Thursday, August 12, 2010

Welcome to Private Healthcare-Quebec Style!

It was good to see a business associate of mine who was in from Toronto for the first time since having heart bypass surgery last year. He had a difficult recovery and as he recounted his ordeal, he mentioned rather conspiratorially, that he had paid for an MRI in a private clinic rather than wait for the inevitable delays in the public sector.

"So what?" I answered. "That's no big deal, it's business as usual here in Quebec!"

Well, apparently it isn't so par for the course outside of Quebec, where private health care doesn't seem to have taken hold to the same degree as here.

In fact, of the 35 Canadian MRI clinics listed on a referring web site, FindPrivateClinics.ca, seventeen are located in Quebec!

While the country debates the ethics of private health care, the Quebec government has quietly thrown the doors open to private care that is normally covered by the RAMQ (Quebec's medicare agency.)

The tiny Westmount Square shopping mall in downtown Montreal is home to one of the largest private health care clinics in the country, offering practically any diagnostic service for pay. For that matter, it offers just about any other treatment you can think of!
Aside from its diagnostic division, it is home to a bunch of private doctors who moonlight for pay by seeing 'private' patients 'on the side,' a practice that I thought is illegal. Check out their web site.

I recently met a friend going into the clinic with a large bandage covering an eye. I asked what happened and he told me that a metal shard had hit him in the eye and after ten hours in the emergency room of a local hospital he had secured an appointment in the Westmount Square clinic. An hour after arriving, he left, after seeing a doctor who took care of his problem ASAP.
WOW! I don't know how much he paid, but it certainly was worth it.

There seems to be a flourishing business wherein doctors who are on the books with Medicare, operate outside the system quite openly. Not so kosher!!!!

Incredibly the government avails itself of private medicine too. The (CSST) (Workman's Compensation Board) uses the private system to bypass the public system in order to speed up evaluations and treatments so that cases can be disposed of more quickly, thus saving extended benefits that are paid to claimants while they spend time on a medical waiting lists. In fact the CSST is the largest user of private health care services in the province! LINK (French)

The other day the Journal de Montreal ran a story about a man who was told that in order to circumvent an eighteen month long waiting list he could see a certain doctor within two weeks by joining a sports club who would then pay the doctor directly as a third party. Obviously the patient would reimburse the club. Supposedly this is legal. Sounds like a real racket.  Link(French)
The government seems to be turning a blind eye to all this. It seems that they've figured out that each MRI treatment done privately, means one less treatment that they have to pay for, something the defenders of the exclusive public option fail to accept.

I myself recently had a rather strange experience with my very own colorectal specialist who told me  that an appointment for a colonoscopy would take two and a half years and then without blinking an eye, informed me that he could do the procedure privately in two weeks! Here's my card, Ka-Ching!

Now I don't have any problem with private health care, it's a wonderful addition to the public option for those who can afford and don't care about the expense. Every dollar spent privately is a dollar less spent publicly. Personally I'd buy insurance if it was available and I'm sure a large percentage of Canadians would do so as well.

But I have a big problem with doctors floating between public and private systems, essentially trolling for patients. The same goes for private diagnostic tests that propel patients faster up the line for public treatments.

It isn't fair for someone to pay for a private MRI and then jump back into public line to secure a procedure faster than someone who is still waiting for a public MRI.

That is the essential conflict with mixing a private and public health system.
A good number of Quebec surgeons will jump you past the waiting line if you pay them.  I know someone who paid $8,000 to have a painful shoulder repaired within two weeks after having been told by her doctor that the operation would require an eight month wait on the public rolls.

Some doctors even rent out idle hospital operating rooms and hire hospital nurses to moonlight to do private procedures, all of this going on with everyone in the health industry turning a blind eye.

The ethics of the whole thing are disgraceful.

Doctors who choose to go private, shouldn't be allowed to practice in the public system, there's too much temptation for abuse.
Let them open up their own facilities and charge what they want. People should be able to buy private insurance if they want or pay for medical services a la carte.

Let us have private doctors, private hospitals and private diagnostic clinics.  Those who want to use them will pay.
Those who can't will stay in the public system, which should technically run better because of the private option.

Bit mixing systems makes for abuse.

And so while one in three Quebeckers don't have a family doctor, it isn't hard to find one for pay. Here's a list where you can hire one today. LIST

Here is web-site where you can find virtually any medical speciality, all for pay HERE

By the way, here's a list of the cost of a variety of private medical procedures.

- Average cost for an MRI in Montreal is $750.
- Average cost for a PET/CT scan in Montreal is $2500.00
- Average cost for a Mammogram in Montreal is $350.00
- Average cost for an Ultrasound in Montreal is $150.00

Does anybody out there have any experience with private health care? Have you paid for a private test or procedure?

Fess up!