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CTV Montreal Published Saturday, September 13, 2014 6:14PM EDT Last Updated Saturday, September 13, 2014 6:30PM EDT

Could a two-tier health system be on its way to Quebec?

Variations on that theme were among the many scenarios presented at a the Liberal Forum for Ideas, which focused on health care spending in the province, in its first of two days in Montreal Saturday.

And although the suggestions were often vague, all agreed that the system needs new ways to refinance, as if left unchecked health care costs will outstrip Quebecs tax revenues by 2038.

The man in charge said that he wants prompt action.

If we are to have a health care system that is sustainable, we need to change not in two, three or four years, we need to change today," Quebec Health Minister Gaetan Barrette told CTV Montreal.

Barrette said that services can be maintained at a lower cost with better use of equipment, more prevention and cutting 1,300 health care managers.

We will make announcements that will go in the direction of restructuring. In doing that there will be a gain of efficiency and when we do that we need normally less people to do the same work, he said.

Premier Philippe Couillard echoed the notion that changes are needed pronto.

I would turn this around and make it an opportunity because of the urgency of our fiscal situation. We are not only obliged but we must absolutely speed up the process of innovation, said Couillard.

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New methods of health funding urgently needed, say Liberals