Robert Libman: Time to Review Healthcare Financing in Quebec

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Prime Minister François Legault is calling the National Assembly to a recess and will deliver a new inaugural speech on October 19 to jumpstart his run toward next year’s provincial elections. It will also present a mini-budget next month, which is expected to focus heavily on “modernizing” our troubled health care system, which took a tremendous hit during the pandemic.

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COVID-19 has certainly revealed the pressure our healthcare system is under. There is psychological pressure on overworked and understaffed healthcare workers who do their best to treat, cure and keep patients alive in the most difficult circumstances. And there is tremendous financial pressure on governments to make the system work effectively.

We take universal access to health care for granted, but the pandemic has shown how fragile the system can be. Taxpayers want governments to prioritize health care, but our pockets are limited. Financial resources are stretched to the limit. Quebec’s annual budget for health and social services is approximately $ 50 billion, or nearly 40 percent of all government spending.

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Recent data from the Canadian Institute for Health Information (CIHI) showed the average cost of hospitalization of patients receiving treatment for COVID is more than $ 23,000, three times more than a patient who has had a heart attack. The fourth wave, marked by the Delta virus variant, is driven by people who are not vaccinated. The financial pressure imposed on the system by those who ignore the overwhelming scientific evidence raises the question of whether those who voluntarily put their health, and that of others, should take responsibility. Is it time for cash-strapped governments to consider financial penalties for recklessness?

To make matters worse, COVID patients who end up in the hospital with symptoms that could have been prevented put others in need of medical attention for other reasons at the end of the line because the system is clogged. Annual cancer screenings, for example, have decreased dramatically, leading to delayed diagnoses that could result in more cancer cases and deaths. On Tuesday, the Canadian Medical Association held an emergency summit to discuss how to move forward now that our healthcare system is at a breaking point, with increasing surgical delays, due to the pandemic.

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Everyone has the personal right not to get vaccinated. However, when someone’s behavior puts undue pressure on the system, thereby compromising the health and treatment of others, is another matter. I believe that COVID patients who can be vaccinated but choose not to and end up in the hospital should receive a bill for their care.

The question is how far the government should go down this path. For example, if someone requires hospital treatment for injuries due to riding a bicycle without a helmet or driving without a seat belt, should a “quid pro quo” apply? What about smokers?

Universal health care means equal access for all without exception, as we all pay our fair share of taxes. No one should be denied medical care, nor should hospital triage procedures be changed. But if someone is unnecessarily depleting system resources due to irresponsible behavior, shouldn’t they pay an extra part? People grudgingly pay fines for being reckless when they are caught breaking traffic rules.

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The devil is in the details, of course. How is “reckless behavior” defined? Who is the referee? But the principle itself deserves to be discussed, similar to the “polluter pays” principle, where the party responsible for producing the pollution pays for the damage caused to the natural environment.

The government must explore meaningful ways to make the system more financially viable. It could be the biggest issue in next year’s election.

Robert Libman is an architect and building planning consultant who has served as a leader of the Equality Party and MNA, as mayor of Côte-St-Luc, and as a member of the Montreal executive committee. He was a conservative candidate in the 2015 federal elections.