da pickle wrote:
> On 3/25/2017 3:14 AM, Dutch wrote:
>
>> All this talk about healthcare prompted me to do a little digging.
>>
>> Last year the U.S. government spent $592 billion on Medicare, Medicaid
>> $309 billion, Subsidies $51 billion, Children's health $15 billion,
>> divided into 242 million taxpayers that's $4000 each. Then you pay for
>> your own health insurance, that's what, about $6000 a year?
>>
>> In 2016 Canada spent $6300 per person on healthcare. That's full no
>> deductible top notch coverage for every citizen.
>
>
> I tried a little digging too ... I cannot find how the "fees" of
> individual doctors are "set" under the Canadian system. Are doctors
> free to charge any amount that they want for a particular "service"?
No, the fees are set by healthcare administrators.
Are
> all doctors somehow "required" to charge a specific amount for a
> specific service? If so, who sets the amount and does it apply to each
> and every doctor?
Yes, afaik. There are a few specialized clinics set up outside the
system that are basically illegal, but they operate anyway with an
apparent nudge and wink from the government.
>
> From what I read, it appears that the Canadian system is a FFS system
> (fee for service) and that encourages doctors to perform additional
> unnecessary services so they get paid more
I don't see why that tendency would depend on through what mechanism the
doctor is getting paid. I'm sure padding happens everywhere.
and the "folks in charge" (I
> am not sure exactly who is in charge) want to try and get more in
> control of exactly what should be done and what to charge for it.
I would imagine that any insurance provider is concerned about milking
of fees.
There
> does not appear to be any "difference" between similarly situated
> doctors ... a doctor is a doctor ... a "specialist" is a "specialist
The amount varies based on doctors’ specialties; family physicians make
about $271,000 while medical specialists make about $338,000 and
surgical specialists earn $446,000.
...
> everyone gets paid under the same rules for the same service. How about
> in the city verses the country? Is there any difference due to cost of
> living?
There are incentives provided for doctors willing to work in certain
less desirable areas.
> Are different "specialists" paid at a different rate than other
> doctors in the same "specialty"? Does the same person or committee
> determine the pay for each and every specialty?
>
> It appears that this is very complicated and who determines how much the
> person or committee members make that determines how much the doctors
> and specialists make?
It doesn't seem that complicated to me, and I do not think you've shown
it is. What is complicated is millions of patients with thousands of
completely different insurance policies.
> There appear to be rules in each Provence about how many days a year you
> must actually live in that Provence to be "covered"? How does that work
> for people that live in more than one Provence from time to time?
Coverage is portable across the country. My provincial plan covers me
everywhere in Canada. If I move to another province I switch to their plan.
It
> appears that the people above making the determination of how much each
> sort of doctor makes for each sort of procedure or service varies from
> Provence to Provence ... and those people making those decisions have
> their pay determined likely from the central government perhaps?
It varies somewhat, yes, but not a whole lot.
>
> Can you visit a doctor in another Provence? Does your Provence pay that
> doctor or does the doctor's Provence pay him or her?
See above.
>
> Can any doctor choose any Provence to practice?
Yes.
>
> I would also ask about hospitals with the same sorts of questions, but
> that might be an entirely different system. Just one ... must all
> hospitals allow all doctors to practice in there hospital or can they
> certify some doctors and not others?
The hospital decides how many doctors they need, which type, and which
applicants to hire.
Your curiosity seems fishy. What are you getting at?