This paper published by the Canadian Health Care Consensus Group (CHCCG) is based on remarks by Claude Castonguay, considered one of the fathers of Quebec’s health care system.

He says the system needs in-depth reform and there’s an urgent need to modernize the Canada Health Act.  

“The future of our health care system is a fundamental issue,” he says. “If the necessary changes are not made, our system cannot survive. That is a certainty from which we cannot escape.”

“We have to move beyond patchwork solutions and filling the gaps in order to respond to the problems that arise continually. For far too long, corrective measures have tried to plug the holes in the system at a cost of billions of dollars. Fundamental changes are necessary.”

In Health Care: Towards significant changes, Castonguay sets out a step by step process to reform health care in Quebec beginning with the fundamentals, the very governance of the Canadian health care system, which he says must change. He said the most significant change is the separation of the roles of the purchasers and the providers of health care services.

Castonguay concludes with seven proposals, which he says would “allow us to save our health care system and its essential universal character.”

The Canadian Health Care Consensus Group (CHCCG), of which Castonguay is a signatory, is coordinated by the Atlantic Institute for Market Studies (AIMS). Members came together in 2006 to provide a platform for bold, reasoned and practical plans for genuine reform of the health care system. Signatories to the Statement of Principles include medical practitioners, former health ministers, past presidents of the Canadian Medical Association and provincial medical and hospital associations, academics, and health care policy experts. 

A transcript of Castonguay’s comments to the Montreal Economic Institute are available in French and English on the CHCCG website at or through the Montreal Economic Institute website at

Follow these links to read Towards significant changes
in Englishen francais.

The CHCCG was made possible through the generous support of the Lotte and John Hecht Memorial Foundation.