At 12:31 PM 9/8/96 -0400, you wrote:
>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.
Currently there are no "caps" on our earnings under the Australian
fee-for-service system. To curtail expenditure for these items the Dept of
Health has recently reduced the rebate on some items (ECGs, Excisions of
tumours, Acupuncture) to make them less palatable. Personally, I think a
co-payment scheme would have curbed demand and government expenditure
without reducing our income (and therefore quality of life, job satisfaction
etc). Currently our patients in this practice pay not one cent for a
consultation, and because of this there are a number who frequently present
for trivial medical problems. I'm sure that if they had to pay $AUS 5.00
(the cost of a packet of cigarettes here), we wouldn't have the frequency of
trivial presentations that we do. The other sensible cost-saving device for
our government would be patient registration with a particular GP/FP because
another small cache of frequent attenders go "doctor-shopping" amongst a
number of GPs either for Narcotics/Benzodiazepines/or even until they get
that antibiotic that they know they MUST have for their viral URTI/URI.
However, the government doesn't seem to listen to us. Sound familiar?
Just my 2 cents/ 1 P worth...
Regards, Chris Collins :)
>
>Bob Frankford
>Toronto
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Dr Christopher T.G. Collins, M.B.B.S. F.R.A.C.G.P. Voice (wk) +61 74 957077
General Practitioner/Family Physician, Fax (wk) +61 74 957151
Caboolture 7 Day Medical Centre, Voice(hm) +61 73 3503009
King St, Caboolture QLD 4510 Email [log in to unmask]
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