Posted at 3:00 p.m.
A monopoly to break
Health spending has been growing faster than GDP for 25 years and the result is still the same, so putting more money into health will still have the same result. The crisis has demonstrated beyond any doubt the inefficiency of the health system. It’s not a question of money, it’s a question of organization. Healthcare is a hospital-centric monopoly run by doctors for doctors. Until we break this monopoly, we will face endless waiting lists.
Jean-Luc Landry, economist
Let’s start with physician compensation
Once again, we are avoiding including in the possible solutions the revision of the remuneration of physicians. Both the remuneration itself and the method of remuneration.
Stephane Charbonneau
A significant obstacle
In the quest to improve our health care system, we must not forget an important obstacle: resistance to change!
Daniele Grenier, Saint-Bruno-de-Montarville
Beyond our means
Couldn’t the problem be that Quebec doesn’t have the means to afford the “famous” Quebec model? Instead of making choices, which are sometimes difficult, we say yes to all the social benefits without having the means to pay for them. So the quality is not there. We want everything for free, but try to get it!
Rejean Durocher, Montreal
The lack of political courage
At the end of the 1990s, the Dr Jean Rochon, then Minister of Health and Social Services, had planned all the actions to solve several fundamental problems of the health system. It was blocked by removing the levers necessary for the “profit” of the zero deficit. Over the years, pressure from hospitals, doctors and other groups has served their interests in the belief that they serve the interests of the population. Not only was there no political courage to “do what we had to”, but we imagined all sorts of reforms without evaluating the consequences that we find 20 years later (Couillard 2004, Couillard and Barrette 10 years later ). The feeling of belonging to a given population and to an organization has lost all meaning. As long as resistance fighters do not see the advantages for the population and for them of making this change, that we do not do what we must do, that we think about our re-election, we find year after year the same problems which become even more difficult to adjust.
Guy Poudrier, former CEO of CLSC-CHSLD
Let’s make room for the private
I fervently hope that the organization of the health system will change and that we leave more room for the private sector. Compared to other countries that have efficient health systems, the amount of funding is not the main issue in Quebec.
Mario LeBlanc
Human management has been neglected
It is not only the under-funding that is the problem, it is above all a systemic problem of operation, of organization. The employer has neglected the management of the human beings who make up its staff and today it’s such an unpleasant job that many are going to do something else. Centralization does not work, decision-making power must be restored locally, hospital by hospital, and managers must leave their offices to be on the floor and know what is happening in real time. It worked like that 40 years ago, the directors of care were present on the floor and knew the problems that the employees were experiencing.
Alain Brochu, Quebec
Too short a horizon
All this is true and the main problem is that governments make their decisions in a four-year horizon. Let’s agree that large ships such as Health, Education and Environment, for example, suffer from this situation. Changing their structures takes a long time and if the next government decides to do the same, things go in circles.
Is our society mature enough to agree that these pillars should be “negotiated” over the long term (15 to 20 years) with the population and the opposition parties, with neutral experts in support, without a new government being able to alone modify its trajectory? It seems to me that this would make these crucial sectors more immune to harmful political biases; successive governments would be obliged to continue the work begun and the responsibility would thus be shared. I may be dreaming in color…
Isabelle Drouin
Act differently
Indeed, we must think differently and act differently. We can’t just inject money, we also have to change our ways of doing things. I hope that the government will act in this direction.
Christiane Lefebvre
Let’s see what else works
Before even thinking about putting a penny more in health, I believe it is imperative to review the efficiency of the system. With a rate of beds per million inhabitants well below the Canadian average and with a higher cost per bed than elsewhere in Canada, let’s do a short analysis. With a health budget that exceeds 50% of the overall Quebec budget and a threatening demographic curve, it seems important to me to see the wall not so far from our noses. Not doing this exercise would be irresponsible as a society. We have enough competence in Quebec to take stock of the situation and to think outside the famous four-year electoral cycle. Status quo is not an option and adding more money is not an option either. You have to look elsewhere and think differently, because money does not make you love your work. Compulsory overtime drives staff away. Pride in a job well done is gone… My opinion: let’s take a break and entrust a group of pragmatic thinkers with rethinking the Quebec healthcare system based on what works elsewhere in Canada. Let’s make choices and rebuild in two or three years. It is possible, because all Quebecers now know that Quebec is sick!
Regent Desjardins
The electoral disease
Indeed, the hospital is sick. This disease is called “winning the next election”! All governments, since that of Lucien Bouchard who amused himself by retiring thousands of health care workers, have reduced the quality of care, reduced budgets and increased administrative tasks to the detriment of health care.
Where the rub is that we have been in a pandemic for more than two years and all the CAQ has found to do in two years has been to increase salaries and hire 3000 administrative clerks in order to help complete the reports.
I cannot understand that no team of analysts has been created and put in place to evaluate the processes, review them and improve them! This will be the only way to review the operation, it takes a multidisciplinary team to analyze how things are done today and what needs to change in order to become better.
Sylvain Dery