04/27/2016 03:20 EDT | Updated 04/28/2017 05:12 EDT

Ontario's Health Minister Is A Master Of Misdirection


Much as I want a fair contract, I don't trust Health Minister Eric Hoskins' latest salvo.

For one, it comes on the heels of a press conference denouncing physicians for providing too many patient services, services that the government then had to pay. Hoskins blames the crumbling health-care system on a select few physicians, drilling down on a group that reflects less than two per cent of the health-care budget.

Well, what about the other 98 per cent?

The public trusts Hoskins because he is the Health Minster and he is a doctor. So it's unclear why this "newest" offer is a rehash of the same old lies.

Ontario physicians are among the lowest paid in Canada per fee, per visit, per procedure. All physician know this. We're not in this for the money. We never were. The feeling of helping your patients and serving your community is unparalleled.

Five hundred physicians in Ontario have sacrificed all semblance of a normal life to serve an astonishing number of patients. Their high billings are a by-product of that care. These are the physicians whom Hoskins belittles.

Hoskins wrongly describes the physician services budget as "out of control."

To stay within Hoskins' arbitrary budget, these doctors would have to refuse care to patients who have no other options. These patients -- some who are going blind, have brain tumours, need image-guided biopsies, or have complicated heart failure -- have nowhere else to turn because the entire system is woefully under-funded and mismanaged. However, that part is ignored when Hoskins calls for a cap to physician billing.

Hoskins also demands that fees be cut for procedures like cataract surgeries. His reason: increased efficiency due to advanced technology. He ignores the fact that fees for cataracts were cut in 2012 and again in 2015. He is fixating on a problem that is already fixed.

Hoskins wrongly describes the physician services budget as "out of control." For one, physicians have no control over this budget. The budget parallels patient need. It's not as if a doctor can ethically turn away a sick patient, saying, "Sorry. Can't. We're over-budget."

Think of it this way: highway gridlock worsens the more cars there are on the road. Health-care gridlock occurs when there are more patients in line. Patient need goes up by two to three per cent every year, so the need for physician time, knowledge and skill goes up two to three per cent every year. Hoskins doesn't want to pony up more than 1.25 per cent.

Let's compare this to some other sectors: energy sector budget rose by over 11 per cent; hospital administration, seven per cent; ministry sector, seven per cent. All told, physician services are pretty darn cheap compared to everything else the Ontario Liberals choose to fund.

If there is fraudulent use of taxpayer dollars, the Ministry of Health has an obligation and the full authority to investigate. They always have. So to pretend that the government is a victim in all this is misleading.

The Liberals have ignored exponentially growing waitlists, so much so that patients are dying as they wait.

The story of high-billers is old news. In fact, I know an obstetrician who is being vilified as a high-biller. For the past 35 years, this OB has worked 70 hours a week, delivering 300 babies a year. He is 70 years old. So, I'm left wondering: either the Liberals did not do their job and investigate this sly senior, or they are wasting everyone's time dredging up tired, old political games.

They are distracting from the very real issue of under-funding our health-care system. All the while, more money is mismanaged.

It's been less than a year since the Auditor General slammed the Liberals for wasting taxpayer money on the LHINs. The obvious response would be to apologize and dissolve organizations that are ineffectual and expensive. Instead, Hoskins has opted to create 80 more sub-LHINs.

The Liberals have ignored exponentially growing waitlists, so much so that patients are dying as they wait. We are now shipping cancer patients to the U.S. for care that should be funded here. What does it mean when our one and only health-care system cannot insure life-saving services?

Waitlists wouldn't exist if the supply of health care matched patient need. Instead, the Liberals invest less in front-line care provided by doctors, nurses, clinics and hospitals. What happens when you don't fund patient services? You get fewer services.

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.

However, the Ontario government has imposed unsustainable contracts on physicians time and again over the years. This vicious cycle must come to an end. It would be nice to have a government that does not resort to unilateral actions every time they don't get their way. It would be nice to have a government that listens to physician concerns about waitlists and patient welfare.

Binding arbitration is a way of keeping governments and physicians accountable and at the table. It is a stabilizing mechanism that stops unproductive stand-offs -- particularly when neither party trusts the other.

Hoskins' mandate is a responsive and responsible health-care system. However, his actions do not reflect a genuine willingness to collaborate with anyone. Although his current offer looks pretty, the details are the same old, same old. His terms and deadlines are short-sighted ultimatums. There is no meeting halfway with him.

He is not promising that his or any future government will avoid imposing unsafe contracts upon physicians.

He is not really offering binding arbitration.

All he's saying is that if Ontario has the money, they might fund physician services. Maybe.

All told, I'm not willing to throw my colleagues and my common sense under the bus for this offer.

Concerned Ontario Doctors is calling for Hoskins' resignation. It's high time we had fresh ideas from a health minister who embodies integrity and accountability.

Let's end this power struggle and get on with fixing Ontario's health-care system.

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