Ontario Health-care System overburdened,underfunded,mismanaged

Ontario Doctors Like Me Won't Play Along With Patients First Act...

...This health-care system is so overburdened, underfunded and mismanaged that it no longer provides patients with reliable, timely or even universal access to care....

Source/more: http://www.huffingtonpost.ca/nadia-alam/ontarios-doctors-walk-awa_b_13521602.html 

 

Doctors worry about patient privacy as they speculate on government plans for eHealth

The province’s doctors are expressing “grave concerns” about the Liberal government’s plans for eHealth Ontario.

In the wake of Health Minister Eric Hoskins’ decision to ask Premier Kathleen Wynne’s privatization guru, Ed Clark, to appraise the monetary value of the electronic health records agency, the Ontario Medical Association is sounding the alarm over patient privacy.

Source/more:

https://www.thestar.com/news/queenspark/2016/10/13/doctors-worry-about-patient-privacy-as-they-speculate-on-government-plans-for-ehealth.html

Doctors worry about patient privacy as they speculate on government plans for eHealth

https://www.thestar.com/news/queenspark/2016/10/13/doctors-worry-about-patient-privacy-as-they-speculate-on-government-plans-for-ehealth.html

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/

Ontario's doctors say budget puts the health care system at risk

"The government's budget continues to drastically underfund health care – that's a problem for patients and it's a problem for doctors," said Dr. Ved Tandan, President of the Ontario Medical Association. "There are 900,000 people in this province without a family doctor and the population continues to grow and age – this budget ignores both that growth and that unmet need and that's unacceptable."

Source/ more:

http://www.newswire.ca/en/story/1523881/ontario-s-doctors-say-budget-puts-the-health-care-system-at-risk

Health care needs to be a priority in provincial budget: Ontario's Doctors

"The government is creating a track record of cutting funding to health care services across the province as a way to tackle the $10.9 billion deficit it created, but this means a decrease in access to quality care for patients,"

More/source:
http://www.newswire.ca/en/story/1514235/health-care-needs-to-be-a-priority-in-provincial-budget-ontario-s-doctors

Subtle Brain Injury

There is an overwhelming ignorance in the medical community that there is even the possibility of permanent brain injury in patients who may have suffered a concussion. To this day, a significant proportion of the medical community believes that there can be no permanent brain injury without a loss of consciousness or without a blow to the head.

More/source:
http://subtlebraininjury.com/#sthash.KyljJAcG.dpuf

Guest Column: Ontario’s doctors are scapegoats for health woes

 
A doctor measures the blood pressure of a man in Stuttgart, Germany, Feb.6, 2009. )Thomas Kienzle , THE CANADIAN PRESS/AP)

Feb 13, 2015 - 12:01 PM EST Last Updated: Feb 13, 2015 - 12:01 PM EST

Dr. Douglas Mark

Like most of my colleagues, I didn’t enter the field of medicine to become rich and famous. I entered medical school for one reason and one reason only – I wanted to help people. Unfortunately, the Liberal government here in Ontario is making it harder and harder for me to do so. That’s because after a year of negotiating with the Ontario Medical Association, the government has decided to impose a deal on doctors – reducing fees significantly – and cutting some $580 million from our healthcare budget.

To make matters worse, the Liberals are trying to imply that the reason they had to make these moves is because they’ve given doctors a 61 per cent salary increase over the past decade. Doctors have received no such increase.
Why would the government do this? In a word, politics.

The province’s finances are out of control, and the Liberals have decided they need to find a scapegoat to blame this mess on.

Is it fair to blame doctors for overutilizing our health-care resources? Not at all. Ontario doctors have worked very hard over the past 10 years – making many personal sacrifices – so that waiting lists in five key areas could be reduced. We also helped the government find family doctors for over one million Ontarians who didn’t have one.

And yet, after all this, the government has chosen to turn around and blame us for going over their healthcare budget.

Truth is, it’s the Liberals who deserve the blame for the decision to ration health care. They’re the ones who decided to impose a deal on doctors instead of negotiating one. Now, instead of being able to co-manage our health-care system along with the government, doctors have been relegated to the sidelines, where we’ll be forced to watch politicians who think they know it all really make a mess of things.

Now, I know what you’re thinking. Isn’t the Minister of Health and Long-Term Care a medical doctor, too? Yes, he is. Unfortunately, he’s not the one calling the shots here. These harmful decisions are being made exclusively by Premier Kathleen Wynne and former health minister Deb Matthews, in her new role as Treasury Board president. Dr. Hoskins is merely their puppet.

So what do doctors intend to do about all this?

Simple. We plan on educating our patients as to what is really behind the government’s move to cut $580 million out of our health-care system. We can’t go on strike – nor would we – but we can engage in some rather creative job actions.

Starting March 2 family doctors will be asked to set an egg timer or stopwatch for five minutes as soon as each patient enters their office and sits down.
Specialists will set the clock for 10 to 25 minutes, depending on the specialty. Once the time is up, doctors will inform patients that the government is no longer paying the doctor – even though the patient will likely be taking up another 10 minutes or more of their time – and that the cost of the rest of the visit will be borne by each individual doctor.

This symbolic act is meant to dramatize the fact that OHIP only covers 47 per cent of the Ontario Medical Association’s recommended fee schedule, which the Liberals have chosen to cut by another 2.65 per cent as of Feb. 1. Doctors will also be asked to download a form from the DoctorsOntario website, asking the government if they feel they can afford the patient’s visit.

The doctor will explain what the patient’s problem is on the form, as well as writing down the treatment they’re suggesting. The form will then be faxed to either the premier’s office, the Treasury Board president’s office, or the health minister’s office, requesting approval from someone at Queen’s Park to go ahead and bill OHIP.

Each patient’s identifiers will be blacked out on the form.

The reason we’ll be doing this, of course, is because doctors are concerned that as a result of these cuts, and the Liberals’ inability to manage our health-care system on their own, we may be forced to close our offices in March every year. We’re also worried that there won’t be enough money to keep some doctors – in particular, specialists – gainfully employed, which is why we’re arranging a job fair for doctors this spring to help them find work in friendlier jurisdictions.
But won’t all this just hurt patients?

Let me be clear. Ontario’s doctors will never do anything to hurt our patients or put their health care at risk. That’s why we’re standing up and speaking out.
Rolling over and accepting what the Liberal government has done to our health-care system is the worst thing we could do.

Dr. Douglas Mark is interim president of DoctorsOntario, a group of more than 1,000 physicians who have broken away from the OMA.



Source: http://blogs.windsorstar.com/opinion/guest-column-ontarios-doctors-are-scapegoats-for-health-woes

Crisis in Ontario health-care system deepens: Hepburn

A critical part of our health care system is grossly underfunded and inefficient, with underpaid, overworked employees scrambling to keep up with growing demand for services.

OurWindsor.Ca

By Bob Hepburn
 

A bitter strike by 3,000 nurses and other health professionals now dragging into its third week is providing a rare and disturbing glimpse into Ontario’s home- and community-health sector.

 

What the strike by workers at 10 Community Care Access Centres across the province has exposed is clear evidence that this increasingly critical part of our health care system is grossly underfunded and inefficient, with underpaid and overworked employees scrambling — and too often failing — to keep up with growing demand for services. 

The result of this worsening mess is that tens of thousands of patients across the province, ranging from seniors to young schoolchildren, often receive too little or no care at home, in nursing homes and schools. 

It’s especially true for patients pushed quickly out of hospitals in an effort to save money and turned over to CCACs, which oversee home- and community-care, to provide such services as rehab therapy, speech training for stroke victims and help getting dressed in the morning. 

At the same time, the stresses and demands being placed on community health-care professionals have created a group of dedicated workers who rightly feel frustrated, disillusioned and underappreciated. 

For years, successive governments have talked boldly about the need to focus more resources on community care. However, barely 5 per cent of the province’s health care budget goes to home- and community-health care. 

Instead of injecting serious money into the sector, the government has provided only token extra help, while at the same time forcing hospitals to kick patients out of costly hospital beds as fast as possible. 

Today, the proof that our community-care sector is short of money and treated like a second-class part of our health system is everywhere. 

In the CCACs, managers desperate to save money are forcing care co-ordinators to reduce home-care services for needy patients. “Our managers sit down with us on a regular basis to discuss ‘high users’ and ways in which we may be able to decrease home support services,” one Peterborough area care co-ordinator wrote in an email, adding she is “sickened by this penny pinching.” 

In private companies contracted by CCACs to provide the front-line workers who actually treat patients face-to-face, managers are squeezing their own employees. They do so by setting strict limits on the time therapists and nurses can spend with a patient, refusing to pay for mandatory professional training and cutting workers’ hours. Most of these employees haven’t seen any pay raise in a decade. 

In community health centres and nurse practitioner-led clinics, workers have seen their pay frozen by Queen’s Park for the last nine years. “We are just going to be collateral damage,” with the province likely arguing yet again that they cannot afford raises if and when doctors and nurses get more money, suggests Adrianna Tetley, CEO of the Association of Ontario Health Centres. 

Clearly, fundamental reform of home and community care in Ontario is desperately needed. 

Health Minister Eric Hoskins has stated repeatedly that such reform is one of his top priorities. 

In the coming weeks, Hoskins will have a tremendous opportunity to make good on his comments by acting on two major reports to land on his desk.

First, a provincial panel created last year to review home and community care, chaired by Gail Donner, the former dean of the faculty of nursing at the University of Toronto, was to have submitted its report to Hoskins at the end of January. Hoskins should release the panel’s findings and recommendations immediately. 

Second, the provincial auditor was ordered last spring by the Ontario legislature to review the financial operations of the CCACs. That report is due this spring.

With these reports in hand, and a provincial budget coming later this spring, the Liberal government has a real chance to revamp the entire system. 

For too long foot-dragging and finger-pointing by the Liberals, Conservatives and New Democrats at Queen’s Park and by timid health ministry bureaucrats have derailed any meaningful reform efforts. 

If Queen’s Park politicians fail again, they will have only themselves to blame.

Sadly, such failure will be another blow to community health professionals who have seen their incomes eroded over the years and their skills rarely acknowledged by bosses and politicians who are more interested in bottom lines than insuring decent and fair levels of care. 

Ultimately, though, the real losers will be our sick, our elderly and our dying who will be forced to struggle even harder to get the care they need and deserve. 

Toronto Star

Source: http://www.insidebrockville.com/opinion-story/5335239-crisis-in-ontario-health-care-system-deepens-hepburn/

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/