Stakeholder Views on Privatization of the Quebec Health Care System MARIE-PASCALE POMEY E ´ cole de sante ´ publique, Institut de recherche en sante ´ publique, Universite ´ de Montre ´al, Montre ´al, Que ´bec RAYMOND HUDON De ´partement de science politique, Universite ´ Laval, Que ´bec, Que ´bec NICOLAS VAN SCHENDEL Institut de recherche en sante ´ publique, Universite ´ de Montre ´al, Montre ´al, Que ´bec ELISABETH MARTIN Faculte ´ des sciences infirmie `res, Universite ´ Laval, Que ´bec, Que ´bec PIERRE-GERLIER FOREST School of Public Policy, University of Calgary En 2005, avec la de ´cision Chaoulli, la Cour supre ˆme du Canada a marque ´ une e ´tape importante dans le de ´bat sur la privatisation du syste `me de sante ´ au Que ´bec. Le gouvernement que ´be ´cois a par la suite mis en place plusieurs mesures, dont la leve ´e de l’interdiction de se doter d’une assurance prive ´e pour couvrir certains services de ´ja ` offerts par le syste `me de sante ´ public. Nous avons interviewe ´ 42 personnes implique ´es, entre 1999 et 2008, dans le processus de ´cisionnel lie ´a ` la question de la privatisation, et nous analysons ici leurs points de vue. Trois opinions types ressortent, et elles s’appuient sur deux facteurs dont il a e ´te ´ question pendant les entrevues : 1. la force d’inertie ide ´ologique et politique de l’E ´ tat et de la socie ´te ´ civile, et 2. l’action concerte ´e des parties prenantes. Mots cle ´s : privatisation, sante ´, de ´cision Chaoulli, parties prenantes, politiques publiques In 2005 the Supreme Court of Canada issued a landmark ruling in the debate on privatization of Quebec’s health care system. The Quebec government subsequently made several decisions, such as lifting the ban on private insurance for some health services already offered in the public system. We interviewed 42 stakeholders who were involved in the decision process between 1999 and 2008 and analyzed their views. We identified three types of positions on privatization, based on two key factors raised in these encounters: (a) the ideological and political inertia of both civil society and the state and (b) the concerted action of stakeholders. Keywords: privatization, health care, Chaoulli ruling, stakeholders, public policies Introduction The Supreme Court of Canada’s 2005 decision in Chaoulli v. Quebec (Attorney General) [Chaoulli cited to SCR], con- stituted a landmark in the debate on privatization of Quebec’s health care system (Flood and Lewis 2005; Flood and Xavier 2008; Marchildon 2005; Pre ´mont 2008a; Quesnel-Valle ´e et al. 2006). It made headlines across Canada, as other provinces were also under pres- sure to grant more room to the private sector. The Supreme Court of Canada struck down Quebec’s legis- lation banning private health insurance for services already offered in the public system (Tiedemann 2005; Chaoulli cited to SCR). In response, the government passed Bill 33 (An Act to Amend the Act Respecting Health Services and Social Services and Other Legislative Provisions, Que ´bec 2006), which authorized the selling of private 8 Canadian Public Policy / Analyse de politiques, September / septembre 2016 doi:10.3138/cpp.2015-056 https://utpjournals.press/doi/pdf/10.3138/cpp.2015-056 - Sunday, June 28, 2020 3:40:49 PM - CARLETON UNIVERSITY LIBRARY IP Address:134.117.10.200