The document discusses the role of private health insurance in Quebec's public drug insurance plan. Some key points: 1) Quebec's plan provides universal drug coverage but is considered "general" rather than "universal" due to the significant role of private insurers. 2) Private health insurance is limited under a universal public plan but is important under Quebec's general plan, with markets reserved for private plans. 3) Quebec's plan has structural characteristics of a private insurance model, including risk screening, premiums, deductibles, and tax-like powers given to private insurers.

1. The role of private insurance
Pharmacare in Quebec
Marie-Claude Prémont
École nationale d’administration publique
Pharmacare 2020- Vancouver
26 February 2013

2. Advantages of the Plan
• The entire population of
Quebec is covered since 1997
• Mutualisation of risks
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3. Twisting universality
• Going from Universal for
Medicare
• To General for Pharmacare
Major differences between the
two, in particular for private
insurance
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4. The role of Private Health
Insurance is redefined
• With a universal plan: duplicative
Private Health Insurance is drastically
limited, or prohibited (Chaoulli decision)
• With a general plan: coverage is basic.
• Markets are reserved for Private Health
Insurance. If offered by an employer
the Private Plan becomes mandatory
for all employees.
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5. Structural characteristics of
the Plan
1. Risk screening
2. Financial Structure: A Private
Insurance Model
3. Tax-Like Deduction Powers given
to Private Insurance
4. Social amity defused
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6. 1. Risk Screening
• Good risks to the Private Insurer
(Workers; 4.3 millions insured)
• Bad Risks to the Public Sector
(Seniors and Welfare Recipients;
3.2 millions insured)
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7. 2. Plan Financing: A Private Model
The financial structure is based on a
Private Insurance model
• Annual Premium
• Deductible
• Co-insurance
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8. 3. Tax-Like Deduction Powers given to
Private Insurance
• Payroll Deductions
• Private Insurers are granted
the Benefit of Group Plans
exclusively
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9. 4. Social Amity Defused
• No possible cross-subsidization between
public and private segments of the
General Plan
• Identical Premiums within groups
 Basic Plan for Public portion
 Private Group Plans may be enhanced
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10. The general Plan presented as a new
model for Healthcare solidarity
On the contrary, it inhibits the fostering
of a truly universal Plan and solidarity
amongst all segments of the
population
Currently, proponents of this Plan
promote it as a model for Hospital and
Medical care.
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11. Thank you
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