RE-MINDING OUR PS AND QS - MEDICAL COST CONTROLS IN CANADA

During the past few years the landscape of Canadian physician reimburs ement policy has undergone dramatic change. Rapidly eroding fiscal env ironments for provincial (and federal) governments have forced provinc es to ''get serious'' about controlling a significant, previously unco ntrolled, budget line: physician expenditures. All provinces now impos e medical expenditure caps, with eight of these being hard caps under which any overruns are the responsibility of the profession. In additi on, policies in five provinces now include individual income caps. One of the effects of this new environment has been a rush to adopt suppl y-control policies. This paper explores a number of other side effects , such as heightened interest in alternative methods of payment, as we ll as the emergence of, and difficulties for, joint province/medical a ssociation management committees.