After having followed the discussions in the parliamentary committee concerning Bill 15, I must express a few comments to the elected members of the National Assembly, in the absence of being able to participate. First, it appears that the three opposition parties, correctly perceiving the imminent dangers for the future of the public health care system, have all opted for a rather constructive approach in order to support the Minister in the search for solutions aimed at get the network back on track; in doing so, however, do they compromise or lessen their oppositional role? Secondly, we cannot deny the minister’s good faith in the search for solutions, but the nature of the debates with the groups invited to present a brief reveals, unsurprisingly, a businessman’s approach on the part of the minister, without reference none to the foundations of a health system or to the risk factors that are the source of the needs of the population and that are the real reason or the real driving force behind an effective and efficient network. Wouldn’t the drafting of the reform deserve, rather than writing on the sly, the active participation of users, network stakeholders and experts who are familiar with the ins and outs of the medico-administrative organization of primarily primary health care and specialized social and hospital services? These have become so complex that even the top executives of private companies are ill-prepared to deal with them. Experience has also shown that several champions of major American firms have broken their teeth there after being recruited as saviors.
The future of the public system will be seriously compromised if the government persists in its openness, even in small steps, to the establishment of private services targeted solely to reduce this or that waiting list rather than adequately funding the public system. Such specialized clinics providing a single type of care (ophthalmological, for example) will be simple to manage because they are not complex, will be appreciated by the public and will thus make the population falsely believe in the superiority of the private sector over the public, despite the increase of the costs that will ensue, as the American or Swiss experience teaches us. The current direction of reform underpinned by Bill 15 will shift consumer care delivery away from last-level managers, which has been shown during the pandemic to be deleterious. Everything will take at best two years to be implemented and will gradually lead us to a “deconstruction” of the public system, probably incompatible, by the way, with the Canada Health Act, for those who like federal-provincial bickering. .
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