May 23, 2014

The inaugural speech did not specifically indicate what the new premier, Philippe Couillard, has in mind for our healthcare system. Of course, he renewed the election promises made by his party during the last campaign, but we will probably have to wait for the next budget to be tabled on June 5th in order to fully grasp its significance.

That does not necessarily mean that we can’t draw some conclusions. Take for example, the 50 super-clinics that the government is proposing to open. It seems obvious that this project is only aimed at pursuing the liberalization of professional services project started by Philippe Couillard when he was the Minister of Health in the Charest government.

After the family medicine groups (for the general practitioners), the specialized medical centres (for the surgeons) and the laboratories (for the radiologists), the super-clinics are the missing vehicle that would enable the other groups of medical specialists to become incorporated. By getting together various specialists in super-clinics and by giving them the opportunity to be open seven days a week, are we not in the process of developing a network of private hospitals parallel to the public sector? Is the goal to reduce overcrowding in emergency rooms with super-clinics?

Remember that the benefits of being incorporated for the professionals are numerous: tax benefits which are a loss of income for the State, the possibility of using his “business” as a cover in the event of malpractice. Think also about the conflict of interest that the professional may have when he has to choose between the patient’s interest and the profitability of his business.

Lastly, what is seen in the super-clinics as a solution for improving access to care is likely to lose its appeal once they realize that it is much more worthwhile for a physician to open his clinic as close as possible to the hospital where he practices.

What do you think?