France the paradise for sicks patients and nightmares in Quebec and Canada

France the paradise for patients and nightmares in Quebecers and Canadians

Lysiane Gagnon La Presse March 14, 2015

Lysiane Gagnon

France."Hello, here Dr. Martel,"Hello, I have a sore throat and cough a lot. Could I have an appointment?

"Let me see. I have an opening at 14:10, or 19:30 to 17h ... What is best for you?

"Attention this point, the Quebec tourist is figuratively fell off his chair. She can not believe his luck: What? A medical appointment that day, close to home, with the added choice of time?

The experience is however common to all those who attended, if only sporadically, service . French Health France is the paradise of patients: doctors available, no waiting emergency... and this is reflected in the reports of the World Health Organization, which ranks France as one of the country effective health care.

You are now at the hour with Dr. Martel. It opens the door himself, and after the consultation, it will cash your payment and sign receipts required.The local doctor often practiced alone and has no secretary. However, it has - Another novelty for Quebec tourist amazed - a computer system.Your file will join those of his other patients in the bowels of the computer.

The rest is in keeping. Should there be an x-ray? An ultrasound?The nearby clinic will give you an appointment for the next day or at worst two days later. And you will leave with reports in hand.

In France, family doctors will go toyou.

Each arrondissement of Paris has over thirty general practices, whose rates vary depending on thesector. In a large village you can even have a choice of a dozen doctors.

This means that there are a lot of GPs in France, enough for patients never have to wait. It is only in isolated areas and in certain sensitive areas (where the crime rate is very high) there may be shortages.

For permanent residents, services are "free" paid by Social Security and a complex of private insurance and mutual systemgeneral...

There obviously has a counterpart to this extraordinary accessibility French doctors are much less well paid than ours Average income of a  70,000 euros (approximately $ 94,000) . Average income of a specialist: 111,500 euros (about $ 150,000)receive.. So they must necessarily work to have a good income and not as in Quebec because more income amounted fewer services that patients  This is the world upside down.

The sweetness of our lives

I've been dealing with a doctor who has spent most of the time from consultation to wonder about life in Quebec. He thought to migrate here because of the new Franco-Quebec agreement on the mobility of professionals, for he had heard from colleagues that Quebec home, it could make the same income by working part time ...

France, like most countries in Western Europe - but unlike North Korea, Cuba and Canada ... - is a good place in private, both at the hospital and medically. Number of minor surgeries, even those requiring hospitalization, are provided by private clinics.

Note that this mixed system was implemented and maintained by often socialist governments, and even the far left has never questioned mixed regime.

However, the French system is expensive to the state.

The Quebec system costs two or three times more expensive, but the services are not at the rendezvous. Medical associations and doctors are businesses and entrepreneurs picking up maximum profits for their members and their families. Our doctors are to service their portfolios and their egos. Many economists believe that the French will not go on to offer a luxurious model and that users may have to contribute out of pocket.

Quebec's doctors, the best paid in the world in relative terms their particular services populations

remains a lesson from the French model: if we produced more doctors, all Quebecers have a family doctor ... they could quickly check if they got sick in their annualmeetings.

Budget of the health network in Quebec

services are and will appointments

December 10, 2013

The 2013-2014 budget of the Quebec Government estimated the public health spending (and social services) to $ 31.3 billion, 42.9% of total public expenditure of the Government of Quebec. Given the magnitude of these costs, it is natural to be concerned about their expected development, especially since it is anticipated that the population growth, aging and the sustained increase of the structural health care costs exert significant pressure on these expenses over the next few years.

Quebecers Doctors

A recent study (by Nicholas James Clavet, Jean-Yves Duclos, Bernard Fortin, Steeve Marchand and Pierre-Carl Michaud) of SIMUL research program uses methods dynamic micro-simulation to address these issues (see Clavet et al. 2011 for technical details). Combined with data from the Canadian Institute for Health Information (ICIS 2012), SIMUL model allows to differentiate among other foreseeable effects of the natural growth of population, aging, immigration and growth Structural costs of health care on the total costs of the system.

Using large representative samples of individuals and households from retrospective and longitudinal surveys, model microsimulation otherwise projected changes in participation the labor market, the distribution of labor income, capital and savings and a portrait of public finances of the Government of Quebec over the next 20 years.

Economic forecasts of the micro-simulation model allows so predict changes in the share of public health spending in Quebec's GDP and total revenues of the Quebec government, which is useful to capture the ability of public finances and the economy in general to support growth prospects Healthy public expenditureFederations.

doctors Quebec  wait time 10 years, you become skeleton

pressure on health spending: structural costs, natural growth and immigration

A first source of pressure on health spending comes from the sustained growth of "structural costs" of observed in health care for years.

Tax Heaven for our elites who well deserve conning us.

This growth in structural costs captures the increase in spending on age and sex health care provided, explained by the effect of the introduction of new medical technologies, the evolution of the health of the population (the increase in the incidence of chronic diseases) as well as the remuneration of medical personnel and the structure of the system health care.

In the absence of detailed modeling of the evolution of these different effects, it is difficult to predict the evolution of these structural long-term costs. The baseline study is based on their relatively recent development, of the order of 2.1% per year (in real terms), but other growth rate scenarios are also considered.

A second source of growth comes from the effect of the natural growth of the population, obtained by removing the population of immigrants arriving beyond 2013 and their children born in Quebec. A third source comes from immigration, given by the difference between the change in public health spending with the presence of immigrants and their children since 2013 and the change in their absence.

Worrying scenarios

Standing at 31.3 billion dollars, that is to say 42.9% of the budget of the Government of Quebec, the public health expenditure of the Government of Québec in 2013 already represent a considerable sum. The most likely scenario SIMUL provides that public health spending will increase by $ 29.8 billion from 2013 to 2030 (an increase of almost 100%) from 8.4% to 13.5% of GDP. This long-term growth of public health spending could exceed that provided for in the medium term in the last budget of the Quebec government (Government of Quebec 2012); the shortfall would be $ 11 billion in 2030.

Dr. Yves Bolduc searched naked, where he has hidden the money back?

Chart 1 shows the predicted value of health expenditures in four growth rate structural costs and depending on the growth rate of 4.8% in nominal spending on health provided by the Government of Quebec1.

Chart  Projection of public health spending between 2013 and 2030 under different growth rates of structural costs

From growth 29.8billion in public spending on health in the baseline scenario, about $ 14.4 billion will come from the effects of the aging population, $ 3.8 billion will be due to the increase of the population by the effect ofimmigration,and $ 18.2 billion will come from the growth of the structural costs of health care.

Note that the sum of the effects of population aging, immigration and growth of structural costs is not exactly equal the value of the total increase in health spending since there is interaction between the effects. For example, the effect of immigration on health spending growth will depend on the structural costs of health care. Note also that SIMUL believes that immigration will increase by about 10% the total income available in Quebec by 2030.

Strong pressure on the Crown

Figure 2 shows the ratio of public spending on health revenues of the Government of Quebec, and to capture the pressure that these expenses apply to other government expenditure items or the need to increase government revenues. The reference scenario that this report will increase from 42.9% to 68.9% of total revenues of the Quebec government between 2013 and 2030.

Figure 2: Projection of public expenditure on health as percentage of total revenues between the Government of Quebec 2013 and 2030 under different growth rates of structural costs

to maintain the share of public spending in constant healthy proportion of government revenues according to the structural growth baseline costs of 2.1% would require a further increase in 2030 anticipated revenues of the government of $ 53.6 billion. It is also expected that government revenues increased by $ 15.9 billion to spend $ 72.8 billion in 2013 to $ 88.7 billion in 2030. It is therefore necessary that these revenues are increasing rather 142.3 G $ for the ratio of public health expenditure on government revenues is the same in 2030 than in 2013. This would amount to an increase of nearly 60% of the overall tax burden of the Government of Quebec.

The observation most general of this study is that the management of the growth of public health spending is certainly the biggest social challenge of the coming years in Quebec. In this regard, it also appears from the study that the structural growth of health care costs is probably a more important issue than the demographic changes and the aging population.

References

CLAVET, N. J., J .-Y Duclos, B. FORTIN AND MERCHANT S. (2011). "Quebec, 2004-2030: an analysis of micro-simulation," Research Report, Centre for Interuniversity Research and Analysis on Organizations (CIRANO).

GOVERNMENT OF QUEBEC (2012): "Budget Plan: 2013-2014 Budget," Working Paper, Quebec(2012).

CANADIAN INSTITUTE FOR HEALTH INFORMATION  "Trends in National Health Expenditures, 1975-2012," Paper Labour, Ottawa (Ont.)

(www.simul.ca;.see particulier http://simul.ca/wp-content/uploads/2013/12/Note-dépenses-santé-08.pdf )

http://blogue.economistesquebecois.com/2013/12/10/les-depenses-en-sante-un-enjeu-de-long-terme/