Today in saskatchwan, there are a number of publically-funded hospitals that refuse to provide medical services...

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Today in saskatchwan, there are a number of publically-fundedhospitals that refuse to provide medical services on religiousgrounds. All canadians have the equal right to access to healthcare. Discuss this issue as is stands in saskatchewan and the restof canada and provide some possible solutions to the problem. Whatare some possible pitfalls that come with your solutions? Is therea place for health in the delivery of health services?

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Questions whether private healthcare services in Canada is illegal or not is by surveying the health insurance legislationso f all provinces The survey revealed multiple layers of regualtion that seem to have as their primary objective preventing the public sector from subsidizing the private sector as opposed to the rendering privately funded practice illegal THe absence of siggnificant private sector is probably best explained by the prohibitions on the subsidy of private practice by public plans measure that prevent physicians from topping up their public sector income with private fees Concenrs have been increasing about access and quality of hospital and physician services within Candas public healthcare system At the same time there has been increasing criticism of the alleged illegality of private medical practice Constraints on the ability to obtain private insurance coverage for services that ostensibly are covered by public sector but that patients would prefer to buy privately People may prefer to buy such services becuase of a desire to avoid public sector queues or to obtain services of higher quality than those avaiable in the public systems in other situations services must be purchased privately because a determination has been made within the public system that the patient does not need the service Opting in and opting out Before describing the constraints on direct billing and extrabilling we want to clarify the concept of opting out A Canadian physician may at any time choose to give up his or her rights to bill the public plan and take up practice in the private sector Although there are differences in terminology eg nonparticipation nonenrolment practising outside the Act not subject to the agreement every provincial plan permits physicians to opt out345678910111213 In Manitoba Nova Scotia and Ontario the financial incentive to do so is significantly dulled because optedout physicians cannot bill more than they would receive if they were working within the public plan In every other province optedout physicians can set their fees at any level However as the status disincentive row in Table 1 shows all of the remaining 7 provinces except Newfoundland and Prince Edward Island have in place measures that prohibit the public purse from subsidizing the private sector In other words patients of optedout physicians are not entitled to any public funds to subsidize the cost of buying their services privately Direct billing Direct billing whereby physicians collect payments from patients rather than from the public plan may adversely affect access to health care services as patients must bear the upfront cost of the care and then seek reimbursement from the public plan Thus in all but 4 provinces optedin physicians are prohibited from billing their patients directly141516171819 Only in Alberta New Brunswick Prince Edward Island and Saskatchewan can optedin physicians bill patients directly at any time for insured services In the other 6 provinces physicians must give up their rights to be paid from the public plan for the period during which they want to bill patients directly This is accomplished either by opting out of the public plan entirely or as in British Columbia by electing to receive payment from sources other than the public plan without completely opting out of it20 There is a narrow exception to the latter option in British Columbia and Newfoundland where optedin specialists who provide services to patients who were not referred to them by another optedin physician may bill those patients directly up to the level of the public tariff2122 Extrabilling Extrabilling is a system whereby a physician charges his or her patients an additional fee or extra charge for services covered by the public plan Thus the physician receives not only the payment from the public plan but also whatever extra he or she is able to bill the patient In this situation the patient would either pay that additional cost out of pocket a user charge or would have private insurance to cover the additional cost subject to other legal restrictions From the physicians perspective the attraction of extrabilling is the ability to set his or her own price without restriction and to have that price partially subsidized by the public plan Provincial prohibitions on extrabilling See Answer

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