Jacques Chaoulli |
A new private healthcare brokerage,
the first of its kind in Canada, officially opened for
business October 10 in Montreal amidst bold declarations
of healthcare reform and a cloud of controversy.
The Chaoulli Group is the brainchild
of Dr Jacques Chaoulli, whose case against the Quebec
government in the Supreme Court of Canada in 2005 resulted
in the repeal last year of Quebec's ban of private health
insurance for services covered by medicare. Now, Dr
Chaoulli is putting his two-tier ideas into practice
with his eponymous organization.
For $150 a year (discounts are
available for families) members can call or email the
Chaoulli Group when they need a doctor. The Group refers
them to a physician who has made a deal with the Chaoulli
Group to provide care outside the public system.
Patients pay physicians directly
(the fees are negotiated between the doctor and patient).
But in some cases, Dr Chaoulli claims, physicians will
be able to bill the public insurance plan for the visit
as well. Dr Chaoulli says a clause in the province's
Health Insurance Act permits this double-billing, though
some legal experts have challenged his interpretation.
The crux of the plan is Dr Chaoulli's
requirement that doctors in the public system who join
his roster must promise not to reduce their public-system
workload.
The plan also offers a 24-hour
info-health telephone line, access to an emergency helicopter
ambulance service and access to the emergency room at
a private hospital in Plattsburgh, NY, just minutes
over the Quebec border. The latter two services are
not included in the $150 fee.
Quebec health minister Philippe
Couillard hasn't made a ruling on Dr Chaoulli's plan,
but ministry officials admit medical brokering is a
"grey zone."
Dr Chaoulli told reporters at a
press conference in Montreal on October 10 he doesn't
anticipate being shut down. "I believe this is in the
interests of the government, what I am doing. I believe
it is in the interest of all Quebecers. It will help
to reduce the waiting time in the public system, so
I don't see why the government will oppose that."
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