Quebec plans to table a bill to prohibit insurance companies from requiring a medical prescription for reimbursement of technical aids, such as a cane or compression stockings. He also wants to reduce the number of visits to the doctor that are imposed on policyholders receiving disability benefits. In doing so, the government estimates it will be able to recover 500,000 appointments per year. The Canadian Life and Health Insurance Association says it is “favorable” to the bill, but believes that “exceptions” must be provided for.
The Minister of Health, Christian Dubé, and the Minister of Labor, Jean Boulet, confirmed their intention to tighten the screws on insurance companies during a press scrum at the National Assembly on Wednesday. “Above all, we want to avoid abuse and reduce paperwork,” said Jean Boulet. The goal is to improve access [à un médecin de famille] “.
According to him, “all the time” visits to the doctor are not necessary for a burnout person receiving disability benefits. “Someone who has a fracture and the doctor tells them: ‘It won’t be healed for two months or three months,’ don’t ask them to go see the doctor in two weeks or every three weeks “, he added.
“Paperwork” takes up approximately 25% of family doctors’ time. To reduce it, the government announced in February that doctors will no longer have to complete a form for requests for long-term care accommodation, a document already completed by a social worker or physiotherapist. From now on, doctors will determine themselves when a follow-up appointment must be made with patients compensated by the Commission for Standards, Equity, Health and Safety at Work (CNESST).
In a press scrum on Wednesday, Jean Boulet repeated that “the frequency and relevance” of medical consultations for insured persons will be a matter of “the clinical judgment of doctors”.
Thanks to this measure, Christian Dubé calculates that 500,000 additional medical appointments per year could be offered to the population. “There are approximately four million Quebecers who have a private insurer,” he said. There are already 90% of insurance companies that do not require these appointments. Put 10% of four million, you already have 400,000 appointments once a year for this kind of thing. And that doesn’t include instruments, canes, etc. »
Asked about the possible increase in insurance premiums in reaction to this measure, Jean Boulet replied that he “could not give a guarantee” to policyholders that there would be no increase. “Is it possible that there will be an impact? I am not in a position to evaluate,” he said, specifying that insurance companies were consulted for this future bill.
Insurers react
Asked to react, the Canadian Life and Health Insurance Association (CLHIA) states that it is “in favor of reducing administrative paperwork for doctors.” “In clear cases of physical problems such as a fracture, in reality, already, the insurer does not ask the patient to go see their doctor every two weeks,” says the president of the Quebec section of the CLHIA, Lyne Duhaime. “That’s already the practice. For this aspect, we are not very worried. »
But the CLHIA believes that the future bill will have to include “some exceptions”, particularly with regard to the coverage of medical devices. A medical prescription should then remain required. ” Of course [quand] we are talking about a cane or crutches, there are not too many concerns, says Lyne Duhaime. There is no one who goes out and buys crutches or rents them when they don’t need them. »
“On the other hand, there are other expensive products where it could potentially be abused. For example, very expensive orthotics or beds intended for people with serious health problems. »
The CLHIA believes that “certain means of control” must be kept in place. “The objective is to eliminate low-value appointments without increasing group insurance premiums,” thinks M.me Duhaime. If people remain on disability “much longer than in the past because there are no longer any means of control,” she continues, “of course that would have an increasing effect on insurance premiums. “.
“A step in the right direction”
The Federation of General Practitioners of Quebec (FMOQ) judges that putting an end to the requirement for “certain medical notes by insurance companies is a step in the right direction.” “However, the government should take a further step by notably and clearly prohibiting insurance companies from requiring medical notes for absences of less than five days,” writes the union on the social network X.
1/3 A possible bill to end the requirement of certain medical notes by insurance companies is a step in the right direction.#polqc
— Family doctors (@FMOQ) May 8, 2024
The FMOQ also says it “questions” “the 500,000 appointments allegedly freed up by this measure”. “This figure seems exaggerated to us at first glance, and we are waiting for the minister to explain his methodology,” adds the Federation.
In the press scrum on Wednesday, Minister Christian Dubé was delighted to be able to eliminate unnecessary appointments. However, he clarified that it was also necessary to work on the “offer” of consultations by doctors. The minister will have access to their data from May 23, the date Bill 11 comes into force.