Blaspheming Ontario Health Care

There are 25,000 medical doctors practising in the Province of Ontario.  The Liberal government, in its cost-cutting exercise, has focused on various ways to practise austerity after ten years of doing the opposite.  In an eight-year period, doctors' salaries have risen exponentially, thanks to the very generous settlements agreed to by the Ontario government in bargaining with the Ontario Medical Association.

So 37 medical procedures have been selected for cuts to fees under the current provincial formulary.  And the Ontario Medical Association has warned the province that loose talk of imposing fee cuts for any routinely approved medical treatment will end up harming the province's health care system, victimizing those who need the care provided by doctors.

Deb Matthews, Ontario Minister of Health, was less than impressed: "Ontario's doctors are the best paid in Canada.  In fact, I've yet to find a jurisdiction that pays their doctors more than we do in Ontario.  So I just don't buy the argument that doctors will leave this province."  Procedures undertaken that take far less time than previously as a result of new and improved techniques and technological assists are to be cut back by about 10%.

A procedure that once took hours and with new technology takes a quarter of an hour to process will now be recompensed, according to the province's proposed new formula, at a somewhat reduced rate.  Diagnostic radiology tests, X-rays, CT scans and ultrasound procedures, are all more efficiently performed than in the past, and they too will be cut by 10%. 

A routine that cost $88 million annually will be cut in half; one that represents 'fees for self-referrals'.  And if that sounds peculiar, it most certainly is, since the phrase represents a situation where a doctor refers a patient back to his or her own practise.  In total the province spends $11-billion in paying doctors who earn an average $385,000 annually.

Public-sector restraint is the name of this particular game called austerity, to match a situation where the province is facing off against an intractable and growing deficit and debt.  Eight years ago, the McGuinty government generously increased the $5.9-billion spent on doctors' fees which at that time averaged $220,000 annually.  In view of the government's generosity in bargaining over the years, it assumed, foolishly, that doctors would be content with a freeze in salary in upcoming negotiations.

Not about to happen.  It's hard as hell to convince people that it might be fair to agree to take less when what you take is so generously endowed for a fundamentally necessary service.  Just to temporarily hold further increases in abeyance until the austerity crisis has passed.  The changes recently tabled will affect cardiologists, ophthalmologists and radiologists, the three professions that earn an average $640,000 annually.

"Let's be clear, we're talking about a handful of specialties that have seen a tremendous windfall in profits because of enhanced technology.  Doctors on average in some of those specialties are close to earning $700,000 a year.  That's far more than was ever intended and they're able to do that because of technology.  Technology means that they can serve more people, they can build more fees.  So it's only appropriate that we update the fees to reflect reality." Ontario Health Minister Deb Matthews