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

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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?


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