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Legault government is revolutionizing how the province’s healthcare system is financed

Renaud BrossardInflation has hurt the wallets of Quebeckers, hard. They feel it every time they go to the grocery store, fill their gas tank, or pay rent.

Compared to its pre-pandemic level, the price of a typical consumer basket has increased by 13.75 percent in Quebec, according to Statistics Canada data. Unless their salary has grown at the same rate, Quebeckers are unfortunately becoming poorer.

It is likely these data that Finance Minister Eric Girard was looking at while drafting the budget he tabled last Tuesday.

His announcement that the rates of the first two tax brackets will be reduced by one percentage point allows Quebec households to breathe a little easier. For the average Quebecer, that means $370 more in their pockets at the end of the year.

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But to be clear, that decrease won’t offset the impact of inflation in Quebec, which, according to Royal Bank estimates, will still cost the average family $3,000 per year.

But very few people will disdain the $370 tax cut. It is a much-needed respite for the highest-taxed taxpayers on the continent.

However, the good news doesn’t end there. François Legault’s government is revolutionizing how the province’s healthcare system is financed, which will benefit patients.

Currently, hospital funding is based on a set percentage being added to the previous year’s budget. From a strictly budgetary point of view, that means each patient who walks through the doors of a hospital is seen as a cost.

In a few specific areas, however, such as radiation oncology, medical imaging, and colonoscopy and endoscopy, the government has tested a so-called “patient-based” funding model. According to this model, the patient is no longer just a source of costs for the hospital but becomes a source of revenue since the government reimburses a fixed amount per procedure.

In short, the more patients the hospital treats in these areas, the better its budget will be the following year. This type of funding encourages hospital administrators to promote the care and treatment of as many patients as possible. And the results are convincing.

Since its implementation in 2018-19, for example, the volume of colonoscopies and endoscopies has increased by 18 percent compared to two years before. This has reduced the number of patients on wait lists by 31 percent. Similar productivity gains have also been observed in radiation oncology and medical imaging.

Beginning in April, the government will extend this “patient-based” funding model to surgical procedures and, within five years, to everything it calls physical care.

And it’s not too early. Surgical waiting lists are not new in Quebec: as of Dec. 31, 20,649 Quebecers had been waiting for an operation for over a year, not counting those who have been waiting for a few months in pain and worry.

For patients, this is cause for celebration.

That being said, no budget is perfect. The fact that the Quebec government will continue to go into debt, despite rising interest rates, is worrying. This year, the deficit will increase by a further $4 billion. Considering that Quebecers are already wasting $9.5 billion a year to cover the cost of past borrowings, there is cause for concern.

Renaud Brossard is Senior Director, Communications at the Montreal Economics Institute.

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