Barer M L, Lomas J, Sanmartin C
Health Aff (Millwood). 1996 Summer;15(2):216-34. doi: 10.1377/hlthaff.15.2.216.
During the past few years the landscape of Canadian physician reimbursement policy has undergone dramatic change. Rapidly eroding fiscal environments for provincial (and federal) governments have forced provinces to "get serious" about controlling a significant, previously uncontrolled, budget line: physician expenditures. All provinces now impose medical expenditure caps, with eight of these being hard caps under which any overruns are the responsibility of the profession. In addition, policies in five provinces now include individual income caps. One of the effects of this new environment has been a rush to adopt supply-control policies. This paper explores a number of other side effects, such as heightened interest in alternative methods of payment, as well as the emergence of, and difficulties for, joint province/medical association management committees.
在过去几年里，加拿大医生报销政策格局发生了巨大变化。省级（以及联邦）政府财政环境迅速恶化，迫使各省“认真对待”控制一项重要的、此前未受控制的预算项目：医生支出。现在所有省份都实施了医疗支出上限，其中八个是严格上限，超出部分由行业自行负责。此外，五个省份的政策现在还包括个人收入上限。这种新环境的一个影响是纷纷采用供应控制政策。本文探讨了一些其他副作用，比如对替代支付方式的兴趣增加，以及省/医学协会联合管理委员会的出现及其面临的困难。
