The big illusion

The government wants to impose a new funding method on health care institutions. A foolish project that will only weigh down an already too heavy administrative burden.

The experimental project, quietly submitted in the summer of 2019, will force the targeted 500 health and social services facilities to establish the cost per user1 for each service received and for every care plan. The health minister, Danielle McCann2, plans to develop cost comparison models, within the institutions and between them, to establish the best practices to fund.

The consequences of the accounting logic

Despite what the government implies, patient-centred funding will eventually decrease the quality of care because of its cost reduction logic.

“This accounting approach is completely unrealistic. Wanting to precisely establish the cost of each service will never account for the complexity and variety of the lived situations. Worse, it could obscure many needs,” claims Sonia Ethier3.

A growing burden

“Imposing new data entries, already too numerous and often problematic, is completely inappropriate. Yet, the government acknowledges the weight of the health care personnel’s task and the need to review some work organization’s elements,” adds Claire Montour4.

Getting rid of under-performance

The government must review its priorities and reinvest in the supply of health care and direct services to the population, instead of in increasingly expensive information systems which complexify the health care system management and decrease the time dedicated to clinical activities. There lies the real challenge the minister must meet.


1 The entirety of costs, both direct (labour expenses, medical and surgical supplies, instruments) and indirect (administrative and support fees), will be considered.
2 Danielle McCann is the Québec’s Minister of Health and Social Services.
3 Sonia Ethier is president of the CSQ.
4 Claire Montour is president of the Fédération de la Santé du Québec (FSQ-CSQ).


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