Why does B.C. allow some physicians to "bill patients privately as much as they like for their services?"

[Anon-e-mous]

I'm an OOP interviewee and while doing research on the health care system in B.C. I came upon this infographic http://evidencenetwork.ca/wp-content/uploads/2015/06/ENinfographic.Nov22.16.pdf

I have a hard time understanding why the province allows physicians to NOT enroll in MSP and "bill patients privately as much as they like for their services, so long as they are not providing care in hospitals or community care facilities." Doesn't that defeat the purpose of our public system, making it even more two-tiered and potentially unfair? Does this mean there are private insurance companies that cover the entire cost of unenrolled physicians?

Also, why do physicians who are enrolled in MSP have the option to "opt-out" and bill their patients directly for insured services? What benefit does that have? Wouldn't that just cause more administrative time and cost to the public system?

Thanks!

[ninjabro]

Good questions. Did you find any answers? 

[JohnGrisham]

There's hardly anyone doing it, because staying in the public system means they pretty much have an endless supply of patients waiting to see them.

Sure they can opt out of MSP, and then charge 100$/visit or 500$/visit but they are going to have a hard time keeping full-clinics, unless they live in the rich area of town and are able to market themselves as a "wellness" business or the likes. As far as I know, there are no private insurance companies in canada that reimburse doctors visit in this manner.

A physician who opts out, is essentially doing everything direct with the patients and getting paid directly by the patient. Some who do it, probably do it for concierge medicine type practices where they have rich clientele and charge 300$/hr 1:1 visits etc. 

 

[NeuroD]

I guess the idea is to allow a mixed or blended model public/private model. Hasn't picked up much steam. Does anyone know of this is the fall out from that supreme Court case with the orthopod?

[JohnGrisham]

35 minutes ago, PhD2MD said:

I guess the idea is to allow a mixed or blended model public/private model. Hasn't picked up much steam. Does anyone know of this is the fall out from that supreme Court case with the orthopod?

Don't think it has anything to do with that. Other provinces have similar opt-outs.  No one can force you to stay in the system, but once you opt-out, you definitely can't take advantage of the benefits of the system either in terms of billing for work.   You're either in or your out. If you're out, then its solely on you and to be a business person to sell your services as valuable to patients, and presumably at a big premium to make it worth even doing in the first place, as you are forgoing a steady stream of publicly funded patients who are clamouring to see a FM doc.