes in Quebec.
In fact, the three major parties either advocate more private care or ignore it, while professing support for the public system. Pauline Marois's own silence on the Castonguay report said it all.
Even Couillard couldn't fake it that well. He said he wanted a "dialogue" on a user fee based on revenues and use of services, he was open to privately run hospitals and allowing doctors to move between the private and public sectors under certain conditions. His Bill 33 could also extend private-insurance coverage to a number of surgeries through a simple change of regulation.
He also said a final no to the only equitable way to finance public health better: increase the sales tax. This government cut income taxes by $900 million and now gives up $1.5-$2.5 billion a year if it took back one or two of the GST points that Ottawa vacated. But isn't money what is needed to train, hire and give better conditions to more doctors and nurses, and to get better technology, more home and long-term care?
By saying no to the tax revenue that would strengthen public health care, it means the private sector will be called upon more and more. Keeping the public system starved of cash also scares the public into wanting more private services. It's called agenda setting.
The private sector is persevering. It knows that profit-based medicine will continue to grow here as governments and political parties fail to protect public health care and voters are told the public system can't do the job without even more private services.
Future generations will pay a very dear price for that.
© The Gazette (Montreal) 2008
Copyright © 2008 CanWest Interactive, a division of CanWest MediaWorks Publications, Inc..
Showing posts with label Claude Castonguay. Show all posts
Showing posts with label Claude Castonguay. Show all posts
Friday, February 22, 2008
Wednesday, February 20, 2008
Quebec Opens Door to more private health care
Instead of tackling problems of waiting times and staff shortages the "reformers" want to shift costs to individuals and let doctors earn more but through private practice. Interesting the Castonguay report is by a former insurance company executive. Of course there is no conflict of interest there!
The less publicly insured services and the worse the system the more private insurers will profit. The whole so-called socialised health care system is for the most part not socialised at all but for-profit from drugs, to contracted out services, to equipment and now to hospitals. Some of the costs are socialised but within the context of making profit.
The choice analogy of people buying houses and cars etc. is interesting. This denies that health care is a right but sees it as a consumer choice. One can choose a Cadillac heatlh system and live in a mansion or choose to shuffle about the city on foot and sleep in the streets.
Quebec opens door to more private health care
RHÉAL SÉGUIN and GLORIA GALLOWAY
February 20, 2008
QUEBEC CITY, OTTAWA -- Quebec Health Minister Philippe Couillard left the door open yesterday to physicians practising in both the public and the private systems under strict conditions in his response to a task force report on the province's health-care system that proposed "profound" changes.
Among the proposals in the report, entitled Getting Our Money's Worth, was the possibility of physicians having "duo" practices as well as allowing private insurance companies to cover services currently covered under the public-health program.
However, Mr. Couillard rejected a proposal to increase the sales tax and opposed the introduction of a tax deductible to help finance the health-care system.
Regarding the groundbreaking proposal to allow "duo" practice, Mr. Couillard said that doctors would be allowed to work in both the public and the private systems only under the strictest conditions, and only if there would be no shortage of doctors. The private sector must support the public system, Mr. Couillard insisted.
"The duo-practice model could be considered, but it won't be applicable for many years," he said.
"If we allow duo practice, it must have no impact on the public health care system and no impact on access to care by the general public."
Mr. Couillard also supported the recommendation that the government should allow private firms to manage hospitals through pilot projects that could eventually lead to "productive new options."
The head of the government task force, former Liberal minister and insurance company executive Claude Castonguay, said people are demanding changes to an "incoherent and rigid" system and should be given the freedom to choose the kind of health-care services they want.
"People can choose what car they want to buy, what suit they want to wear, what house they want to live in, but when it comes to their health, they don't have a choice. That's what I'm against," Mr. Castonguay said in an interview yesterday. "We are proposing to give a greater role to the private sector so that people can exercise a freedom of choice."
University of Toronto law professor Colleen Flood, who is Scientific Director at the Canadian Institute of Health Research and an expert on public-private health-care financing, said she was surprised the task force would go so far as to recommend that doctors be allowed to practise in both the public and private systems.
"In my view, that is the sort of irrevocable step towards a two-tier health-care system," Ms. Flood said in an interview yesterday. "Once physicians are able to work in the private system then you will start to see the real flourishing of that private system. Doctors will have a financial incentive to spend more time in the privately financed system ... and there is already a concern that there aren't enough doctors in the public system to allow this."
The task force insisted that the recommendations complied with the spirit of the Canada Health Act, but urged the federal government to change the law, which "hampers the evolution of the provincial health systems."
Federal Health Minister Tony Clement said yesterday that he is reviewing the report.
"Our government is committed to the principles that ensure that Canadians have universal access to medically necessary, timely and quality care based on need and not on an ability to pay," Mr. Clement said in a statement. "We are respectful of provincial jurisdiction in the delivery of health care."
The task force also proposed the creation of a "health stabilization fund" financed by an up to a 1-per-cent increase in the provincial sales tax.
Funding would also come from a maximum 1-per-cent to 2-per-cent deductible based on income and the number of times a person uses the health-care system. Lower-income earners and chronic care patients would be exempt.
"This is not a user fee," Mr. Castonguay stressed. "We reject user fees."
However, Action Démocratique du Québec health critic Eric Caire, who supports the task force's bold proposals for greater privatization, said the deductible was a good thing and that it amounted to nothing less than a user fee. "If it walks like a horse and looks like a horse, then no doubt that's what it is," Mr. Caire said yesterday.
The new funding scheme would collect slightly more than $2-billion and would be used to slow the projected 5.8- per-cent growth in government spending for health care to 3.9 per cent. Health and social services costs currently make up 44 per cent of the total provincial budget or $24-billion, which includes $5-billion for social services.
Another cost for patients would involve an annual access fee of a maximum $100 to become part of a health clinic and obtain access to a family doctor and other services. Statistics show that one in four Quebec residents does not have access to a family doctor. It would involve a "voluntary" contribution and act as an incentive for doctors to take in new patients and give all Quebeckers access to a family doctor within five years.
Hospital budgets should also be set differently and the report proposed that funding be determined by the services provided to patients. "The money would follow the patients," Mr. Castonguay explained. "Patients would no longer be viewed as an expense, but rather as a source of revenue for hospitals." Mr. Couillard said this was a proposal he intends to implement soon.
The report also responded to the needs of the province's aging population. It recommends that the government focus on improving home-care services and eventually move to privatize long-term-care facilities.
A spokesman for the Bloc Québécois said that, as long as the principles of free and universal health care are upheld, his party recognizes the need for a debate about the future of province's health system.
The less publicly insured services and the worse the system the more private insurers will profit. The whole so-called socialised health care system is for the most part not socialised at all but for-profit from drugs, to contracted out services, to equipment and now to hospitals. Some of the costs are socialised but within the context of making profit.
The choice analogy of people buying houses and cars etc. is interesting. This denies that health care is a right but sees it as a consumer choice. One can choose a Cadillac heatlh system and live in a mansion or choose to shuffle about the city on foot and sleep in the streets.
Quebec opens door to more private health care
RHÉAL SÉGUIN and GLORIA GALLOWAY
February 20, 2008
QUEBEC CITY, OTTAWA -- Quebec Health Minister Philippe Couillard left the door open yesterday to physicians practising in both the public and the private systems under strict conditions in his response to a task force report on the province's health-care system that proposed "profound" changes.
Among the proposals in the report, entitled Getting Our Money's Worth, was the possibility of physicians having "duo" practices as well as allowing private insurance companies to cover services currently covered under the public-health program.
However, Mr. Couillard rejected a proposal to increase the sales tax and opposed the introduction of a tax deductible to help finance the health-care system.
Regarding the groundbreaking proposal to allow "duo" practice, Mr. Couillard said that doctors would be allowed to work in both the public and the private systems only under the strictest conditions, and only if there would be no shortage of doctors. The private sector must support the public system, Mr. Couillard insisted.
"The duo-practice model could be considered, but it won't be applicable for many years," he said.
"If we allow duo practice, it must have no impact on the public health care system and no impact on access to care by the general public."
Mr. Couillard also supported the recommendation that the government should allow private firms to manage hospitals through pilot projects that could eventually lead to "productive new options."
The head of the government task force, former Liberal minister and insurance company executive Claude Castonguay, said people are demanding changes to an "incoherent and rigid" system and should be given the freedom to choose the kind of health-care services they want.
"People can choose what car they want to buy, what suit they want to wear, what house they want to live in, but when it comes to their health, they don't have a choice. That's what I'm against," Mr. Castonguay said in an interview yesterday. "We are proposing to give a greater role to the private sector so that people can exercise a freedom of choice."
University of Toronto law professor Colleen Flood, who is Scientific Director at the Canadian Institute of Health Research and an expert on public-private health-care financing, said she was surprised the task force would go so far as to recommend that doctors be allowed to practise in both the public and private systems.
"In my view, that is the sort of irrevocable step towards a two-tier health-care system," Ms. Flood said in an interview yesterday. "Once physicians are able to work in the private system then you will start to see the real flourishing of that private system. Doctors will have a financial incentive to spend more time in the privately financed system ... and there is already a concern that there aren't enough doctors in the public system to allow this."
The task force insisted that the recommendations complied with the spirit of the Canada Health Act, but urged the federal government to change the law, which "hampers the evolution of the provincial health systems."
Federal Health Minister Tony Clement said yesterday that he is reviewing the report.
"Our government is committed to the principles that ensure that Canadians have universal access to medically necessary, timely and quality care based on need and not on an ability to pay," Mr. Clement said in a statement. "We are respectful of provincial jurisdiction in the delivery of health care."
The task force also proposed the creation of a "health stabilization fund" financed by an up to a 1-per-cent increase in the provincial sales tax.
Funding would also come from a maximum 1-per-cent to 2-per-cent deductible based on income and the number of times a person uses the health-care system. Lower-income earners and chronic care patients would be exempt.
"This is not a user fee," Mr. Castonguay stressed. "We reject user fees."
However, Action Démocratique du Québec health critic Eric Caire, who supports the task force's bold proposals for greater privatization, said the deductible was a good thing and that it amounted to nothing less than a user fee. "If it walks like a horse and looks like a horse, then no doubt that's what it is," Mr. Caire said yesterday.
The new funding scheme would collect slightly more than $2-billion and would be used to slow the projected 5.8- per-cent growth in government spending for health care to 3.9 per cent. Health and social services costs currently make up 44 per cent of the total provincial budget or $24-billion, which includes $5-billion for social services.
Another cost for patients would involve an annual access fee of a maximum $100 to become part of a health clinic and obtain access to a family doctor and other services. Statistics show that one in four Quebec residents does not have access to a family doctor. It would involve a "voluntary" contribution and act as an incentive for doctors to take in new patients and give all Quebeckers access to a family doctor within five years.
Hospital budgets should also be set differently and the report proposed that funding be determined by the services provided to patients. "The money would follow the patients," Mr. Castonguay explained. "Patients would no longer be viewed as an expense, but rather as a source of revenue for hospitals." Mr. Couillard said this was a proposal he intends to implement soon.
The report also responded to the needs of the province's aging population. It recommends that the government focus on improving home-care services and eventually move to privatize long-term-care facilities.
A spokesman for the Bloc Québécois said that, as long as the principles of free and universal health care are upheld, his party recognizes the need for a debate about the future of province's health system.
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