Flood C M, Archibald T
Faculty of Law, University of Toronto, Toronto, Ont.
CMAJ. 2001 Mar 20;164(6):825-30.
We addressed the question of whether private health care is illegal in Canada by surveying the health insurance legislation of all 10 provinces. Our survey revealed multiple layers of regulation that seem to have as their primary objective preventing the public sector from subsidizing the private sector, as opposed to rendering privately funded practice illegal. Private insurance for medically necessary hospital and physician services is illegal in only 6 of the 10 provinces. Nonetheless, a significant private sector has not developed in any of the 4 provinces that do permit private insurance coverage. The absence of a significant private sector is probably best explained by the prohibitions on the subsidy of private practice by public plans, measures that prevent physicians from topping up their public sector incomes with private fees.
我们通过调查加拿大所有10个省份的医疗保险立法,探讨了加拿大私立医疗保健是否违法这一问题。我们的调查揭示了多层监管,其主要目的似乎是防止公共部门补贴私营部门,而非使私人资助的医疗行为违法。在10个省份中,只有6个省份规定,为必要的医院和医生服务购买私人保险是违法的。尽管如此,在允许私人保险覆盖的4个省份中,均未形成规模可观的私营部门。公共计划禁止补贴私人医疗行为,这些措施防止医生用私人诊疗费来增加其在公共部门的收入,这很可能是私营部门未得到显著发展的最佳解释。