HEALTHCARE ECONOMIC REALITY CHECK:
- Supply is limited (it is a service & commodity that is rendered by others)
- Demand is inexhaustible (innumerable definitions of healthcare needs and wants)
- Fixing prices exacerbates shortages (resources flow to where they are valued)
This article instantiates the snares and trappings of gov’t financed systems where gov’t functions as a buyer, payer and regulator!
In the case of this Alberta Canada conundrum, cutting fees is a surrogate for rationing. It encourages providers to short-cut care by reducing time spent with complex patients. The dangerous flip side of that ugly coin is that the cuts encourage emphasis on increasing the number of shorter visits.
Last fall, Premier Jason Kenney’s United Conservatives passed Bill 21, which gives the government the right to unilaterally end the agreement.
A decade ago, Alberta added in an extra fee — called a complex modifier — to recognize that some patients have multiple or complex issues and doctors should be compensated for overly long visits.
If a visit went more than 15 minutes, doctors were able to extend it 10 minutes and bill the province a complex modifier fee of $18, for a total of $59.
As of April 1, the fee will be halved from $18 to $9, for a new total fee of $50.
As of April 1, 2021, the $18 complex modifier will return. But physicians won’t be allowed to bill for it until the 25-minute mark.
Doctors warn of cutting visits
Shandro’s ministry says the change is necessary for two reasons: more time is needed to assess complex patients and the current complex modifier is being abused, with too many doctors billing the $59 right at the 15-minute mark.
At a news conference announcing the changes, Shandro said the modifier was being used for almost 50 per cent of visits.
The Alberta Medical Association, the bargaining arm for doctors, has said extending the length of a visit to 25 minutes would reduce fees by a total of $200 million and devastate many family and rural practices.
The AMA has argued the complex modifiers are not only for exceptional cases and take into account all the work — preparation, follow-up and face-to-face time — needed for patients with complex needs. It also says it keeps those patients out of the hospital.
The issue has riled up some doctors, many of whom have put up signs warning patients they may have to cut future visits short to recoup funds needed to keep their practices going.