When I arrived from Italy, I was deeply impressed by the strongly democratic, modern and tolerant character of Quebec society. Italy and several European countries have a lot to learn from Quebec. But faced with the health system, I feel, like all Europeans no doubt, perplexity and discouragement.
I must say that the doctors I met in Quebec were very professional and well trained. The problem is rather the access to the system. In Quebec, there are approximately 254 physicians per 100,000 inhabitants, while in Italy there are 405 per 100,000 inhabitants. Paradoxically, things are going even better in certain European countries which, however, are less industrialized than Quebec (and Canada), such as Cyprus, where there are 427 doctors per 100,000 inhabitants, and Bulgaria, which has 423. .
On February 5, 2022, the magazine News published worrying figures: Quebec has less than 2 beds per 1000 inhabitants, Canada 2.5, Italy 3.2, Germany 7.9 and Korea 12.4. To say that countries in the world, although they are less wealthy and industrialized than Quebec, have a higher number of doctors and beds in their hospitals, is also to say that Quebec has no excuse, since it is certainly not a question of money.
My spouse had a family doctor who was extremely difficult to consult. When our daughter was born, he refused to take her as a patient. Fortunately, my doctor agreed to take care of my wife and our daughter. A friend of my spouse no longer has a family doctor, although she recently had cancer, suffers from celiac disease and is over 60 years old. Her husband has a family doctor who doesn’t want his wife among his patients. Why are they called family doctors, then?
Basic medicine in Italy works quite differently. Every household is entitled to a family doctor who practices in the neighborhood where their patients live. His consultations are free. The fact that all members of the same household have the same doctor is important because, in this way, the doctor knows the genetic, psychological and social background of each of his patients. Each family doctor must have about 1500 patients on average. If he has less than three years of experience, he earns an average of 71,500 euros gross per year. But if he has more than ten years of experience, he earns around 150,000 euros, always gross.
This family doctor must guarantee at least four hours of consultation per day in outpatient care. It is available Monday through Friday. The patient does not have to make an appointment. He goes straight to the doctor, and no one can be fired. In the remaining hours of his day, the doctor must go to the homes of patients who cannot travel for health reasons. He must also devote a few hours to “medical duty”, which takes place in public medical offices open at night and on weekends. This is where a patient goes for a problem that is not serious enough to require them to go to the emergency room.
Here, in Quebec, my family has private medical insurance offered by my spouse’s employer. It costs my wife $90 a month and her employer $360. However, our daughter has to take medicine twice a day, every day. When we were supported by the ARRQ (Association of directors and directors of Quebec), this drug was covered at 100%. Now, with my spouse’s private insurance, we have to pay for it, albeit partially.
What I find outrageous is that this system seems to be inspired by the free market, but I wonder what freedom is it? We are obliged to take out this insurance. We do not have the freedom to choose another or to abstain from it altogether.
What if that $90 was split between my family and the state? We would have more purchasing power and, for its part, the State would have more resources to invest in health care. Even the $360 spent by the company would be more useful if split between the company and the state. The third link was expected to cost $10 billion (its cost was lowered last spring to $6.5 billion). However, the Montreal CHUM was built at a cost of $3.6 billion.
Investing so many billions in a tunnel is not the only way to obtain employment benefits, you can also have them if you invest in health, which will also have an effect on the well-being of people. The government has just increased the number of Quebecers per family doctor. We should see if they still have as much difficulty consulting. Because 10% of the population does not yet have a family doctor. It is enormous.
In conclusion, the issue of family physicians is, in my opinion, the real electoral issue. This is an issue that comes under civilization, dignity, ethics. During the leaders’ debate, the latter should clearly declare how they are going to ensure a family doctor for every Quebecer.