The Medical Services Plan of British Columbia (MSP) is a government-administered, single-payer health insurance in the Canadian province of British Columbia, operating under the auspices of the country's national Medicare program. Under the Canadian constitution, provinces are responsible for the delivery of health care, while the national Canada Health Act ensures access to universal health care for all citizens of the country.
The plan covers medically required services provided by a physician enrolled with MSP; maternity care provided by a physician or a midwife; medically required eye examinations provided by an ophthalmologist or optometrist; diagnostic services, including x-rays and laboratory services, provided at approved diagnostic facilities, when ordered by a registered physician, midwife, podiatrist, dental surgeon or oral surgeon; dental and oral surgery, when medically required to be performed in hospital; and orthodontic services related to severe congenital facial abnormalities.
MSP claims processing system is integrated with a web-based telecommunications system, Teleplan. Teleplan is used by practitioners to securely submit their claims, notes and eligibility requests to MSP from over 4,200 computer sites and receive payment statements, rejected claims and patient eligibility data from MSP through an encrypted Internet connection. Teleplan receives and processes over 5 million claims monthly, valued at approximately $116 million. Approximately 95% of all claims are processed within 30 days, with the majority being paid within 14 days. Billing software is developed for these sites by over 80 software vendors who are registered with MSP. An association called Medical Software Vendors Association (MSVA) is formed by the major vendors to work with MSP for ongoing specifications and method changes. Teleplan was started in late 1980s, went through many specifications and technological changes and is MSP's main gateway of medical claim information.
As of April 2005, Health Insurance BC is the new name for administrative operations of the Medical Services Plan (MSP) and PharmaCare, including Fair PharmaCare.
On 16 September 2016, Michael de Jong, Minister of Finance for British Columbia announced that the government will spend $500 million on housing affordability, while also canceling the planned increase in MSP premiums and possibly increase Welfare rates. [1]
From 2023 it is proposed to move to a new payment model and away from the fee-for-service model for family doctors. There will also be a province-wide database for British Columbians to be matched with a GP. It is expected that doctors will then earn $385,000, up from an average of $250,000. [2]
Medicare is an unofficial designation used to refer to the publicly funded single-payer healthcare system of Canada. Canada's health care system consists of 13 provincial and territorial health insurance plans, which provide universal healthcare coverage to Canadian citizens, permanent residents, and depending on the province or territory, certain temporary residents. The systems are individually administered on a provincial or territorial basis, within guidelines set by the federal government. The formal terminology for the insurance system is provided by the Canada Health Act and the health insurance legislation of the individual provinces and territories.
The Canada Health Act, adopted in 1984, is the federal legislation in Canada for publicly-funded health insurance, commonly called "medicare", and sets out the primary objective of Canadian healthcare policy.
Primary care is a model of health care that supports first-contact, accessible, continuous, comprehensive and coordinated person-focused care. It aims to optimise population health and reduce disparities across the population by ensuring that subgroups have equal access to services.
Healthcare in Canada is delivered through the provincial and territorial systems of publicly funded health care, informally called Medicare. It is guided by the provisions of the Canada Health Act of 1984, and is universal. The 2002 Royal Commission, known as the Romanow Report, revealed that Canadians consider universal access to publicly funded health services as a "fundamental value that ensures national health care insurance for everyone wherever they live in the country."
Medical billing is a payment practice within the United States healthcare system. The process involves the systematic submission and processing of healthcare claims for reimbursement. Once the services are provided, the healthcare provider creates a detailed record of the patient's visit, including the diagnoses, procedures performed, and any medications prescribed. This information is translated into standardized codes using the appropriate coding system, such as ICD-10-CM or Current Procedural Terminology codes—this part of the process is known as medical coding. These coded records are submitted by medical billing to the health insurance company or the payer, along with the patient's demographic and insurance information. Most insurance companies use a similar process, whether they are private companies or government sponsored programs. The insurance company reviews the claim, verifying the medical necessity and coverage eligibility based on the patient's insurance plan. If the claim is approved, the insurance company processes the payment, either directly to the healthcare provider or as a reimbursement to the patient. The healthcare provider may need to following up on and appealing claims.
Allied health professions (AHPs) are a category of health professionals that provide a range of diagnostic, preventive, therapeutic, and rehabilitative services in connection with health care. While there is no international standard for defining the diversity of allied health professions, they are typically considered those which are distinct from the fields of medicine, nursing and dentistry.
IMS Health was an American company that provided information, services and technology for the healthcare industry. IMS stood for Intercontinental Medical Statistics. It was the largest vendor of U.S. physician prescribing data. IMS Health was founded in 1954 by Bill Frohlich and David Dubow with Arthur Sackler having a hidden ownership stake. In 2010, IMS Health was taken private by TPG Capital, CPP Investment Board and Leonard Green & Partners. The company went public on April 4, 2014, and began trading on the NYSE under the symbol IMS. IMS Health was headquartered in Danbury, Connecticut.
Hospitals in Canada were initially places which cared for the poor as those with higher socioeconomic status were cared for at home. In Quebec during the 18th century, a series of charitable institutions, many set up by Catholic religious orders, provided such care.
Brian Day, is an orthopedic surgeon and health researcher in Canada, a past president of the Canadian Medical Association, and a prominent sometimes controversial advocate for privatization of Canada's health system.
A Health and welfare trust (HAWT) or Health and welfare plan (HAWP) is a tax-free vehicle for financing a corporation's healthcare costs for their employees. They were introduced in 1986 by Canada Revenue Agency (CRA) in their interpretation bulletin entitled IT-85R2. Many companies offer this product to Canadian employers.
A Private Health Services Plan in Canada is Health and/or Dental Care, as part of an insured Group Insurance Plan or a self-insured plan, such as a Health Spending Account, Cost-Plus Plan or one of the three options under a Health and Welfare Trust.
Healthcare in Israel is universal and participation in a medical insurance plan is compulsory. All Israeli residents are entitled to basic health care as a fundamental right. The Israeli healthcare system is based on the National Health Insurance Law of 1995, which mandates all citizens resident in the country to join one of four official health insurance organizations, known as Kupat Holim which are run as not-for-profit organizations and are prohibited by law from denying any Israeli resident membership. Israelis can increase their medical coverage and improve their options by purchasing private health insurance. In a survey of 48 countries in 2013, Israel's health system was ranked fourth in the world in terms of efficiency, and in 2014 it ranked seventh out of 51. In 2020, Israel's health system was ranked third most efficient in the world. In 2015, Israel was ranked sixth-healthiest country in the world by Bloomberg rankings and ranked eighth in terms of life expectancy.
The Saskatchewan doctors' strike was a 23-day labour action exercised by medical doctors in 1962 in the Canadian province of Saskatchewan in an attempt to force the Co-operative Commonwealth Federation government of Saskatchewan to drop its program of universal medical insurance. The strike was from July 1, the day the Saskatchewan Medical Care Insurance Act took force, to July 23.
Doctors of BC, formally known as the British Columbia Medical Association (BCMA), is a professional organization that represents 16,000 physicians, medical residents and medical students in the province of British Columbia. Its goals are to promote a social, economic, and political climate in which members can provide the citizens of BC with the highest standard of health care, while achieving maximum professional satisfaction and fair economic reward. Membership is voluntary.
Balance billing, sometimes called surprise billing, is a medical bill from a healthcare provider billing a patient for the difference between the total cost of services being charged and the amount the insurance pays. It is a pervasive practice in the United States with providers who are out of network, and therefore not subject to the rates or terms of providers who are in-network. Balance billing has a variable prevalence by market and specialty.
The Hospital Insurance and Diagnostic Services Act is a statute passed by the Parliament of Canada in 1957 that reimbursed one-half of provincial and territorial costs for hospital and diagnostic services administered under provincial and territorial health insurance programs. Originally implemented on July 1, 1958, with five participating provinces, by January 1, 1961, all ten provinces were enlisted. The federal funding was coupled with terms and conditions borrowed from the Saskatchewan Hospital Services Plan, introduced in 1947 as the first universal hospital insurance program in North America. In order to receive funding, services had to be universal, comprehensive, accessible and portable. This stipulation was dropped in 1977 with the Established Programs Financing Act and then reinstated in 1984 in the Canada Health Act. Widely acknowledged as the foundation for future developments in the Canadian health care system, the HIDS Act was a landmark example of federal-provincial cooperation in post-war Canada.
A midwife is a health professional who cares for mothers and newborns around childbirth, a specialization known as midwifery.
The College of Physicians and Surgeons of British Columbia is a regulatory college which regulates the practice of medicine in British Columbia. The primary function of the college is to ensure that physicians are qualified, competent and fit to practise medicine. The college administers processes for responding to complaints from patients and for taking action if a physician is practising in a manner that is incompetent, unethical or illegal.
Physicians and surgeons play an important role in the provision of health care in Canada. They are responsible for the promotion, maintenance, and restoration of health through the study, diagnosis, prognosis, and treatment of disease, injury, and other physical and mental impairments. As Canadian medical schools solely offer the Doctor of Medicine (M.D.) or Doctor of Medicine and Master of Surgery degrees, these represent the degrees held by the vast majority of physicians and surgeons in Canada, though some have a Doctor of Osteopathic Medicine (D.O.) from the United States or Bachelor of Medicine, Bachelor of Surgery from Europe.
Friends of Medicare is Canadian non-profit organization that advocates for the Canadian universal public health system. The group was founded in September 1979 in Edmonton, Alberta. Friends of Medicare is a coalition of many individuals and organizations, from physicians to patients, seniors’ organizations, cultural and community groups, and labour unions. It has played a role in defending the principles of Canada's universal public health system both in Alberta and nationally.