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A new IRIS study shows that increasing the contribution of large private companies to the Fonds des services de santé (FSS) could bring up to $10 billion a year directly into the healthcare system. On the other hand, the network's projected deficit for the coming year is $11 billion, and the government wants to make budget cuts.
The FSS is a fund to which both employers and workers contribute. Anne Plourde, a researcher at the Institut de recherche et d'information socioéconomique (IRIS), explains: “Over the past twenty years, corporate contributions to the FSS have grown much more slowly than their profits.”
In the early 2000s, the FSS covered a quarter of the expenses of the Ministry of Health and Social Services, but today it funds just 14% of health services. In the case of large corporations, their contribution has fallen by 23%, while their profits have quadrupled between 1999 and 2019.
And yet, at the end of September, Radio-Canada had obtained a letter stating that the Deputy Minister of Health is demanding that the network's CEOs reduce CISSS spending without touching care. The ministry is asking for “optimization” measures to redress the deficit without additional budgetary additions from the government.
For the CAQ, it seems that asking more from large companies that contribute the least, such as those in finance, insurance and real estate services, is not an option.
According to Prime Minister François Legault, the deficit will be solved by cutting administrative expenses. He explains that 15,000 people retire annually in the public administration sector, so the solution would be not to replace them and to distribute the tasks to other workers. But is this really possible?
Less money, fewer services
The consequences are already being felt in several integrated health and social services centres (CISSS). For example, in Abitibi-Témiscamingue, the board of directors declared in a meeting that they “will have no choice but to cut [services]”.
In Laval, workers have already reported problems. In an interview with Radio-Canada, the president of the union which represents nurses, respiratory therapists and auxiliary nurses in Laval mentions an example of the consequences for workers: "Auxiliary nurses, instead of having 29 patients for one floor, which is the norm, are down to 58 patients to do two floors."
In Quebec's seldom-mentioned Far North, there is an “absence of basic equipment,” and the mortality rate is six times higher than in the rest of Quebec. The situation has been described as a “national emergency” by the Quebec College of Physicians.
According to the IRIS study, by modernizing the tax rules governing corporate contributions to the FSS Health Services Fund, this deficit problem can be avoided. This little-known fund, created in the 1970s, was a major source of revenue for the healthcare system in its early days.
The study mentions that, “in 2019, companies in the finance, insurance and real estate services sector pocketed 45% of all profits generated in Quebec, but paid only 11% of total contributions to the FSS.”
It concludes that “if the growth in corporate contributions to the FSS had been equivalent to the growth in their taxable revenues or net profits, the health and social services system would have benefited in 2019 from additional annual revenues of $5.1 to $10 billion.”