The health system, which is facing significant challenges in providing services to the population, could recover billions of dollars by reforming the method of financing the Health Services Fund.
This is shown by a study by the Institute for Socioeconomic Research and Information (IRIS) published on Wednesday. The Health Services Fund (FSS) is little known to the general public. However, at the beginning of the 2000s, it represented a quarter of the Ministry of Health’s revenue, said the author of the study, Anne Plourde.
Currently, the FSS is financed by a tax on business payroll. That is to say, the more businesses create jobs, the more they will contribute to the fund.
“It’s a salary tax that finances the fund and that’s what we identify as the main problem,” explains M.me Plourde. The economy has evolved and this type of tax contribution is no longer suitable to be able to charge companies which have the greatest means to contribute to the financing of health services. »
According to the researcher, it would be preferable for companies to contribute to the FSS based on their profits. “If the contribution of businesses to financing health services had grown equivalent to the growth in their profits over the last 20 years, today we would have 10 billion more per year to finance health services. “It’s far from negligible,” she emphasizes.
She points out the fact that large companies saw their contribution to the FSS decrease by 23% between 1999 and 2019 while their profits increased fourfold during this period.
“Large companies or companies in the financial sector manage to generate a lot of profits – and therefore have a significant capacity to pay – without creating jobs. The payroll of large companies has decreased by 19% in the last 20 years. This explains why their contribution to the Health Services Fund has also decreased,” explains M.me Plourde.
The IRIS study also indicates that in 2019, companies in the financial sector monopolized 45% of the profits generated in Quebec, but their contributions to the FSS represented 11% of total contributions.
SMEs currently at a disadvantage
Mme Plourde does not fear that SMEs will suffer in the event of a reform of the method of contribution to the fund, on the contrary.
“By changing the method of contribution to the financing of health services, we will restore a certain justice between SMEs and large companies. And by basing the contribution on profits rather than on payroll, we are sure to make companies that have the means to pay pay. »
“In the current framework, there are even companies which can be loss-making, have no profit and still have to pay a contribution because they have a payroll,” she adds.
In the context where the Quebec government is asking health care facility managers to cut their administrative expenses, an increase in revenues in health care coffers would be welcome.
Mme Plourde warns, however, that reform should be gradual. “We wouldn’t get this money overnight, we would have to do it gradually, but it’s certain that we can get very large sums,” she said.
The researcher reiterates that the 10 billion that she calculated based on a change in FSS funding could help the health network in several respects. She mentions that this money could help to better finance front-line services and make a shift towards home support to better meet the needs of the aging population.
“Governments have wanted to make this shift towards home support for years, but to do so, we will have to invest significant sums in the short term. This is the type of challenge facing the network which could be partly resolved if we sought these sums which are available from large companies and companies in the financial sector,” she concludes.