Quebec is unique. Family doctors can opt out of medicare. In Quebec the provincial payor is RAMQ.

We just got the list with all those doctors who have opted out of medicare in Quebec.

The list that we got has about 700 doctors who have opted out. There are about 8,700 family doctors in Quebec.

And because these doctors have opted out, they can charge patients privately.

Doctors who have opted out of the province’s public health insurance plan, the Régie de l’assurance maladie du Québec (RAMQ), are free to

set their own fees for medical services. These fees are not regulated by the RAMQ, and they are usually higher than the fees charged by

doctors who participate in the public insurance plan.

For example,  a primary care doctor in Quebec might charge $100 to $150 for an office visit.

A primary care doctor in Ontario might get $35  for the same office visit from OHIP which is the provincial payor in Ontario.

Recently, we tried to help a patient in Montreal to get access to primary care. We found the majority of the doctors in RAMQ

were not accepting new patients.  The private opted out primary care doctors would likely have had room in their practices for

new patients.  This is an example of market forces at work in primary care.

And Quebec might be a window into the future for primary care in other provinces.

Time will tell.