Many voting against the PSA argue that a fixed budget prevents physicians from providing necessary care to patients. No one is suggesting this. Patients who need care will be seen, necessary tests and surgeries will be done, family and specialist clinics will still see patients and physicians will continue to get paid to provide these services.
Merits and failings of the contract aside, many wonder about the aftermath of this vote. Ratify the contract and what -- ration care and pinch pennies? Reject the contract and what -- face a vengeful government's unilateral cuts? The uncertainty inherent in the contract is mirrored by the uncertainty of the unilateral actions that we have weathered for the past 18 months.
The OMA ramped up their aggressive endorsement: ads appeared on Facebook, Twitter and Instagram. Calls for a balanced discussion were met with threats from the OMA: "it's either the PSA or more cuts." Rules govern how such votes occur. The OMA's methods rigged the votes towards a "yes," seemingly breaching them all.
We need health-care reform. To do that, we need an honest conversation between patients, government and front-line workers about what can be covered, what should be covered and what must be covered. We can't have it all. So we need to talk about what we all can have. To get there, doctors must be part of the conversation.
Dr. Hoskins, you in particular have been very fortunate to have worked in many positions where you could be in charge, and set you own terms. While you clearly understand the hard work, dedication and passion it takes to get through medical school and residency, I don't think you appreciate the frustration that comes when, after all that, your voice is not accepted when you advocate for your patients.
Ask yourself this: Do you have to pay back part of your salary because your employer is poorly run and losing money? Do you have to start saving six months in advance for potentially not being paid two and half months and not being told exactly how much until only months before you're getting the cuts?
Some evidence suggests that about one-third of the tests doctors order are unnecessary -- and doctors make a pretty penny on those tests. Recently the Ontario government announced that it is reducing OHIP fees by 50 per cent in situations where self-referral has occurred. The government has good reason to be interested in this issue, but cutting fees for self-referral isn't the answer.