Critics are incensed with Quebec's new health-care fee – $25 per year as of 2010 with yearly increases to $200, and a possible health deductible in the future.
The fee, announced in Tuesday's budget, will go to a dedicated fund to defray ballooning health-care costs, estimated at $33 billion per year.
'We've already said there are a number of things the government hasn't done ... for example, the computerization of file systems. Family physicians say they could treat 20 per cent more patients, if they had access to computerized offices.' —PQ health critic Bernard Drainville
The cost of Quebec's health-care system is rising steadily every year, so much that "we need around five per cent" more revenue annually, said Health Minister Yves Bolduc.
"If we don't have that, we will have to cut services" or else health care will eat up two-thirds of Quebec's budget by 2030, he said.
The Parti Québécois isn't convinced a fee is the only way to pay.
"We've already said there are a number of things the government hasn't done" to reduce costs, PQ health critic Bernard Drainville claims.
"Efforts should go into [cutting] bureaucracies. We're not convinced that they've reduced administrative costs."
"There are solutions – for example, the computerization of file systems. Family physicians say they could treat 20 per cent more patients, if they had access to computerized offices," he said.
Other ways to reduce costs include better support for nurses and nurse practitioners, the so-called super-nurses trained to perform basic medical procedures.
They could play a bigger role in hospitals and clinics, but "the problem is that these solutions aren't being put into place," Drainville said.
Pharmacists could also be given more responsibilities, as they are in other provinces, he added. "What are we waiting for in Quebec? There are solutions."
The Liberal government insists Quebecers aren't opposed to paying for health care.
"People want to know where their money goes," said Bolduc. "With the [fee], people are going to know that when they pay their money, it goes directly in the health system."
"Every citizen benefits from the health system," and so they should have to pay, said Liberal Finance Minister Raymond Bachand.
Fee marks fundamental change in system
The new health-care fee structure signals a major transformation of the health system, to the detriment of the poor and elderly, according to Quebec's Federation of Medical Specialists.
Paying an additional fee for service is the end of an "open bar mentality" in Quebec's health- care system, said Gaétan Barrette, a radiologist and the federation's president.
While the middle class may be able to afford extra contributions, "it is very well documented in medical literature that when you put a significant user fee, it is detrimental for the elderly and poor people," he said in an interview with CBC on Wednesday.
Barrette suggested an exemption be introduced to spare Quebec's economically marginalized populations from the fee cost.