In Ontario the government system is budgeted to pay $3.8 billion for doctors
(specialists and GPs). Since the payment of doctors is predominantly fee
for service, this means that the government can only make things work by
forcing caps on physician incomes (i.e. only paying a percentage of billings
above a certain net $ figure) and clawbacks (i.e. paying a reduced
percentage of each claim to keep within budget.
I would be interested to know whether anything similar exists elsewhere,
particularly in countries where fee for service is the predominant mechanism
within a government system. Australia for instance.
Bob Frankford
Toronto
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