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Health Care: It’s time for an in-depth reform

Montreal, May 16, 2007 – Claude Castonguay, considered one of the fathers of Quebec’s health care system, says the system needs in-depth reform. “The future of our health care system is a fundamental issue,” he told a Montreal audience today. “If the necessary changes are not made, our system cannot survive. That is a certainty from which we cannot escape.”

Speaking at a luncheon sponsored by the Montreal Economic Institute, Castonguay said, “We have to move beyond patchwork solutions and filling the gaps in order to respond to the problems that arise continually. For far too long, corrective measures have tried to plug the holes in the system at a cost of billions of dollars. Fundamental changes are necessary.”

Castonguay set out a step by step process to reform health care in Quebec beginning with the fundamentals, the very governance of the Canadian health care system, which he says must change. He said the most significant change is the separation of the roles of the purchasers and the providers of health care services.

Castonguay said the Régie de l’assurance maladie should become the purchaser of hospital and ambulatory services, as well as, evaluating the performance of such institutions.

“The new concept of purchasing care would have significant indirect effects,” he told the Montreal audience. “Firstly, it would bring about certain decentralization at the institutional level. It would reverse the very strong, paralyzing tendency towards the centralization of decision making powers in our system at the Ministry level. Secondly, the new separation of roles would have the effect of lessening the overly great politicization of our system.”

Castonguay said the sharing of functions proposed between the Ministry and the Régie would allow Quebec’s health care system, following the example of numerous countries of the European Union, to embark on promising reforms both for the mid and long-term.

“The future of our health care system is a fundamental issue,” he said. “If the necessary changes are not made, our system cannot survive. That is a certainty from which we cannot escape.”

Castonguay left his audience with seven recommendations, which he said would “allow us to save our health care system and its essential universal character.” The proposals are:

  • 1. Allocate to the Régie de l’assurance maladie the functions of purchasing health care and evaluating the performance of institutions.
  • 2. Accelerate the development of medical clinics in areas where the needs are greatest and according to the model which offers the best guarantees from the point of view of quality, cost of services and the adaptation to the environment that is being served.
  • 3. Optimize the use of hospital equipment making it accessible to private practice on weekends and evenings which could generate revenue and reduce wait times for the public system.
  • 4. Opt for a “loss of autonomy” insurance plan so as to concentrate the resources on priority services and on the greatest needs including, for vulnerable persons, a caregiver assistance program.
  • 5. Abolish the prohibition regarding private health insurance.
  • 6. Abolish the divide between public and private.
  • 7. Modernize the Canada Health Act.

Castonguay is a signatory to the Canadian Health Care Consensus Group (CHCCG), whose members came together to provide a platform for bold, reasoned and practical plans for genuine reform of the health care system. The CHCCG, coordinated by the Atlantic Institute for Market Studies (http://www.aims.ca), includes medical practitioners, former health ministers, past presidents of the Canadian Medical Association and provincial medical and hospital associations, academics, and health care policy experts, all of whom are signatories to the Statement of Principles. The Montreal Economic Institute is an independent, non-partisan, non-profit body that takes part in public policy debate in Quebec and across Canada, offering wealth creation solutions on matters of taxation, regulation, and reform of health and education systems.

Click here to read Towards significant changes in English or in French.

For further information, contact: André Valiquette, M.A, APR Directeur des communications / Director of Communications Institut économique de Montréal / Montreal Economic Institute Téléphone: 514-273-0969 / Cell : 514-574-0969 / avaliquette@iedm.org

Barbara Pike, Director of Communications, Atlantic Institute for Market Studies, 902-429-1143 – office / 902-452-1172 – cell

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