private not for profit

[Guest lots of thinking]

Can someonw please explain to me how these private not for profit clinics work as opposed to private for profit??

thanks,

M

[Guest monksters]

Private means that it is owned by an individual or group of individuals. My understanding is that all clinics even in BC are private. Not for profit just means that, for each fiscal year, the expenditure equals the revenue. This typically means that the clinic bills the government (MSP), for services it provides. Whereas for profit means that, each fiscal year, the revenue is expected to exceed the expenditure. As a result, the clinic bills the patient directly.

[Guest macdaddyeh]

Further to the above post, as per the CHA, in order for a health facility to receive funding transfer money, they cannot operate on a "for profit" basis period (except in some circumstances). It is currently illegal to ask a patient to pay for services which are publicly paid for via taxation.

 

So when one talks of "for profit" in the hospital or clinic sense, this is really a misnomer because it typically can not happen (except as I described before where it is legally exempt ie. private laser eye surgery clinics, private cosmetic surgery clinics). However, it is an increasing (but rare still) phenonmena for the government to contract out private clinics to do specific technical functions (ie. provide after hour MRI's, etc), but typically the patient still does not pay.

 

Also, a GP or any other doctor for that matter can make a "profit" for those services which are not covered under the negotiated fee schedule. I imagine *some* doctors make serious cash this way.

 

For example, I often vacation in the summer very close to the American border and I had to pop in to the local hospital one day. The "non-insured" service fees were clearly posted because it turns out that tonnes of american tourists end up in wee accidents and mishaps on vacation in that area every year and have to pay out of pocket. Bizarrely, I too had to pay out of pocket when, having been out of Canada for 11 months, my health card expired and I had to pay $250!!!!!!!upfront.

 

Anyways, bottomline is that I understand the confusion surrounding the public/private dualism. Look at it this way: public refers to payment (typically) whereas private refers to the practice (typically) or in other words public funding for private delivery. There are VERY few publicly owned and operated facilities in Canada; most are publicly funded but not publicly operated. I hope that clears things up a wee bit, further to Monkster's well-stated fiscal explanation!

 

I am VERY informed on this topic, having taken a Canadian public health policy course (and enjoyed it and did well) so if you have any further questions just ask me (or any other posters)!

 

On an "operational/fiscal/office level" Mayflower (Peter) may also be of some assistance, whereas I will likely be of more help on the policy level.

[Guest lots of thinking]

Thanks so much macdaddyeh,

that does help alot. that sounds like a great course, especially right now with the state of Canadian Health Care so up in the air!!

So can you clarify a bit more for me.

OK- so

1)there is the public medicare system (no explanantion necessary)

2)there are privately owned clinics (i.e. day surgery's, MRI, CT's... and things along those lines) that are privately run and operated. These clinics, if they offer services that are covered under medicare, are contracted out by the government in order to reduce waiting times and such in the public system. SO, in this situation do the patients have to pay up front?? OR does it work the same as in the public system? SO, this would be a private not for profit, right??

3) there are privately owned clinics (although I don't know if any of these exist except for things like lazer surgery and cosmetics "stuff", and here if these services are not covered under the public system, patients pay for everything?????

 

So, am I somewhat on the right track?? Can you fill in any blanks for me that I'm just not thinking of??

 

One last question, in the private not for profit clinics, how do the docs get paid???? IN this situation, wouldn't that solve the problem of a disparity between docs in the public system and docs in private clinics since they are not making a profit off their patients????

 

thanks so much,

this is totally helping!!!!

M