Nova Scotia doctors lobbied the provincial government to remove a provision in new legislation that would prevent public payment for medical services delivered outside the public health-care system, CBC News has learned.
"Doctors Nova Scotia tried unsuccessfully to remove the proposed provision," the lobby organization reported to members after the NDP government introduced the Insured Health Services Act last week.
"The association is concerned this would create a potential situation in which a patient may have to pay for an insured service."
The act is designed to protect a single tier, publicly funded health-care system. Section 38 of the act prevents patients from billing the public health-care system for medical services performed by a doctor who has opted out of the public MSI plan.
"We understand and we recognize they are concerned," Dave Wilson, the Minister of Health and Wellness, told CBC News.
Wilson confirmed he had been lobbied on the section but kept it in as a safeguard.
"We're not saying you can't go outside the system and get treatment. We agree that people may chose to do that. What we're saying is ensuring they can't come back to the publicly funded system and ask for reimbursement," he said.
"The current situation is that patient has the opportunity to come back to the province and seek reimbursement."
Legislation called 'visionary'
Doctors Nova Scotia downplayed its objection as a "philosophical" difference.
"We just felt it was unnecessary. Physicians have never opted out of the insured services program in Nova Scotia. We believe physicians and their patients are better served inside the insured services program," said Kevin Chapman, the director of health policy and promotion for Doctors Nova Scotia.
Chapman acknowledged the situation has come up in other provinces, including British Columbia where he said two dermatologists opted out in a dispute over fees.
"We have mechanisms within our agreement with government that address fee schedule issues," he said.
"The probability of a physician opting out because of that is very, very low, if non-existent."
Adrienne Silnicki, of the Council of Canadians, sees it differently.
"We see this as a visionary piece of legislation," Silnicki told CBC News.
"What we're not going to do is use public money to use private services to jump the queue."
Doctors Nova Scotia said it supports the legislation that was introduced — including Section 38. Bill 144 is currently before the Nova Scotia legislature.