The Government Must Clear Up All Confusion

Montréal, July 4, 2011 - The Québec Medical Association (QMA) is concerned by the emergence of business or professional practices that the population could perceive as obstacles to the accessibility of health care services.

For several years now, many medical clinics have been promoting various options to take advantage of what they consider grey areas in legislation.

The option of annual or quarterly block fees has been chosen by many clinics. Based on this arrangement, patients pay a certain amount that allows them to get an appointment with a physician more rapidly.

At a clinic in Laval, patients can get an appointment with a specialist more rapidly on the condition that they join the gym in the same building. Another clinic launched its "pediatric concierge service" that offers 24/7 pediatric medical service in exchange for an annual fee of $975.

RAMQ is investigating these practices, as well as the practices of a few health-care cooperatives that allow access to a family physician upon purchase of a share in the cooperative. In all, 11 investigations have been conducted by the RAMQ over the past year.

Nobody is challenging the perfectly legitimate right of citizens to pay out of pocket for access to private medical services from a physician who has chosen to opt out of RAMQ. But when clinics take advantage of the shortage of family doctors to attract patients by giving them priority access, in exchange for some sort of financial contribution, to a physician paid by the public system, it is time to say enough is enough.

These practices are not merely administrative glitches. Above and beyond the RAMQ investigations, it is the government that must intervene to clarify the exact nature of the incidental costs that a physician or clinic has the right to bill to patients. The government has the duty to apply the Health Insurance Act: it is a matter of justice and fairness.

In Ontario, the McGuinty government launched proceedings against guilty clinics and physicians and took decisive action by reimbursing $1.3 million in fees charged to patients illegally since 2007, by creating an effective investigation system that has triggered close to 200 investigations in the last year, and by setting up a watchdog service via telephone and an e-mail address to receive complaints from citizens.

In Québec, the population no longer knows where things stand and people are beginning to believe that they must pay to have access to rapid, efficient health care services.

We can only praise government initiatives to improve primary care services, especially with the accreditation of many family medicine groups. These measures, coupled with the emergence of new models for medical organization based on interdisciplinarity and the efficient use of information technologies, will produce meaningful results in the end.

Until then, the government must shoulder its responsibilities and show leadership. Until it clearly defines the rules of the game, "private/public" hybrid initiatives will continue to multiply and create confusion among citizens.

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Source: Direction of Public Affairs
Québec Medical Association

Information:    Annabelle Beaudry
Communications Advisor
514 866-0660 ext. 242
annabelle.beaudry@amq.ca