Dr Charles S Shaver wrote in Friday’s National Post (October 1, 2004, editorial section), that Canada should become involved in the disbursement of the difference of healthcare payments to doctors of different provinces, since Quebec will not honor the (higher) fees paid to the doctors of other provinces.
Anyone who thinks that Canada’s healthcare system is truly national is deluded. It isn’t. And it’s never been.
To be a national system, would mean that Canadians would get “free” healthcare wherever they traveled in Canada, But that is not, and has never been the case because of Quebec.
I’ve written on this issue a great many times. And every time I write about it, people from Quebec are shocked to learn that they are not covered when traveling outside of Quebec in the rest of Canada.
The way the system works is simple:
Doctors get paid directly from their own provincial health ministries for whatever procedure(s) they provide. Each procedure has a predetermined value to it. But not all provinces pay their doctors the same amount for similar work. Some provinces pay more. Some provinces pay less.
But; all provinces with the EXCEPTION of Quebec will honor the rates each province pays their own doctors per procedure(s).
To make this simple; here is a made-up example: Ontario pays its doctors $50 for a basic check-up. Manitoba pays its doctors $25 for the same basic check-up.
If a person from Manitoba goes to Ontario for a basic check-up; Manitoba will pay the Ontario doctor $50 for the procedure, even though Manitoba only pays their own doctors half that amount.
But Quebec will not.
Quebec will only pay out of province Canadian doctors what they will pay their own doctors, which is virtually always substantially less. Therefore; Canadian doctors outside of Quebec do not want to accept Quebec medicare cards.
Who can blame them?
My doctors are all in Montreal. But I live in Ontario. All but one of them are registered with OHIP (Ontario Health Insurance Plan). They love it when I come for their services, since they get to charge OHIP what Ontario pays their doctors which is generally substantially more. And being paid by OHIP, doesn’t impact upon their Quebec revenue quota.
My family doctor in Hudson (Quebec) is not a member of OHIP, since he says he has so few Ontario patients that it really isn’t worth his while to join, and pay the annual fee. So, when I visit him, I have to pay cash.
What type of seamless national healthcare is that?
The first time I visited him after leaving Quebec for Ontario was a unique experience. After seeing him whenever I wanted to for “free”; now I had to pay.
I had no idea how much a visit to see my Quebec doctor was going to cost. They didn’t take charge-cards or direct debit. And the receptionist would only tell me that the cost of the visit would depend upon what the doctor had to do. So I took $200 in cash and my check-book.
When I went to the receptionist, and didn’t have a healthcare card to hand-over, it felt very strange, since I spent virtually my entire life in Canada’s “free” healthcare system. And all of a sudden, it was no longer seamlessly free.
After the basic check-up, the doctor wrote out a bill which I had to pay to his receptionist. I was told that OHIP would reimburse me for the total.
It was $18.
I leave bigger tips at restaurants than $18.
I considered not bothering to submit this bill to OHIP, but on principal I did. If I didn’t present it for reimbursement, it would mean that I was personally outside the Canadian healthcare system. And I didn’t want that distinction because of Quebec.
What Dr Shaver wants from Canada, is for Canada to pay the difference between what each province pays its own doctors because of Quebec.
In other words: If the shoe was on the other foot, and my visit would be as a Quebecer to Ontario, where OHIP would pay their doctor $50, but only be reimbursed by Quebec healthcare for $18, the $32 difference would be paid by Canada to the Ontario doctor.
What Dr Shaver is promoting, is yet another subsidy for Quebec.
The “almost” national Canadian healthcare system works very well between all provinces with the EXCEPTION of Quebec. So, in the opinion of Dr Charles S Shaver, we should change the entire system to accommodate the will of just one province, and add yet another layer of bureaucracy to the national healthcare system. All because of Quebec.
I have a better idea. Why not just exclude Quebec entirely? Then the rest of Canada will have to change nothing. And the system will continue to work as efficiently as it always has.
I’m always amazed by the number of people within Quebec who have no idea that their supposedly national healthcare is not worth a great deal in the rest of Canada, since most doctors outside of Quebec insist on being paid directly by the Quebec patient for services rendered, or at least for the difference they will not receive from the province of Quebec.
I travel a great deal throughout Canada, and when I lived in Quebec, I always purchased an annual health travel insurance policy for Canada. It didn’t cost me that much, but it truly made my Quebec coverage national.
Perhaps that’s what Quebecers should consider doing if they want to be protected nationally. But, to change the whole system and finance “Distinctland” simply because Quebec doesn’t want to be a part of our national healthcare system is ludicrous.
As I’ve been saying as loud and as clear as I know how to: Here’s just one more reason of many to de-Confederate Canada.