A clinician’s view of mixed health care in Quebec
نویسندگان
چکیده
MJM: Please describe how your divide you practice on a week-to-week basis. Dr. Stein: I actually spend about 90% of my time in the hospital system. I've done it that way since 1974. Our group has always had a community clinic. I don't like to use the word " private " clinic, it's a bit of a misnomer because until about quite recently, patients didn't have to pay for the imaging that was available at these clinics—chest x-rays, lumbar/spine, mammography, barium studies. These clinics started in the late 1960's as an outlet for patients to get their outpatient imaging done using their medicare card without relying on an expensive hospital infrastructure. Our group had such a clinic, as did radiologists at most other hospitals. Then about five or six years ago, these clinics started to include CT, MRI, PET scanning and even nuclear medicine. This was new in that these procedures weren't covered by the medicare card and therefore patients had to pay for that. The Quebec law is very clear regarding radiological procedures; if it's not insured within a hospital, you can charge for it outside a hospital. For some other specialities, there's more of a grey zone. MJM: What changed five or six years ago? Dr. Stein: What changed is that CT, MRI and ultrasound just became more used and everyone saw that there was probably a group of patients that would be able to afford or have insurance for these procedures, and who would benefit from them. At our clinic downtown, we offer everything we offered since 1967, and since 2000 we've added to that these advanced imaging procedures, so 60% of our volume is medicare covered and 40% isn't. It's legal to do this in Quebec, as it is in BC and Alberta. Also, in Quebec, most private health-insurance programs that people are enrolled in as an employment benefit cover these kind of procedures, sometimes up to 100%, and usually about 80%. This is unique to Quebec; if you have a job, you probably have this kind of insurance. MJM: What was the reaction when you introduced these new services not covered by medicare? Dr. Stein: Well, in 2000 we moved from a smaller office where we had only offered the covered services and opened a new and larger office where we offered the advanced imaging as well. At the time we developed and opened it, …
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ورودعنوان ژورنال:
- McGill Journal of Medicine : MJM
دوره 11 شماره
صفحات -
تاریخ انتشار 2008