The Castonguay Report

February 20
Headed for the waiting room?
‘doomsday report’ lets couillard look moderate
AARON DERFEL, The Gazette
The man considered the father of Quebec medicare is calling for the end of public health care as we know it.
Claude Castonguay, the former health minister who introduced universal medical insurance in the province a generation ago, issued a report yesterday that recommends the government embrace a parallel private system.
February 19
Castonguay recommends $25 fee per doctor’s visit
Kevin Dougherty, The Gazette
Quebec – The Castonguay task force on health care proposes a $25 charge for every visit to a doctor and an increase up to one percentage point in the Quebec sales tax to help pay for medicare.
Claude Castonguay, the chair of the task force, notes that health care, as a share of the provincial budget is growing 5.8 per cent a year, while total government spending increases 3.9 per cent annually.
He proposes capping health spending at 3.9 per cent and making up for the shortfall with a new health-stability fund, financed by the $25 doctor’s charge and the sales-tax increase.
Extra billing for health care is currently illegal under the Canada Health Act, which Castonguay concludes “hampers the evolution of the provincial public health systems.”
The 25 per cent of low-income Quebecers, earning less than $13,470 for a single person, or $27,470 for a couple, would be exempt from the $25 charge, which would be collected when taxpayers file their income tax returns.
Castonguay said access to a family doctor is a priority and proposes a $100 annual subscription fee for all adults to encourage doctors to take new patients.
Castonguay proposes a greater role for the private sector, and would allow doctors to practice in both the public and private systems, an approach Health Minister Philippe Couillard opposes.
He also suggests private management of hospitals, a greater role for private health insurance and higher charges for drugs Quebec’s PharmaCare plan.
Castonguay thinks medicare should not cover less essential services, giving the example of hospital meals.
Michel Venne, the Parti Québécois representative on the task force, wrote a minority report, objecting to mixed public-private medical practice, a greater role for private insurance and the entrusting of public hospitals to private health management firms.