(Quebec) The Régie de l’assurance santé du Québec (RAMQ) has given the green light to a draft regulation from the Minister of Health, Christian Dubé, to limit the coming and going of doctors between the public and private sectors , where patients are willing to pay thousands of dollars to have surgery and avoid waiting lists.
What there is to know
More and more doctors are commuting between the public and private sectors.
In the private sector, they operate on patients who are willing to pay thousands of dollars to avoid waiting in public.
Quebec has prepared a draft regulation to slow down this back and forth.
The RAMQ gave the green light to this project which the government has not yet officially adopted.
The Press obtained the agenda for a meeting of the RAMQ board of directors held on February 21, following a request for access to information. The document reveals that there was discussion of a “draft regulation amending the Regulations implementing the Health Insurance Law (RALAM) to restrict the possibilities of alternation between the status of participating and non-participating doctor” in the public plan. Three sources confirmed that the board of directors had approved the minister’s draft regulations.
Christian Dubé is still considering this draft regulation, his office responds. It is not yet at the stage of presenting it to the Council of Ministers for final adoption.
The Press revealed last month that the government was considering tightening the rules allowing doctors to commute between the public and private systems, a growing phenomenon.
Over the past 10 months, 137 doctors have temporarily left the public system more than once to work in the private sector. This is twice as much as five years ago. The phenomenon is up 10% compared to the whole of 2022-2023. These are mainly specialist doctors (133), especially orthopedists and radiologists.
It was added that the government plans to extend the deadline for disaffiliating with RAMQ from 30 to 180 days – approximately six months. Such an extension of the notice period would prevent any doctor from jumping the fence several times a year.
Currently, to leave the public plan, a doctor only has to send a notice to the RAMQ and wait 30 days. After this one-month period, he becomes “non-participant” in the public system and can begin practicing in the private sector. To become a “participant” in the public plan again, simply send a new notice to the state corporation, and the doctor can resume public practice eight days later.
Christian Dubé had not given an interview to The Press on the subject, but his office had confirmed that reflection was underway to slow down the back and forth.
“The question of in and out, the doctors who walk around (between the public and the private sector), (…) we are looking at (it), affirmed the minister during a debate in a parliamentary committee last week. “There is one thing that is clear: the four parties here have the same objective, which is to protect our public system and ensure that Quebecers are able to receive free care. »
Note that in an interview on 98.5 FM a week after the RAMQ board of directors meeting and the day after the revelations of The Press, the minister responded in the negative when asked if he had “placed an order with the RAMQ to put in place measures to prevent doctors from commuting.” He added: “I don’t know if they are working on that. »
He deplored the fact that patients had to pay thousands of dollars to the private sector to be able to undergo an operation due to waiting times in the public network. And he said he understood the frustration of specialist doctors who are given little time to carry out operations at the hospital, particularly due to the lack of nurses and technical platforms. This situation leads them to offer their services privately, at a high price for the patient.
The minister wants to make greater use of private clinics to carry out operations which would be paid for by the State – therefore covered by RAMQ – and not by the patient.
Last year, the College of Physicians recommended to the minister to tighten the regulations “in order to ensure truly universal and accessible care”.
“The rules allowing alternation between public and private plans must be strengthened to prevent a doctor from being able to offer the same service almost simultaneously to the public and the private sector, and thus creating situations of two-speed medicine,” we can say. read in a memorandum sent to Quebec as part of the consultations on the Dubé reform.
The College adds that “this alternation between the public and the private sector also has an impact on the availability of professional resources within public establishments”, with the growth of the private sector draining the public workforce.
reference: www.lapresse.ca