Can we improve the healthcare system overnight?

All political parties say they want to improve healthcare access in Quebec, but the necessary funds must be invested to achieve this goal. It won’t happen overnight: decision-makers have to make the appropriate budget decisions!

Some data on Quebec’s healthcare budget

The health budget stands at $68B, which includes the MSSS, Santé Québec, RAMQ, Héma-Québec, INSPQ, INESSS and Urgences-santé.

In 2025, public sector healthcare spending amounted to $6,786 per person.[1] It is one of the lowest amounts in Canada. For example, in British Columbia, spending amounted to $7,570 per person.

Between $9,000 and $17,000 is the cost of antenatal care and delivery without complications.

Private companies can make an estimated 10% to 15% profits from their healthcare contracts with the government. It is difficult to evaluate the total value of these public contracts but when big international groups buy clinics for which almost all activities are publicly funded, you can assume the profits are substantial.

[1] Canadian Institute for Health Information. Table B.3.2.a: Public-sector per capita health expenditure by province/territory and Canada, in current dollars, 1975 to 2025

Investment or expense?

Taking care of the population is one way to ensure revenue for the government since people who work pay taxes and thus create wealth. Healthcare spending is therefore investment.

If public funds are used to fill the coffers of private companies, then those are expenses!

Preventive or curative?

Maintaining infrastructure isn’t glamorous and it doesn’t bring in votes. The current state of healthcare institutions is the proof! The same observation could be made for occupational health and safety and investments in preventive health care. Governments choose to invest more in curative care and that unfortunately has a cost.

Not enough funds?

All political parties aspire to have a balanced budget. Until now, governments have attempted to achieve this by cutting spending and imposing periods of austerity, with all the negative consequences that this entails.

All the same, it is also possible to increase government revenue. If tax policies were revised to ensure that the wealthy pay their fair share and to prevent tax evasion, achieving a balanced budget would be made much easier.

More private sector?

To solve problems in the short term, some parties propose handing over more to the private sector, especially through public-private partnerships (PPP). PPPs are nothing new in the health network! The CHUM and the MUHC were both built with this type of partnership. Positive results? Only if you ignore:

The dubious practices used to secure contracts (described in 2015 as “the biggest corruption scandal in Canadian history” by the l’Unité permanente anticorruption – UPAC)[1]
The non-compliant and unsuitable building for a medical facility (adequate ventilation and surfaces that can be sterilized are essential when building a hospital)[2]
The cost overruns (not surprising)
Exorbitant modification costs (for example, $8,200 for a door and $7,700 for support rails in the bathrooms)

[1] The Canadian Press. Les accusés du CUSM devant le juge

[2] |a432c56f342f4cbdf27308de90c3026e|6cbafdf6bccc44b987c4de46b36a2dc2|0|0|639107364414552827|Unknown|TWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ==|0|||&sdata=vAIL5STfnYYO2g07eieOXGijxJSx2g/x8sZRuLZH6f8=&reserved=0">Coalition des CHUS sans PPP. Le CHUM et le CUSM en PPP des trous sans fond pour les citoyennes et citoyens

[3] Bureau d’enquête du Journal de Montréal. $8,200 to change a door, $45,000 for a contemplation room: hefty price tags for PPP work at the CHUM