Barrette believes standardized costs for health treatment would save millions
Health Minister Gaétan Barrette says standardizing the cost of medical treatments in Quebec will not only save the province “hundreds of millions of dollars” in the long run, it will also have the added impact of reducing wait times for patients.
“It will have an effect on wait times if we’re able, by doing this, to get access to more money,” Barrette told reporters Wednesday, on his way to a cabinet meeting.
“So it will have an indirect effect on access, but the objective here is to manage properly and to give services at the proper cost, so we can extract money, if you want, to direct it to more surgeries for instance.”
Since becoming minister in 2014, Barrette passed Bill 10, merging health boards, and Bill 20, restricting access to in vitro fertilization and increasing the number of patients Quebec family doctors have to take on.
He said the third part of his sweeping health-care reform consists of evaluating the cost of each type of medical service offered in various institutions across the province, reducing regional disparities, and setting an average price for each service that hospitals can bill the government to help lay the groundwork for what’s called “activity-based funding.” Under the reform, government funds would “follow the patient” and be distributed according to each establishment’s volume of activity, instead of annual budgets being based on past budgets, as is currently the case.
The government announced Wednesday that the company Logibec is poised to obtain the contract to study the costs for each medical procedure in institutions across the province, an exercise that’s expected to cost taxpayers about $70 million.
“We’re not inventing something here, we’re implementing something that should have been implemented years ago,” Barrette said, adding activity-based funding is already well established in the United States, for example.
A study conducted in 2011 and 2012 for the Health Department revealed major differences in costs for the same health procedure at 12 institutions.
For example, for a C-section, costs ranged from $2,356 to $4,714 and between $10,411 to $14,575 for a hip replacement.
Many factors explain the discrepancies, such as distance and demand for the health service, Barrette said.
The Parti Québécois said it fears a reduction in services, since health-care establishments may be tempted to stop certain, less lucrative treatments. “What’s the cost of a life?” PQ Leader Pierre Karl Péladeau asked.
“What’s the cost of a life if you do not have the proper healthcare services when you need them because you live in a region?”
The health-care union Alliance du personnel professionnel et technique de la santé et des services sociaux (APTS) wasn’t impressed with the minister’s plan either. This “race for performance and the lowest possible price for a given medical act” has resulted, in many countries where it applies, in selecting care that brings in the most funding, and in the reduction of acts that are the most costly to the hospital, it said in a statement. “This model does not lead to greater accessibility and quality of service,” said APTS president Carolle Dubé.
The Confédération des syndicats nationaux (CSN) union added it worries the changes will lead to more privatization in the network. “The minister cannot decide this unilaterally,” argued CSN vice-president Jean Lacharité.
Barrette’s office said the minister does not have to proceed with legislation, since what is being proposed is simply a new way of calculating funding.