7 September 2017, 07:00
Lyne Duhaime | Photo : Réjean Meloche
The Association québécoise des pharmaciens propriétaires (AQPP) has broken the sugar on the backs of the insurers, asking them to disclose their profit margins in health insurance. However, it is 3 %, learned of the insurance Journal.
It is this that has revealed Lyne Duhaime, chair of the division québécoise de l’Association canadienne des compagnies d’assurances de personnes (CLHIA Quebec), in an interview with the Journal of insurance. She recalled that this information is easy to find with theAutorité des marchés financiers.
At the beginning of July, the AQPP has criticized the practices of the insurers, including by arguing that the difference of the premiums paid by the insured, and the benefits paid by insurers has increased in nearly 10 years, from 90 % in 1997 to 79 % in 2015. The AQPP asserts that the insurers would have pocketed the difference of this difference as profit.
«Without the tags, the insurers do not seem able to discipline themselves and it is the consumers who pay unfortunately the price. How many tens of millions of dollars were overpaid, every year, by Quebecers and how many of those million have been realised as profits by insurers and their shareholders ? «
This questioning is that of Jean Bourcier, executive vice-president and general manager of the AQPP. He took this position following the publication of the study Functioning of the market of private insurance of persons in the framework of the drug and its regulatory framework in Quebec, conducted by the CIRANO and funded by the AQPP.
To illustrate his point, Mr. Bourcier compares the situation to that of the United States, where insurers have to pay out a minimum of 80 % in the benefits of the premiums received, otherwise they must give rebates to their customers. He added that if insurers had the same obligation, they would have paid$ 70 Million for an additional insured.
The CLHIA belies the claims of the AQPP
CLHIA Quebec rejects of the reverse side of these arguments. «If the insurers were making a profit margin huge in group insurance, and if it was not really in danger as a result of the cost of the drug, it would not put as much energy in there. It puts a lot of energy to try to contain the cost of medicine in Quebec and Canada. This is because it is necessary, » said Lyne Duhaime.
In addition, Ms. Duhaime deplores the fact that the leaders of the study, Mélanie Bourassa Forcier and Pierre-Carl Michaud, have used results from the report, in 2014 The Increasing Inefficiency of Private Health Insurance of Michael Law, disputed by Stephen Frank, now president of the CLHIA. Ms. Duhaime noted that the output of this study, the CLHIA has sent a letter to the ministries of Health of Canada and of each province with the caveat that the figures published were not valid. The study of CIRANO mentions the disagreement of Mr. Frank of the time to get the results.
«The researchers would have wanted that each insurer should transmit its information to do its analysis, rather than rely on our aggregate figures. Except that it is not true that an insurer such as Sun Life or Desjardins will want to disclose its confidential information and to contribute to a study paid for by the AQPP, which aims to demonstrate that they lack transparency «, says dr. Duhaime.
She adds, moreover, that the Régie de l’assurance maladie du Québec (RAMQ) and the Authority shall have all of the figures in hand, agglomerates and by insurer. «The AQPP charges on the industry, based on figures that are not good, and shall request the Authority to conduct an investigation. But on the other hand, the regulatory authorities have the right figures. The report will not hold the road. »