Fee controls as cost control: tales from the frozen North.
Uniform and binding fee schedules for physicians have been advanced as a cost-control strategy that can also improve patient access to care, as well as spread costs more equitably. Counter-arguments, however, predict very different effects on utilization and costs. Empirical evidence to challenge economic theories of physician behavior may be drawn from Canada. The experience of innovative policies of two provinces--within a national framework--emphasizes a multipronged approach to fees, practice patterns, and numbers of physicians; political will and ongoing negotiations are necessary.
D001955:British Columbia; D002170:Canada; D003363:Cost Control / Q000379:methods*; D005245:Fee Schedules / Q000331:legislation & jurisprudence*; D005102:Health Expenditures / Q000706:statistics & numerical data; D007350:Insurance, Hospitalization / Q000331:legislation & jurisprudence; D007357:Insurance, Physician Services / Q000331:legislation & jurisprudence*; D009313:National Health Programs / Q000191:economics*; D011792:Quebec; D014481:United States