Government Cuts to Physician Fees and Services

The Ontario Medical Association and the Government of Ontario, represented by Minister Eric Hoskins, have not been able to reach an agreement on a Physician Services Agreement. The OMA Board of Directors unanimously rejected the Government’s final offer that included a 4.8% cut and more cuts to follow if the cost of health care increases in the next 3 years.

Most of our members are quite happy that the OMA Board rejected this open ended series of cuts, but some of our members did want us to accept. They want to help their patients and their government out of a jam. I agree with this sentiment, but cannot support an agreement with a government who wants complete, unconditional victory with no chance to mitigate drastic cuts by working cooperatively with Doctors.

“The OMA wants you to believe that doctors in this province can’t provide the same level of care as last year unless they receive a pay raise and we simply don’t agree,” Eric Hoskins, Ontario Minister of Health. CBC news Jan 15 2015

Hoskins has also said that doctors who work roughly the same number of hours this year as last and bill roughly the same will have the same income.

Is either of these statements true?

Well of course they are not true. The Ministry of Health is cutting all fees in the schedule of benefits and all similar payments to doctors by 2.65% effective February 1 2015. So if a doctor works and bills the same this year as last, her revenue will automatically be cut by 2.65%. In addition the Government has targeted decreases to family physicians, general medicine internists, nephrologists, cardiologists, gastroenterologists, rural physicians, new physicians and physicians who provide on-call services in hospital. This large group of physicians, almost everyone in other words, will get even bigger cuts.

On average, Ontario physicians are looking at 4.8% in cuts.

An Ontario physician who works about the same this year as last and bills roughly the same way will have a revenue cut of 4.8%. Since most overhead costs are fixed, their income cut will be much higher.

To help the Minister and the Government out of their fiscal mess, the Doctors of Ontario have offered a 2 year freeze on all fees and asked the government to live up to their responsibility to fund the increasing growth in the system.

Under such a freeze, NO physicians would get a ‘pay raise’. If they worked the same this year as last, their income would be the same. That’s a true freeze.

So why is this important?

For starters, honesty is important. We cannot have a productive discussion about health care reform unless the government is being completely honest and transparent.

Our Doctors know that the Province is in economic trouble and would like to help. In 2012, Ontario’s Doctors worked with the Liberal Government to find $850 million in saving with a mixture of evidence based reform and fee cuts. Our members were confident that their patients’ access to quality care was being preserved and that their own personal sacrifices were respected.

A cut is a cut. Cuts may be justified in the short term to help the Province get back on its feet. But the Government has to be honest. No group should have to endure the double indignity of a large income cut while being told that they are greedy.

Let’s have an honest discussion about physician payments. It’s the only way to get everyone working together to fix a broken system.

Scott Douglas Wooder, MD

This is the first of a series of posts about the Government’s unilateral cuts. I focused on the big picture today. Next I’ll look at how some targeted cuts will negatively effect patient care