Election 2014 in Quebec: No Real Health Care Reform in Sight
Despite their questionable legality, there will be elections in the Canadian province of Quebec on April 7. During the electoral campaign, I shall address some of the issues discussed by the parties and show that Quebec is ruled by a “gouvernemaman” (nanny state), to use pamphleteer Joanne Marcotte’s expression. Today: the main parties’ take on health care (Read Part I: “Parties Expose Their Empty Slogans“).
Health care takes the biggest chunk of the province’s program spending (excluding debt) at 51.8 percent. And unfortunately, it’s likely to increase even more, as no major party plans to end the (quasi) monopoly government has over the provision of health care.
It’s especially obvious when looking at the Parti Québécois (PQ) platform. In typical big-government fashion, they want a population-wide consultation in order to promote healthy habits at all ages. Ironically, this is likely to end up costing more than the purported savings from preventative measures. They also want to implement a centralized system where people could select medical appointments with either general practitioners or specialists. If past attempts are any indication, then it’s likely this too will be well over the projected cost.
One must, however, give credit where credit is due. The PQ idea to encourage older people to receive health care at home is good, as it’s much less expensive than CHSLD (long-term healthcare facilities). Health Minister Réjean Hébert says it could cost CAN$3 billion if the focus is on CHSLD only.
Québec Solidaire (QS) too is focused on big-government solutions. They denounce a supposed obsession with balanced budgets, which endangers “our” public system. They also abhor letting people who can afford it to get private health care. In other words, this socialist party wants everyone to be equally waiting to get their care.
In terms of application, though, their proposal to have CLSC (local health clinics) open 24/7 is an excellent idea. Right now, most health clinics are not open at night or during weekends, meaning that people have to go to the emergency room, which costs much more.
QS Member of the National Assembly Amir Khadir, himself an M.D., would also like to see more nurse practitioners, but he is meeting strong resistance from the medical lobby. They oppose any competitive force that might decrease their workload and taxpayer-funded compensation.
The Parti libéral (PLQ) also proposes hiring more nurse practitioners, along with the elimination of the health tax the party had previously imposed and that the PQ failed to abolish as promised. Let’s see if they can accomplish it… (I’m not holding my breath.) Tax or not, they still promise to let health care expenditures increase by 4.5 percent per year, but PLQ leader Philippe Couillard, who has been the health minister in previous cabinets, knows that these increases barely — if at all — do anything to shrink waiting lists.
Finally, the Coalition Avenir Québec (CAQ) also proposes to abolish the health tax. They also want to change how doctors are paid, so they might actually be incentivized to take better care of their patients. As it stands right now, doctors are paid for every medical act they do, be it for a healthy or a sick patient. They are therefore encouraged to retain patients, and be paid for them, rather than refer them to specialists.
But like the other three parties, the CAQ believes in health care as an entitlement, and they and promise to “keep the social programs adopted in the province.” Even the proposal to abolish regional health care agencies within the province may sound good, but is bound to fail. Consider that the PLQ “abolished” healthcare agencies in place during their tenure… only to replace them with another structure.
As you can see, health care is subject to many empty promises by Quebecer politicians. It monopolizes half the budget, has very long waiting lists — which have doubled in the past 20 years — and yet politicians promise to pour more money. In other words, it is the prime example of a “white elephant” — an expensive project of dubious utility/effectiveness. So next time a Michael Moore worshipper talks about the wonders of our healthcare system, you know what to say.