Isabelle Leblanc is a family physician who works at a community clinic in Montreal. She is also the president of the group Médecins québécois pour le régime public (MQRP), or Quebec Doctors for Medicare. Scott Neigh interviews her about the importance of the public health care system, and about the work of MQRP to defend and improve it.
It is very common for workers who deliver public services, as well as their unions, to be at the forefront of struggles to defend those services. They fight back against budget cuts, seek to improve service quality, and work to ensure that services remain public. That last one is because the insatiable private sector drive to make a profit means that money that would otherwise be used in the delivery of services gets diverted into the pockets of shareholders, making the services more expensive overall, driving down wages, and/or eroding service quality and accessibility.
When it comes to physicians within the public health care system in Canada, though, things are somewhat different than for most public sector workers. Along with having significantly higher status than other workers in the sector, the vast majority of physicians in Canada -- unlike, for instance, doctors in the National Health Service in the United Kingdom -- are not employees of the state or of broader public sector entities like hospitals. Most physicians in Canada are, in fact, effectively small business owners who bill provincial health insurance programs for their services. And while there are certainly individual doctors and particular physicians' organizations that are active in struggles to defend the public character of the health care system, this is much less broadly true than it is, for instance, for public sector unions.
MQRP, however, is one such organization. The group got its start over a decade ago after a major Supreme Court of Canada decision that allowed for a much greater presence of for-profit health care in Quebec (though not, or at least not yet, in other parts of Canada). Today, the group gathers together more than 600 physicians, medical students, and medical residents in Quebec for the purpose of defending and strengthening public health care in the province.
MQRP meets regularly in Montreal. Some of their work involves responding to issues related to the health care system that are in the news, or to statements and actions by the government. They regularly participate in interviews and debates in the media. And some of their work is more focused on pushing specific issues that they have identified as priorities. Each year, they release major position papers on one or two particular issues and then work via lobbying, advocacy, and the media to push for relevant changes in the system. They also regularly collaborate with public sector unions and with associations representing other health care professionals.
Their long term goal is a health care system that is adequately funded, completely accessible, and much more thoroughly public in character than what we have in Canada at present. In 2017, they received attention in English Canada and around the world for publically taking the stance that physicians should be paid less than they currently are, and instead that money should be invested in the system and in improving the wages and working conditions of the many other workers who are also crucial to delivering health care. This was in fact the third time they had taken such a stance, and while it has been met with dismay and even hostility from some of their physician colleagues, they have also found that an increasing number have been coming to agree with them, even if only privately.
Though they have not yet won on that issue, they have been part of other reform efforts in recent years that have resulted in concrete changes. They were part of a successful challenge to the Quebec government's tacit acceptance of physicians who charged illegal accessory fees to patients. They were part of winning public funding for ultrasounds done in non-hospital settings, making them more accessible to people who could not afford them. And they were part of pushing the government to allow Indigenous people, particularly children, who have to be flown out of remote northern communities to urban hospitals to be accompanied by a parent or guardian – though subsequent experience is showing that the actual implementation of this change has so far not been adequate.
Their most recent position paper is an examination of the ways in which access to the health care system is unequal, and certain populations face significant barriers. They are also keeping a close eye on Quebec's new CAQ government. The party did not talk about privatization of health care at all during this year's election campaign, but their manifesto is full of policies pushing a radical privatization agenda that would, if they decide to implement them, be devastating for health care in Quebec.
Image: The image modified for use in this post is used with the permission of Médecins québécois pour le régime public.
Talking Radical Radio brings you grassroots voices from across Canada, giving you the chance to hear many different people that are facing many different struggles talk about what they do, why they do it, and how they do it, in the belief that such listening is a crucial step in strengthening all of our efforts to change the world. To learn more about the show check out its website here. You can also follow them on FaceBook or Twitter, or contact [email protected] to join our weekly email update list.
Talking Radical Radio is brought to you by Scott Neigh, a writer, media producer, and activist based in Hamilton (formerly Sudbury), Ontario, and the author of two books examining Canadian history through the stories of activists.
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