Ontario’s Health Care Budget – Time to Cut the Fat?

The release of Ontario’s budget last week prompted comment from the president of the Ontario Medical Association, Dr. Ved Tandan, that the government’s policy of taking from the health care system to balance its budget is putting the healthcare system in jeopardy. Population growth and unmet needs for family doctors and other services are being ignored, he says. This is certainly an important and complex issue. That said, budgeting requires a careful look at unnecessary spending to determine where cuts can be made.
 http://otlablog.com/cut-the-fat/

Liberal health care plans a pipe dream

By Stephen Skyvington

Thursday, January 29, 2015 10:24:43 EST AM

 

 "There can be no justification for doctors turning away patients or rationing care. We don't believe Ontario's doctors would let that happen."

-- Dr. Eric Hoskins, Ontario's Minister of Health and Long-Term Care
So this is where it begins. The end of Ontario's health-care system as we know it. Going out, not with a bang, but a whimper.

For those who've been out of the country, or just plain hibernating, Kathleen Wynne's Liberal Government will--for the first time ever--impose a contract on the doctors of Ontario, instead of having negotiated one with the Ontario Medical Association, on the first of February.

The new deal--I hesitate to call it a "deal" because the doctors haven't agreed to any of this--will feature $580 million in cuts to healthcare spending, including a 2.65% reduction in payments to doctors. Funds previously earmarked for weekend coverage will also be chopped, as will funding for continuing education programs for doctors. There will also be a 1.70% reduction in the fees paid to doctors working in walk-in clinics.

As mentioned, all of this will come into effect on February 1, 2014, assuming ministry lawyers are able to finish dotting i's and crossing t's in time.
Rookie Health Minister Eric Hoskins--himself a doctor--has been particularly busy since talks broke down on January 15, visiting various media outlets in order to explain how he had no choice but to impose these cuts in order to counter the 61% raise in salary doctors have received over the past decade.
Doctors, of course, have received no such raise, but if there's one thing the Wynne Liberals have shown a propensity for, it's perpetrating the Big Lie. Which, in this case, is a doozy.

While it's true that the Liberal Government has dramatically increased the amount of money they've invested in the physician services budget since 2003, when they formed the government--going from approximately $7 billion in 2004 to $13 billion in 2014--it should be pointed out that the province of Ontario has 4,000 more doctors and 1.4 million more patients today than it did when the Liberals took over.

But that's only half the story.

The OHIP schedule of benefits, which is what all provincial governments here in Ontario use to determine what doctors are paid, and which is based upon the OMA's original schedule of fees, dating back to 1922, only covers 47% of the actual recommended fees.

You heard me right--47%. This means the Government of Ontario is paying doctors less than half of what the fee schedule says they should be paying. Forty years ago, that number was 90%. Quite a difference, wouldn't you agree?

But what's most galling for Ontario's 28,000 doctors is that the Wynne Liberals have chosen to punish them this time around, even after they helped the Liberals, if not exactly "fix" our healthcare system, then at least get it off life support. Thanks to the hard work and many sacrifices made by the province's physicians, one million fewer people are today without a doctor than in 2003.
And those waiting lists for hip replacements and cataract surgeries? Pretty much under control. Again, thanks to the investments made by the Liberals and the heroic efforts of our doctors.

But that was then, and this is now.

Thanks in no small part to boondoggles and scandals like eHealth, the ORNGE air ambulance fiasco, and the cancellation of the gas plants, the Wynne Liberals are about to go over a fiscal cliff unless they do something dramatic.

So, come the first of February, they'll be imposing a new contract--not just on doctors, mind you, but on all of us. For the reality is, by making all these cuts unilaterally, the Ontario Government is about to do something no other government has ever dared do in quite such a dramatic way--namely, ration healthcare.

Don't believe me? Here are just a few of the consequences we can expect, as a result of the Wynne Liberals risky and irresponsible move . . .

-- Every March 1, starting in 2016, doctors will be closing their practices until the first of April--when the new fiscal year begins--in order to avoid the inevitable clawbacks that government will impose for exceeding their healthcare allotment.

-- Surgeries will be cancelled or delayed, tests will not be run, and appointments with both family doctors and specialists will be harder to get in a timely fashion.
-- Even worse, can the day be far off when those over a certain age--say 70 or 75--are denied expensive medical care, and/or other interventions and investigations, simply because there isn't enough money to go around?

Sadly, this is what the future will, in all probability, look like. Thanks to the Wynne Liberals, who now own our healthcare system here in Ontario for the next three years, as a result of the contract they are imposing on our doctors, who thankfully had the good sense not to participate in this ridiculous charade.
My advice to everyone? Don't get sick. At least, not in Ontario.

Source:  http://www.saultstar.com/2015/01/29/liberal-health-care-plans-a-pipe-dream---column

NDP wants secret info on Ontario’s top billing doctors made public

January 22, 2015 3:29 pm

By Keith Leslie The Canadian Press

AP Photo/Cleveland Clinic, Janine Sot

TORONTO – Ontario’s New Democrats plan to introduce legislation next month to force the government to disclose the names of physicians who bill the province’s health insurance system and the amounts they charge each year.
There is “no valid reason” the province should not disclose the names of physicians and the amounts they bill OHIP, said NDP health critic France Gelinas.

“This is taxpayers’ money and the information should be made available to the people of Ontario, with the right disclaimer that we understand this is not the take-home pay,” Gelinas said in an interview. “It’s $11 billion of taxpayers’ money that is completely opaque right now. Nobody gets to see it, and that’s wrong.”

Figures show an ophthalmologist was the highest paid physician in Ontario in 2013, billing over $6 million, but the government will not reveal his or her name.
At least two other doctors charged OHIP over $4 million – and 28 billed over $2 million – but all the public can find out is that radiologists and cardiologists were the next highest billing physicians by speciality after the ophthalmologists.

After contract talks with the Ontario Medical Association broke off last week, Health Minister Eric Hoskins said there were 400 doctors who billed over $1 million last year, but he wouldn’t say who they are or where they work.

Most doctors are not covered by Ontario’s so-called sunshine list of public sector employees who are paid over $100,000 a year, even though taxpayers fork out $11 billion a year in compensation for physicians.

Media outlets have launched an appeal to get more information on doctors’ billings after requests through freedom of information were rejected.

The OMA, which represents 28,000 Ontario doctors, said it doesn’t actually get the names of doctors with the amounts billed to OHIP, but added doctors with higher billings usually have high overhead costs.

“They often employ a large and skilled staff, use expensive equipment and require a larger footprint than the average clinic,” said OMA spokeswoman Danielle Milley.

The average Ontario doctor bills OHIP $360,000 a year, but must pay staff and any office expenses out of that amount, which the group DoctorsOntario estimates at 30 per cent of billings.

DoctorsOntario, which describes itself as a grassroots organization dedicated to protecting physicians’ rights, freedom and independence, is planning a job fair in the spring “to help doctors, especially the nearly 20 per cent of new specialists who are unemployed, find work in friendlier jurisdictions.”

Hoskins said the Liberals have hiked doctors’ salaries by more than 60 per cent since they came to power in 2003, which helped stop physicians from leaving Ontario to work in other provinces or the United States.

“We corrected the situation a decade or more ago when there was a brain drain of physicians leaving the province,” said Hoskins. “We now have the opposite, where the income potential of physicians in this province is such that it is attracting physicians.”

If any of the highest billing doctors made any inappropriate claims, the Ministry of Health would have detected them, said the OMA.

“The ministry has clear processes in place to ensure billings are appropriate, which includes regular auditing of doctors’ billings, and that is especially true of those who bill higher than their specialty’s average,” Milley said. “If the ministry paid them, clearly they believed they were providing value for that money.”
A study by Roger Martin at the Institute for Competitiveness and Prosperity, an independent research group supported by the Ministry of Economic Development, said doctors’ compensation is adding to rising health care costs. At $51 billion this year, Ontario’s health-care budget eats up 42 per cent of government program spending.

“Engage physicians to be leaders for change and renew the payment model,” wrote Martin, the former dean of the Rotman School of Management at the University of Toronto. “Use peer performance data to stimulate healthy competition among providers.”

The NDP said many medical specialties have had huge technological advances that allow procedures that used to take hours to be done in a fraction of that time, including eye surgeries, but doctors are paid the same rates as before.
“Those in the million-dollar club are basically surgical specialties that have evolved so much, but the payments remained the same,” said Gelinas. “Things have changed for the better, but the savings have certainly not been passed on.”
Ontario’s Information and Privacy Commissioner declined to comment because of the ongoing appeal of the FOI ruling, but has spoken in the past about a growing trend towards greater transparency when it comes to government expenditures.

British Columbia and Manitoba already release information on physician billings to the public.

Source: http://globalnews.ca/news/1787657/ndp-wants-secret-info-on-ontarios-top-billing-doctors-made-public/

 

 

Splinter group of Ontario doctors planning a protest ‘job fair’

DoctorsOntario, a break-away group unhappy with the Ontario Medical Association, says it wants to help MDs find jobs in jurisdictions "friendlier" than Ontario

Richard Lautens / Toronto Star file photo 

Dr. Douglas Mark leads a breakaway group unhappy with the OMA's representation of doctors in Ontario. 

By: Theresa Boyle Health, Published on Thu Jan 22 2015

 

A splinter group of doctors, angry with the outcome of the province’s negotiations with the Ontario Medical Association, is planning a job fair to help physicians find work in “friendlier” jurisdictions.

DoctorsOntario (formerly the Coalition of Family Physicians and Specialists of Ontario) will hold a job fair this spring to help doctors find jobs in “places where doctors are cherished and respected and not made to be scapegoats for the failures of others,” said the organization’s interim president, Dr. Douglas Mark, a Scarborough family physician.

The province last week imposed a new payment scheme on doctors after a year of negotiations with the OMA resulted in an impasse.

It will see a 2.65 per cent cut to all physician payments, including fee-for-service, salaries and alternative payment plans.

The pay cut will grow if doctors don’t stay within their budget of $11.4 billion this year and 1.25 per cent more in each of the next two years.

Health Minister Eric Hoskins has said that physician compensation has jumped by 61 per cent since the Liberals took power in 2003, with doctors now earning an average of $360,000 annually.

From their payments, doctors must pay overhead costs that amount on average to about 30 per cent of their billings.

DoctorsOntario is a small group of physicians unhappy with how the OMA has represented the profession. Mark said it has 1,000 members, up from 500 last year. The OMA, the recognized bargaining agent for doctors, has 28,000 members.

Mark said physicians are paying the price for the government’s inability to balance the budget and charged that it has “blown several billion dollars on various boondoggles,” including eHealth, ORNGE and the gas-fired power plants cancellation.

Former OMA president Dr. Doug Weir said DoctorsOntario “is not taken seriously by the majority of physicians in the province.”

Weir called the group’s approach “destructive” and said it’s important for physicians to try to work with the province.

On that note, he said he hopes the government will come back to the bargaining table, and said doctors are willing to take a pay freeze.

Even with a pay freeze taken into account, overall spending on physicians needs to grow at about 2.7 per cent annually to meet demands from a growing and aging population and to pay 700 new physicians who are graduating from medical school, Weir said.

Given this, it’s inevitable that doctors won’t be able to stay within their budget, he said, warning that patient care will ultimately suffer.

Weir said family physicians are getting the rawest deal because the province is not allowing any more doctors to join family health teams.

That might result in new grads going to other jurisdictions, he warned.


Source: http://www.thestar.com/life/health_wellness/2015/01/22/splinter-group-of-ontario-doctors-planning-a-protest-job-fair.html