Patient-focused funding: treatment without prior diagnosis!
In the middle of the summer, while Quebeckers are on vacation, the Minister of Health and Social Services, Danielle McCann, has launched an experimental project for the least disturbing: the establishment a new funding model for the health and social services network (RSSS), patient-based funding.
No’would have been the vigilance of the reporter from the Sun , Patricia Cloutier, this opinion would surely go unnoticed. Yet this is a fundamental change in the funding of our RSSS that will inevitably lead to a major reform – another! – its operation. Staff in the institutions are not yet handed over the passage of Gaétan Barrette and its reforms that he will have to undergo a reorganization once again. This will create extra work for staff who are already at the end of the road.
The Alliance of Professional and Technical Personnel in the Health and Social Services (APTS) has always opposed a mode of financing based solely on the performance, the volume of activity or any other indicator whose purpose, confessed or not is to reduce the costs of the public health and social services system regardless of quality.
It is wrong to think that only the threat of budget cuts is effective in instilling change and improving the quality and accessibility of social care and services. Without even making sure of the right diagnosis, we apply an experimental treatment whose results in other countries, in France for example, have been more than mitigated.
The effects will be particularly pernicious for psychosocial care and services. The great variability of the situations and the care and services that are attached to them makes it difficult to quantify them, much less to attribute them a cost. At the very least, the minister should exempt this important part of our RSSS from this reform.
The regions will also suffer a hard blow. By comparing the performance of public institutions, those outside major centers, with less volume of operation, can not compete with those with very high traffic. As a result, they will see their funding decrease. Funding based solely on activity and performance will promote centralization of operations and social services to major cities such as Montreal and Quebec City.
Another element of this failed project is the comparison of the public network with that of private clinics in order to set the costs of the care and service pathways. Why stubbornly comparing apples and oranges? By selecting lighter cases and focusing only on operations that do not require huge resources, private clinics will always benefit. Let’s stop wasting our resources in this barren competition.
Hopefully at the end of the experiment, the 1 st September 2022, the Minister will prepare an objective assessment and uncompromising that will recognize the limits or excesses of the operation and it will bring the necessary adjustments for that the whole population can have access to a universal, free and quality health system. Otherwise – and this is the most worrisome with patient-based funding – we will take another step toward privatizing health care and social services.
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