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Assessing
the health promises
Waiting. Whether it's waiting for emergency care, surgery, or to see a family doctor, many Quebecers are tired of waiting for health care. Considered one of the most important issues in this election, many Quebecers are still wondering which party's health-care policy would be the best for Quebec. The universal health-care system is more than just popular; it forms a part of how we view our society and the way it treats people. And for that reason, the PQ is laying low on the issue while on the campaign trail. Crowded emergency corridors, a protracted dispute with medical specialists, and an illegal strike by overworked nurses are all things that haunt the Parti Québécois. The Liberals are playing up the PQ's embattled image on this issue, having made it their top priority in their literature and on the campaign bus. The ADQ is also talking about it at stops around the province, but many of its proposals come from a neo-conservative perspective. In particular, leader Mario Dumont and his party want more involvement from the private sector, marking a significant change in the dynamic of the debate for reform in the health system. More privately operated care The ADQ wants privately-run services paid for by public funds. But the party is also suggesting a second tier of care, where people have the opportunity to pay for certain health-care services. This, they say, would speed up access and reduce waiting lists. With the same aim of reducing waiting times, Liberal leader Jean Charest also says there is room for some private sector services, citing private and specialized clinics as examples. However, he does want to maintain it as a public and universal system. That the parties are bandying about ideas on private participation is welcome news to some experts. "Finally, someone's talking about common sense, after eight years of controlling costs by inconvenience," says Dr. Mark Roper, head of primary care at the McGill University Health Centre. "Now we have two parties that are coming up with some ideas." Dr. Roper likes the notion of re-thinking private involvement as a way of making health care more efficient. "If we can farm [cataracts] out to the private sector …, which are done at cheaper rates to private institutions, [while] the patient pays no money, that's fine. And that's what the Liberals are saying," Roper says. It's also what the ADQ are saying. However, with the ADQ you
also open the door to a second level of care that is completely
private.
"The ADQ are saying, 'Well, let's charge a fee for that.' And that raises up the resistance of the general public, and myself as well," Roper says, pointing out that the ADQ's endorsement of totally private care providers is more like queue skipping, where if a patient has the money, he or she will get treated faster. On the other hand, the ADQ's private clinics would be available to pick up the slack when waiting times become excessive. "The Action Démocratique are the only ones to say, 'If you don't get your service in a particular time period, we will pay for it to be done in a private clinic,' which pushes the government. It's the only one to actually say, 'We will guarantee your service or we will pay [for] it in the private sector.'" Investing in private clinics
Régis Blais, a health administration professor at the Université de Montréal, also believes privately-owned clinics could help the public system, which is something the Liberals have in their health platform. "The PLQ is proposing to reduce waiting lists for surgery by transferring small surgeries from hospitals to private clinics," Blais says. "I think it's a good idea. There are a number of things that could be done in private clinics. Of course, you have to invest in those clinics and make them ready to do that care." Emergency room 'overload'
For Premier Bernard Landry, health is important but not pivotal in this election campaign. In his 25-step plan, only four of the highlighted proposals deal with health. One of those steps includes improving care for the elderly and home care. But the Liberals are proposing to do that, too. The improvements would spell relief for patients in hospitals. "If we have emergency room overload, it's a multi-factor problem," Blais says. "There are no beds available in the hospital to take care of those people properly [because] those beds in the hospital are occupied by long-term care patients who should be outside the hospital, who need care, but not acute care in the hospital." Addressing long-term care is not how the ADQ would handle the problems in the province's emergency rooms. It proposes giving nurses more power to order more procedures and deal with simple cases, such as minor burns. Its platform also proposes to "allow people to pay the associated costs … for medications … and administrative costs." Related Stories:
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