🚀 go-pugleaf

buckland@ucs.ubc.ca (Tony Buckland) writes:

> How is the capping of fees paid to doctors actually implemented?
> What reports I've heard indicate that it isn't done by telling
> the individual doctor, "Sorry, you've spent your limit for the
> year," but is done on some kind of "overall" basis.  But what kind,
> I can't discover.  So many dollars for a specialty?  For a city
> or region?  For the whole province?  And, if on anything other
> than an individual basis, how is the capping made to happen?
> By turning back claims?  By demanding repayment of claims already
> paid?  By issuing orders (enforced how?) to doctors or to labs
> not to do any more (of certain things? of anything?)

I thought it was set at x$ per GP and y$ for every specialist.

It was my understanding that the capping for specialists will cause
the most problem because there are so few of them that if one goes
over his cap you won't get into anothers office very easily.

Also, specialists probably have no problem going to the US and making
a lot more money.

I think enforcement will just mean that Doctors will only get paid for
claims up to the cap.

Without careful management, there might be a lot of empty Doctors
offices during the last month of the year. :)

I think the whole process is stupid.

BC should do what they did in Oregon and make up a list of Doctors
Procedures, order them by cost per life saved, and cut off the
extremely expensive procedures that cost way too much and spend more
money on the inexpensive procedures that save a lot of lives or illness.