How does healthcare system work?

[DrIng]

I'm curious to know how the system works in Canada? I understand that the government pays for health care, so if I'm a specialist the governemnt will pay me $X to see a patient. However, in Australia there is also a private systemt hat tops this up, so the government pays $X but then a patient (or their health insurance) pays $Y on top to be a private patient. Of course not all doctors charge the $Y component and there is always the public fully funded system but I know a number of doctors who say that they could not run private practices and pay reception staff etc without charging the $Y on top of the government fees. (one of them told me he would have to work 49 weeks a year full time to pay for his costs and give himself a salary of $100K a year on the Medicare system.) All of which makes me wonder how the Canadian system works?
Thanks for your help.

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[Nekrotik]

It really depends, on your pratice, on the province, on the region....It's complicated.

Most of an MD salary is paid by the "act" which means the physician bills the government for the procedure or services he provided to a patient. The compensation for each act varies from province to province. Procedure pay more than exams or other basic stuff. Not all medical acts are covered (e.g plastic procedures are not covered). There are also other forms of compensation like bonuses or package, but the majority of a doctor's income is trough billing for each act. Note that there can be substantial overhead, which means the doctor has to pay his office, staff, furnitures, etc. out of his compensations This depends on your practice (clinics carry more overhead than hospital based).

Private insurance covering services already covered by the public regime is illegal (altought this was recently challenged successfully in Quebec). Also, a doctor cannot "double dip" i.e one cannot participate in the public regime and at the same time run a private practice (where you bill the patient instead of the government). Those measures were put into the law to discourage the creation of a private regime.

So whenever you go to a "public" doctor, you never pay anything, you just show your insurance card. There are, of course, exception to that but they are minimal. You can choose to go in the private sector but you then pay from your own pocket.

 

[DrIng]

Thansk for that. I wonder how the system works at all? There seems to be no benefit to be being in private practice over being employed in a fixed fee employed by the public system. How interesting.

 

[tussy]

Private practice isn't really an option in Canada other than in cosmetic surgery or other services that aren't covered by the government. Apart from that everything gets billed to the provincial government. the system is slightly different in each province but the general medicare principles apply to all.

 

[DrIng]

When I said private practice I actually meant simply running your own business and being responsible for salaries for receptionists etc...

 

[tussy]

Most Canadian physicians still are responsible for their offices/staff etc, even if they are associated with a hospital or university. You are not on a "fixed salary" either way. You bill for every service you provide, however you are billing the government, not the patient. There are a few places where people are salaried, but it's not the norm.