Health-care issues in this election
According to a recent Vote Compass poll, healthcare in this election is the number one issue - 32% overall, and 40% for persons 55 years and older.
One key proposal of the CAQ is to reopen the signed contract with specialists and slash each MDs gross income by roughly $80,000. FMSQ President Dr Diane Francoeur warned, “We are much better when we collaborate.” She claimed that rural patients now have improved access to anesthesiologists and that doctors plan to extend operating hours for medical imaging in hospitals.
The Parti Quebecois and Quebec Solidaire would also re-open the contract. The latter party would limit fee-for-service billing and cut MD gross incomes by 12%.
Thus, of the four parties, only the Liberals would honour the signed contract.
Former Ontario Medical Association President Dr Shawn Whatley recently wrote, “When government sets a low price on a medical service, it does not follow that patients can get the same medical service that they might have, had the price been different. If doctors cannot afford to provide all the care they would like for X, then doctors will adjust. They will shorten visits, refer more often, or choose different patients.”
The gross incomes of Quebec physicians have finally risen to slightly above other provinces. Until recently, they were the lowest in Canada. Large border areas in West Quebec had difficulty attracting specialists and family physicians. This was due to low fees and inadequate funding of health facilities. Many Quebec citizens sought care in Ottawa, Pembroke, and Hawkesbury.
Because of the low fee schedule, few physicians in Ontario or elsewhere would accept a Quebec health card as payment in full. Patients treated electively, or those who developed an illness while on business or vacation would be forced to pay out-of-pocket and then await reimbursement.
Quebec has refused to sign the Reciprocal Medical Billing agreement and the federal government has ignored this violation of the Canada Health Act. For years it seemed the only solution was for Ottawa to pay physicians directly for treating out-of-province patients, as it does for federal prisoners, refugees, and, years ago, members of the RCMP. Now that Quebec physicians have achieved fee parity, the simpler solution would be for Quebec to sign the RMB agreement.
If the CAQ does win and implements its fee cuts for Quebec physicians, this retrogressive move would lessen the chances of Quebec ever signing the RMB agreement. Its impact would not be confined to West Quebec. Many Quebec MDs might leave for other provinces. Moreover, all Quebecers would remain second-class citizens when they sought medical treatment in other parts of Canada.
We hope Premier Couillard will promise that if re-elected he will sign the RMB agreement and leave as his legacy fully portable health care throughout Canada for all his fellow Quebecers.
Charles S. Shaver, MD