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Various health groups have joined forces to launch legal action against the federal government to ensure it applies the Canada Health Act in Quebec and across the country. The goal is to obtain a court order that would force the federal health minister to "fulfil a statutory duty" to prevent overbilling through extra fees.

The College says its investigations are hampered because patients are not coming forward with complaints. Also, there's often no paper trail.

After The Gazette first reported 14 months ago that doctors at several Montreal hospitals routinely accepted bribes from patients to fast-track services to publicly funded health care, Quebec Health Minister Yves Bolduc demanded the Quebec College of Physician's disciplinary board, as well as the provincial health insurance board, investigate allegations of black-market medicine.

A 14-month investigation by the Quebec College of Physicians led to a disciplinary hearing for two cardiologists accused of accepting bribes in exchange for preferential treatment.

many people to write and call The Gazette offering personal anecdotes of giving doctors payoffs to expedite consultations and surgeries in publicly funded health care

"For the College to say that they don't know what's going on, that's bulls--t."

In 2007, the Quebec coroner faulted hospital administrators for failing to spend enough money on measures known to contain the spread of the superbug.

A Quebec report concludes psychotherapy is as effective as drugs for treating depression and moderate anxiety — and cheaper, with longer lasting results.

Sheehan lost a son to suicide, and he now leads a Quebec coalition aimed at improving access to psychotherapy.

However, with just one in three psychotherapists practising in the public sector, by far the majority of those benefiting from talk therapy either have private insurance or the financial means to pay for it themselves.

Quebec's commissioner for health and social welfare recommended in 2012 the government should insure more mental health services and offer more equitable access to psychotherapy. The health ministry mandated INESSS to undertake the assessment of the costs and effectiveness of psychotherapy compared to psychopharmaceuticals at that time.

While a view of the corpse proved sufficient to reach that conclusion, Lafrenière said digital fingerprints and DNA samples were taken that will lead to scientific tests "to eliminate all possible doubt." Porter was accused of receiving part of an alleged $22.5-million payment from SNC-Lavalin in order to rig a $1.3-billion Montreal super-hospital contract to ensure it went to the engineering giant. Lafrenière confirmed the charges against Porter, 59, will be dropped but that proceedings will continue against seven co-accused.

Porter's wife, Pamela Porter, was sentenced in December to 33 months in prison after she pleaded guilty to two counts of money laundering in connection with her husband's case. The investigators from Quebec's anti-corruption unit were granted entry to the morgue in Panama City on Monday afternoon. The alleged $22.5-million fraud has been described by a Quebec provincial police investigator as one of the largest corruption cases in Canadian history.

Porter, who vehemently denied any wrongdoing, was transferred last May to a cancer clinic where he was receiving treatment. His doctor said he'd been treating himself while imprisoned. Porter was also once appointed head of Canada's spy watchdog agency by Prime Minister Stephen Harper.

He said he believes low-cost manufacturers in India or China would likely win the tenders and Quebec pharmacists have suggested alternative ways to achieve savings that don't run the risk of leading to shortages or issues with quality. Quebec's proposed changes would allow the health minister to issue a call for tenders from accredited drug manufacturers or wholesalers.

The current formula results in high profits on some drugs and minimal or no profits on others, said Keith Howlett of Desjardins Capital Markets, who described Quebec's legislation as a "surprise proposal." He said it would hurt Jean Coutu's Pro Doc generic manufacturing business. Pro Doc is the legal manufacturer of many of the most profitable drugs. Jean Coutu declined to comment.

Robert Salois, Quebec's former health and welfare commissioner, is slamming the province after his position and organization were abolished under last week's provincial budget.

The independent health watchdog — which was created by Quebec Premier Philippe Couillard when he was health minister in 2006 — published annual reports on the performance of the healthcare system. 

The reports were often critical, highlighting flaws within the public system. A March 2015 report, for instance, found that Quebec's drug plan is unsustainable.

Prior to the budget, Salois says he was not giving any indication or warning that his office would close down. A government employee called to tell Salois, but he says he wasn't given any explanation or justification for disbanding the office of 23 staff members.

Quebec has many private clinics. One performs 200 joint replacements per year; some 30 per cent of patients come from other provinces. When Philpott threatened to penalize Quebec for extra billing by MDs, its health minister, Dr. Gaétan Barrette, retorted that Quebec was not subject to the Canada Health Act. He is wrong. The CHA was passed unanimously in 1984, thus every Quebec MP voted for it. The solution is not to break the law, but to amend it.

Philpott admits "innovation" is required. Yet governments are constrained by blindly adhering to certain parts of the CHA, while ignoring others. As Ben Eisen of the Fraser Institute has emphasized, provinces have been forbidden to experiment with user-fees, copayments, etc. that would encourage individuals to use health services more responsibly. A "two-tier" system has always existed. Federal prisoners, Workplace Safety and Insurance Board patients, members of the military and RCMP, politicians and professional athletes usually obtain more timely care - often at private facilities. For those not near an inter-provincial border and not a member of a "special group," the main option for timely care may be to go to the United States. This provides employment to American doctors and nurses and profits to U.S. hospitals. Wouldn't it make more sense to allow all Canadians to spend their after-tax discretionary income on health in their own province? Frozen hospital budgets have caused excessive wait times for knee and hip replacements as operating rooms often don't function at full capacity. According to a 2013 survey, 15 per cent of Canadian surgeons considered themselves underemployed and 64 per cent cited poor access to ORs. About 25 per cent of nurses in Newfoundland and Labrador work only part of the year.

If orthopedic surgeons had access to additional "private" OR time, wait times could be shortened for all Canadians and new employment would be created for health-care professionals. If hospitals were permitted to operate electively on Americans and other foreign patients, this would bring in extra revenue and relieve the strain on provincial health ministries. So that MDs did not abandon the public system, they could be required to work 25 to 30 hours per week in the public system in order to receive government reimbursement for malpractice insurance. Most MDs would confine their practice to the public system. They deserve fair treatment. Philpott should amend the Canada Health Act to mandate binding arbitration when provincial negotiations fail, as they have in Ontario. Since 1984, the population has grown and aged, new diseases have been recognized, and new drugs and technologies have developed. Some 32 years ago, it was understood that Ottawa would pay half of health costs. Now it covers less than a quarter. We need to amend and modernize the Canada Health Act. Where wait times are excessive, certain diagnostic services and surgical procedures should allow for private access for all Canadians - not just a select few. This would maximally utilize expensive equipment and provide new employment for nurses, technicians and surgeons. It would provide extra revenue that would help to keep universal public health care sustainable and accessible for all Canadians. Ottawa should then enforce all sections of the Canada Health Act on all provinces and territories. Dr. Charles Shaver Ottawa

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Polls show Canadians overwhelmingly support these conditions. Medicare's key limitation, however, is that it applies only to services offered by doctors and hospitals. It does not apply to home care. Increasingly, provincial governments are trying to save money by encouraging acute-care hospitals to discharge patients as quickly as possible. In most provinces, these patients find themselves reliant on badly underfunded home-care services. Unlike hospital care, such services are usually neither comprehensive nor universal. As an Alberta oil worker with incurable cancer found when he tried unsuccessfully to come home to Ontario to die near his family, they are not even portable. Ontario pays $3 billion on home care each year. But Queen's Park saves more than that in foregone hospital and nursing home costs. In that sense, home care is a revenue tool. It allows provincial governments to evade the spirit, if not the letter, of the Canada Health Act. In Ontario, as my Star colleague Bob Hepburn has pointed out, the results are sometimes absurd. When the provincial Liberal government boosted wages for badly paid home-care workers earlier this year, some cost-conscious agencies responded by cutting services. In the weird world of Canadian health care, it was the logical thing to do. But there is a way to fix the home-care anomaly. Roy Romanow's royal commission on health care pointed to it 14 years ago.

Romanow argued it made no sense to exclude home care from medicare. He recommended home care services for the mentally ill, for patients just released from acute care hospitals and for those needing palliative care be written into the Canada Health Act immediately. By 2020, he said, all home care services should be covered by medicare. Interestingly, federal Health Minister Jane Philpott is also focusing on home care, mental health and palliative care. How would she get the provinces onside? Many assume a final deal over medicare spending can be hammered out only by the first ministers meeting in a marathon bargaining session - as happened in 2004. In that session, the premiers ran roughshod over then Prime Minister Paul Martin. Quebec demanded and received the principle of asymmetric federalism - that it could do whatever it wished with the massive health transfers Martin was offering. Alberta then demanded and received the principle of provincial equality - which meant any province could mimic Quebec. As a result, no real conditions applied to any of the money Ottawa agreed to hand over.

This is one way of doing things. The other is for Ottawa to ignore provincial objections. That's what Lester Pearson's Liberal government did in 1966 when, in concert with the New Democrats and over the strident objections of Ontario, Quebec, Alberta and the federal Conservatives, it passed Canada's first national medicare act. The Canada Health Act is the successor to that 1966 law. It is a federal statute that can be amended unilaterally by Parliament. In 2016, it makes sense that it be amended to include home care as a core medicare service. Some provinces may disagree. If so, they won't have to take any extra money that Ottawa puts on offer. Thomas Walkom's column appears Monday, Wednesday and Friday.