Ontario's doctors say the provincial Liberal government's decision to unilaterally slash some of the fees paid to physicians amount to cuts to the healthcare system that will result in reduced patient access to a number of common medical services.
After claiming it was unable to reach a deal at the negotiating table, the government announced Monday it is cutting the Ontario Health Insurance Plan (OHIP) fees it pays for hundreds of services that doctors perform.
Some specialists will be more affected than others, especially ophthalmologists, cardiologists & radiologists.
The government said it would save $338.3 million in the coming year by implementing these changes, which amount to 80 per cent of the cuts it needs to make to freeze total doctor compensation at $11 billion this year.
"We’ve been deceived," said Doug Weir, the new president of the Ontario Medical Association at a news conference Monday afternoon.
He railed against the government for imposing the new fee schedule instead of striking a deal.
"It’s clear the government never had any intentions of negotiating with Ontario’s doctors."
Health Minister Deb Matthews told a news conference at Queen's Park that the failure to reach a deal with the OMA left her with no other option.
"I was left with no choice," she said. "We were very clear with the OMA. We campaigned on a wage freeze (for doctors), our budget was explicit — we were looking for a real wage freeze with doctors — so this comes as no surprise to doctors, and I'm just hoping that they will now come back to the table so we can continue to work."
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But Weir said the government's decision is not a "freeze" but a "cut," the effects of which will be felt acutely by patients.
The move "is the first thread in the unraveling of all the progress that has been made in our health-care system."
There will be reduced care for seniors suffering from conditions like glaucoma and diabetes, said Weir. And there will be longer wait times for services like X-rays, MRI and CT scans and radiology diagnoses, he warned.
Weir said some doctors in Ontario may also be tempted to go to provinces like Alberta, Saskatchewan and Manitoba, where he said fees are being increased.
Health Ministry officials say there is room still to negotiate other payments — such as retention bonuses — but it has set all the OHIP fees by regulation.
The physician services agreement expired at the end of March.
Some of the savings that the government says it will realize as a result of the changes include:
- $44 million by cutting in half the fee for "self-referrals" — referring a patients for such tests as X-rays and ultrasounds.
- $30 million by 5 per cent cut in fees for interpreting results of diagnostic radiology.
- $20 million by cutting pre-operative echocardiograms for elective non-cardiac surgery.
- $6.4 million by 10 per cent fee cut in cataract surgery which now takes 15 minutes compared to two hours a decade ago.
On Sunday negotiations for a new contract between the OMA and the government reached an impasse.
Matthews said she was disappointed the two sides could not reach a deal, but also said the deadline to reach a deal has passed.
She set the deadline because there has been no real progress with the OMA since formal talks began in February, Matthews said. She made it clear that the government needed an agreement by end of April, but the OMA hasn't offered any concrete proposals that will help the government reach its fiscal target, she added.
The two sides have been battling it out for weeks, with the cash-strapped government insisting that it can't afford any new funding increases for doctors as it faces a $15-billion deficit.
The minority Liberals are demanding the same from all broader public sector workers, including teachers, nurses and civil servants. They've also threatened to legislate the pay freeze if all other options at the negotiating table fail.
But the OMA says a rushed process isn't the way to negotiate a fair deal with doctors.
The OMA said it offered to freeze doctors' fees for two years and find an additional $250 million in savings, but Matthews rejected the proposal.
Matthews said the OMA wants the government — which already spends $11 billion a year on doctors' fees — to pay for the rising costs of health care as the population ages. She wants the doctors to find the money to fill the gap.
The OMA has warned that patients will have to wait longer for health care if the government forges ahead with the fee cuts.
Matthews has dismissed it as an "absurd" and "misleading" argument, saying 93 per cent of Ontarians now have access to a family doctor — about 2.1 million more than when the Liberals took office in 2003.
The pay freeze for doctors and nurses is part of the Liberals' plan to reduce annual growth in health-care spending to 2.1 per cent a year from the current 6.1 per cent, in order to slay the deficit in 2017.