SALARY ASPIRATION SLOWDOWN

"Too long has the Ontario government been unwilling to flex some of its muscle as the payer for health-care services, which represents all of us, the public.  Governments need to be more demanding in terms of the contracts and the agreements they have with physicians about what is actually expected of them."  Colleen Flood, Health law, University of Toronto

The current Liberal-led government of Premier Dalton McGuinty opted for an agenda to keep the province's physicians through agreements with the Ontario Medical Association, happy and energized.  And nothing works quite as well as increasing their payments for inestimably important work done on behalf of those requiring their care.  Under this current government doctors have been recompensed handsomely.

Therefore, given the current financial difficulties facing the provincial treasury - in effect all taxpayers, from the medical community to those whom they serve - through a growing deficit and poor employment figures along with lost manufacturing and rising costs, one might think that those same doctors who have done so well in the past decade would be willing enough to be grateful for what they have.

They feel threatened, though, that their indispensable services are now going to be held to tighter account by a cash-strapped government, and that they cannot now contemplate another raise as has been their good fortune in the near past, but a belt-tightening which no one enjoys the prospect of, but in all fairness everyone must agree to share in.

The Ontario health insurance plan does not have limitless funds.  Annual fees that doctors can anticipate will shrink marginally, and affect mostly those on the high-end of physicians-specialist-incomes.  Those whose surgeries have become more efficiently expeditable thanks to newer technological advances, but who still charge the going rate for a service that takes far less of their precious time.

The doctors and the Ontario Medical Association have been huffing indignantly over the prospect of their being expected to tie in to the belt-tightening, and they warn that patients will suffer in the end.  They can indulge in stoppages in refusing to take on more patients, in a revolving protest that will see them continue to do their work, but in a constrained manner to emphasize their unwillingness to be taken for granted. Heaven forfend the health-needy public would take the medical professionals we so rely upon for granted. 

"We're wasting millions of dollars on some very unnecessary technologies.  We need the capacity to re-evaluate technologies that are in the market and that may be of questionable value", stated a health policy analyst at University of Toronto, a former senior health ministry official.  The public takes for granted that doctors would have the integrity and intelligence not to engage in treatments said to be of doubtful benefit to patients.

The University of Toronto health law expert explained also that in the United States that government too is taking a second look at fees paid through Medicare and Medicaid, as well as private insurers, weighing the intelligence of continuing to pay fees to doctors performing procedures that have become more expeditious thanks to new medical technologies.  The imprudently unnecessary ordering of diagnostic tests might also be intelligently curtailed.  

Medical experts claim scarce funding can be put to better use by delisting treatments that have a dubious record of usefulness.  Doctors tend to respond by threatening to cancel elective surgeries, by limiting their office hours, by indulging in general work slowdowns to demonstrate their disgruntlement, and at the same time how powerfully needful is their full attention to their patient load.  For which they must be well compensated.

And they most certainly are.  Scant few in the medical profession are prepared to be reasonable about the need to acknowledge the government's past generosity in raising their incomes when times were good, by now, when finances are constrained, agreeing to temporarily slow down their expectations.  The Ontario Medical Association has been running full-page advertisements in newspapers exhorting the public to support their dismissal of the government's attempt to work within current financial constraints.

It isn't all that likely that the majority of the public will feel too compassionate over doctors' financial plight, knowing how comfortably well off they are, while at the same time appreciating the work that doctors do on behalf of their healing profession and the patients they take on.  It is unfair for the OMA to try to manipulate public opinion to line up with them on this issue, prodding people to take a stand in fear of alienating those who look after their health needs.

The health budget, already accounting for a large chunk of the GDP and growing at an alarming rate, has to be reined in.  It can be done through efficiencies, through recognizing the need to be prudent in using those elements of health care diagnostics that are usefully needful only when they are usefully needful, without threatening the health care of patients through longer wait times. 

The prima donna profession of health care should be prepared to indulge in a little introspection.  The focus should remain on the goal; improving health care and access to it for all who require it.  The cost to do so cannot continue to be such a weightily cumbersome one; reasonableness can be found within the system and between bargaining partners; much depends on it.