Montreal, June 15, 2017 – The Quebec government is missing the mark by trying to centralize the provision of hospital care, as is the case once again with Bill 130. Indeed, a Viewpoint published today by the MEI shows that Quebec would have an interest in following the example of Sweden, which has a decentralized model.
In Sweden, the kinds of confrontations we’ve gotten used to seeing between the Health Minister and doctors are rare. This is largely due to the fact that many private care providers operate side by side with public providers, seamlessly integrated into a publicly funded system. Access remains universal, yet care provision is decentralized, autonomously managed, and competitive.
“Sweden has a very limited degree of bureaucratic control over the health care sector. Essentially, Stockholm is responsible for establishing principles and guidelines,” explains Johan Hjertqvist, President of Health Consumer Powerhouse and co-author of the publication. “Quebec must be the only place in the world where it’s the Health Department that determines the menu to be served in hospital cafeterias!”
Moreover, in return, Swedes obtain better access to care than we enjoy here. Statistics show that in Canada, 30% of patients waited two months or longer to consult a specialist in 2016, versus just 19% in Sweden. The same is true of elective surgery: 18% of patients waited four months or more, versus 12% in Sweden. This is 50% more in both cases, a difference representing thousands of patients.
“The Swedish experience shows that health care facilities can be privately managed and decentralized, all while having equal and universal access to care. It’s time to get over the myth that these two objectives are incompatible,” adds Jasmin Guénette, Vice President of the MEI and co-author of the publication. “The most important reform to implement in Quebec is to allow the private sector to complement the public system as well as introduce some competition into the provision of care.”
In Sweden, far from being a threat to universal access, the integration of the private sector into the health care system has on the contrary helped make Sweden’s egalitarian values sustainable: Patients who visit private clinics are treated the same way as they would be in public clinics, and no one is turned down based on health condition or financial situation.
The Swedish health care model shows that there is no contradiction between private provision of care and equal access to care, given a sound policy framework and decentralized management. Swedes see no difference between public and private care, but they do benefit from choice, better access to care, and better service overall. This is a lesson that Quebec could stand to learn,” concludes Jasmin Guénette.
The Viewpoint entitled “Health Care in Sweden: Decentralized, Autonomous, Competitive, and Universal” was prepared by Jasmin Guénette, Vice President of the MEI, and Johan Hjertqvist, President of Health Consumer Powerhouse and Associate Researcher at the MEI. This publication is available on our website.
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The Montreal Economic Institute is an independent, non-partisan, not-for-profit research and educational organization. Through its studies and its conferences, the MEI stimulates debate on public policies in Quebec and across Canada by proposing wealth-creating reforms based on market mechanisms.
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