Revolution Within A Revolution: Québec's experiment with co-operative health care & social service delivery

Abstract

Québec's decade of experimentation with health care and social service co-operatives has given rise to a reconfiguration of the actors in the health system. No longer do people talk about a system with two actors. Rather than wait for the State or for physician-entrepreneurs to supply needed services, more and more citizens are taking effective action through the structure of the solidarity co-op or that of the nonprofit community-based organization. Without discounting the importance of the state in health care, Girard invokes economist Gilles Paquet who “Forget the Quiet Revolution” whose analysis of state intervention in the 60’s across numerous sectors of Quebec society leads to his conclusion that a new social consciousness is required – “one that prizes initiative and local development and eases the grip of State supervision and protection”. Girard demonstrates that concrete results are being achieved. However, he points out that success it is not a foregone conclusion, citing several examples on the other side of the ledger. Nevertheless, the problems in the health care system and a steadily aging demographic will, Girard believes, lead to a multiplication of initiatives that reconfigure the relationship between citizens, professionals, insurance claimants and the community.