246 more Québec doctors leave public health care system, bringing the total to about 880
One of Canada’s top health care reporters, award-winning Aaron Derfel of the Montreal Gazette, has a new story showing that three months after a new law was passed it appears to have failed to stop doctors from leaving the public sector.
In spite of Law 83, 246 more doctors were authorized to leave public practice.
These new numbers published by Derfel are from the Régie de l’assurance maladie du Québec (RAMQ), the provincial Medicare board.
Bill 83 is focused on stopping newly graduated doctors from opting out of the public system for the first five years after graduation, or risk paying a fine of up to $200,000 a day. It did not address the issue of Quebec’s health care law that allows three categories of doctors: those who work solely in the public sector, those who go back and forth between the public and private sectors, and those who are “opted out” and work only in the private for profit sector.
Fewer than 20 doctors have opted out of Medicare in the rest of Canada.
The Canadian Health Coalition appeared virtually before Québec’s National Assembly’s Health Committee on February 11, 2025, to voice concerns about the numbers of Québec doctors opting out, and the importance of closing the loophole that allows so many Quebec doctors to simply bill patients directly.
Pro-medicare physicians such as Dr. Xavier Gauvreau, Vice-President of Médecins Québécois pour le regime public (MQRP) who also appeared before the Committee say it looks like many new family physicians left the public system in anticipation of Bill 83’s adoption.
“It’s alarming,” Dr Gauvreau told the Gazette. “We’ve just busted the five per cent mark of family physicians practicing completely in the private sector… the options that the government chose to limit the number of physicians opting out are not strong enough.”
In total, the number of general practitioners in Quebec who have become “non-participants” has surged to 561 as of July 11, the latest date for which complete figures are available. That compares with 509 in July 2024, an increase of 10.2 per cent in a year. More than half a million Quebecers do not have a GP.
The greatest number who have gone private are anesthesiologists at 54 (out of 794 in total), putting huge pressure on hospitals with a backlog of urgent and elective surgeries.
The Canada Health Act (CHA) forbids doctors from charging patients user fees. In March 2023, Health Canada fined Quebec nearly $42 million — a record and by far the highest of any province — for allowing patients to be charged illegally out of pocket for “medically necessary diagnostic services” that should be covered under medicare.
Health Canada’s latest annual report on the state of the Canada Health Act is silent on the flight of physicians to the private sector.
Jennifer Goodyer, Executive Director of the Canada Health Act Division, and Lee Whitman, Assistant Director of the Compliance Unit of the Canada Health Act Division said during a recent webinar organized by the Canadian Health Coalition about the Canada Health Act that Health Canada is aware of what is going on with Quebec doctors. Watch here, starting at 36:02.
Whitman also mentioned that people can complain to the province and to Health Canada and that their concerns are taken seriously (at 54:55).
Most recently the Ontario Health Coalition has pushed ahead on 50 complaints about upselling and privatization of cataract surgery.
In general citizens and tax payers are encouraged to use their voices to speak up.
