Montreal, January 27, 2004 – The public health system in its current form is no longer sustainable in the medium and long term, said Claude Castonguay, former health minister and father of the Quebec health insurance plan, during a speech today to about 150 people organized by the Montreal Economic Institute (MEI).
Mr. Castonguay reiterated his deep attachment to the public system created three decades ago, but noted that new sources of financing are now essential. Among them only user fees and the development of a parallel private system will have a significant impact, he said.
A matter of principle
Mr. Castonguay raised the “important question of principle” involved in adopting new sources of financing.
Forbidding a private system and the absence of freedom of choice were “justified while our health system met our needs adequately,” he said. Now, in a profoundly different context, the status quo is “in direct conflict with an individual’s fundamental right to health.”
“More than one example exists of positive coexistence between the private and public sectors,” Mr. Castonguay said. “Claiming that the use of private resources opens the door to a two-tiered system, one for the rich and another for the poor, serves only to distort the debate.”
In Quebec, freedom of choice in health services would increase the amount of care and as a result improve access to services. “There is no reason to justify the limitation of individual freedom of choice with respect to health services,” Mr. Castonguay said.
The political challenge
The former health minister noted that his proposed solution is currently “blocked by the strict interpretation of the principles which form the basis of the Canada Health Act.” He used his speech to the Montreal Economic Institute as an opportunity to call upon the new government in Ottawa to face the challenge of modernizing health legislation.
The ex-politician acknowledged it will not be an easy task for current political leaders: “The introduction of user fees and the development of a private health care system would require that they enter a difficult debate that can easily slip into demagogy.”
“However, if they choose one more time to continue injecting new funds and keep the status quo, the same causes will yield the same results,” Mr. Castonguay concluded. “If this avenue is taken, we may very well be witness to or victims of yet more crises.”
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