La santé au Québec : des options pour financer la croissance
Bibliographic record
Abstract
The positive social return on most health expenditure leads us to suggest a shift in Quebec to move away from attempts at restricting these outlays and towards a "growth management"" attitude. Such an attitude also proves compatible with the conclusions of the numerous public reports recently published in Canada on healthcare and healthcare funding, which often include recommendations for extending Medicare coverage. In order to materialize the proposed change, elements of solution are put forward in this paper. On the one hand, to face the upcoming population ageing and the increase in care consumption, it is suggested to emphasize fiscal prudence and a progressive payback of the public debt, as well as the ""prevention turn"" of medicine - an approach that could bring only long-term returns. On the other hand, our proposals to manage the inevitable increase in unitary costs are to 1) review all government spending and budgetary priorities on a regular basis to ensure the favouring of healthcare; 2) adopt clear economic growth-oriented policies; and 3) consider revising the coverage mode of certain interventions or categories of care, among those available both today and in the future, with a view of possibly adopting a ""mixed coverage"" scheme extended beyond the existing program for drugs." Le caractère socialement rentable de la plupart des dépenses de santé nous amène à proposer d'adopter au Québec une attitude de « gestion de la croissance » plutôt que de restriction de ces dépenses. Une telle attitude s'avère également compatible avec les conclusions des nombreux rapports publics récemment publiés au Canada sur la question des soins de santé et de leur financement, et qui suggèrent souvent d'élargir la couverture de l'assurance-santé. Pour concrétiser ce changement d'attitude, certaines pistes de solutions sont mises de l'avant. D'une part, il est suggéré, pour faire face au vieillissement de la population et à la hausse de la consommation de soins, de favoriser la prudence budgétaire et le remboursement progressif de la dette publique, de même que le « virage prévention » de la médecine - une approche qui pourrait ne rapporter qu'à long terme. D'autre part, afin de gérer l'inévitable croissance des coûts unitaires, nous proposons 1) de réviser régulièrement l'ensemble des dépenses ainsi que les priorités budgétaires du gouvernement en faveur de la santé; 2) d'adopter des politiques claires en faveur de la croissance économique; et 3) de considérer la révision du mode de couverture de certains soins, parmi ceux disponibles actuellement et dans le futur, dans le sens de l'adoption possible d'un « régime mixte » élargi au-delà des seuls médicaments.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.005 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.021 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".