New OMA notice - cuts to fees

[lostintime]

What do you guys think?


PRESIDENT’S UPDATE

Vol. 17, No. 13

April 24, 2012



Negotiations Impasse



Negotiations with the Ministry of Health and Long-Term Care for a new Physician Services Agreement have reached an impasse.



As members know, we have been at the table with the Ministry since late February. The OMA has presented a very reasonable and flexible position, mindful of the province’s fiscal challenges, and recognizing the vital importance of maintaining improvements in the health-care system during the last eight years.



After much deliberation on the part of the OMA Board, and guided by the input of our member consultation, we proposed to government what we considered to be an unprecedented and very fair offer:



• No fee schedule increases for the next two years;

• Savings of $250 million over two years; and

• A commitment to work with government to find more efficiencies and savings in the health-care system.



To date, the OMA and government have already identified almost $300 million in savings, with no risk to patient care.



We have asked for government to continue negotiations with the assistance of an independent third-party conciliator to help the parties resolve our differences.



While we have demonstrated good faith, and made every effort to advance a constructive dialogue, the government remains fixed on a “take it or leave it position” — the same position it presented on the first day of negotiations.



The government has proposed that the doctors of Ontario accept cuts to fees and programs that total more than $1.1 billion over the next four years.



While the impact across specialties would vary, we estimate an average reduction in payments of 16% over the course of four years (the traditional length of our Agreements).



The government intends to freeze the medical services budget at the 2011 level for the duration of the next Agreement.



Within that capped budget, the medical profession would be expected to absorb the impact of billings by any new physicians joining the OHIP pool (an estimated 700 new doctors next year alone), and all costs associated with the increased provision of medical services to our growing and aging population (utilization). Ontario’s overall population is projected to increase by 1.2% annually (or about 170,000 persons per year), and the number of seniors will rise by 3.8% per year (or about 80,000 persons per year).



To achieve its targets, government has declared its intention to unilaterally impose income thresholds and clawbacks on physician earnings during the second, third and fourth years of an Agreement.



Also, government intends to apply a series of targeted cuts to X-ray, ultrasound, cardiac care, colonoscopy, vision care, chronic disease services, basic visit fees for family physicians, and the elimination of the Comprehensive Care Model (CCM) fee.



And, government has proposed that it would significantly reduce the CMPA malpractice insurance reimbursement program.



The result going forward, no matter how you analyze it, is a substantial reduction in payments per physician, and not a “wage freeze” as government has attempted to portray it.



Meanwhile, as members are fully aware, practice overhead costs continue to increase.



Our Negotiations Team has briefed the OMA Board and Executive Committee regularly.



We have made every effort to work with government at various levels to encourage progress at the bargaining table. To no avail, it is clear that government has no interest in negotiating a new Agreement with physicians at this time.



So where does this leave us?



Today, the OMA will host a press conference in Toronto to inform the media and the public of the current status of negotiations.



We will reinforce the OMA’s desire to negotiate a fair and reasonable Agreement with government that maintains a strong partnership between the Ministry and the doctors of Ontario, and provides a collaborative framework for the effective management and delivery of health-care services in the province.



We will outline our offer. And, we will explain the true impact of the government’s unilateral position for patients, physicians, and the health-care system.



The OMA is organizing physician information sessions across the province and an online presentation for members to learn more about the status of negotiations and potential next steps.



We will seek face-to-face meetings with MPPs from all parties and government officials to encourage their support to revive negotiations, and to ensure that they appreciate the ramifications of a legislated Agreement.



And we will employ various communications measures, including television and print advertising and social media, to advance our position with the public, media, our patients and other audiences of influence.



We may call upon members to assist with this action plan as events unfold. Through this sensitive time, it is imperative that we maintain the trust and confidence of our patients. We need their help and support through this challenging time.



We remind our members that our disagreement is with the current government and not with our patients. We must continue to provide the same excellent care to all of our patients.



It is unfortunate that we have reached this position. At the same time, we remain determined to achieve an outcome that is in the best interests of our patients and our members.



We will provide a further report and update our action plan in the coming days.



Thank you for your continuing support.



Dr. Stewart Kennedy

OMA President

[futureGP]

Doesn't sound good.

Is it the mcguinty government that is closely tied with the nurses?

I'm not quite familiar with the history behind Ontario and health care, but is the reason why Ontario is running out of money because of something else other than how health care is run?

Other provinces seem to do much better than Ontario in health care... Is it just the fact that Ontario is now the not-have province? (how about Manitoba? Saskatchewan?)

[lostintime]

I just love how I keep reading about scandals of how they mess up and waste money like ORNGE and then take it out on services/individuals who have nothing to do with any of this.

[future_doc]

There is a history of greed/corruption of those connected to politicians. Government is trying to play power politics believing it will win and physicians will cave.

[aaronjw]

Originally Posted by future_doc

There is a history of greed/corruption of those connected to politicians. Government is trying to play power politics believing it will win and physicians will cave.

Yeah, as if physicians have no history of greed...

[future_doc]

You cannot tar physicians with the same brush, although some are expert at playing the system not interested in their patients.

[NLengr]

Originally Posted by futureGP

Doesn't sound good.

Is it the mcguinty government that is closely tied with the nurses?

I'm not quite familiar with the history behind Ontario and health care, but is the reason why Ontario is running out of money because of something else other than how health care is run?

Other provinces seem to do much better than Ontario in health care... Is it just the fact that Ontario is now the not-have province? (how about Manitoba? Saskatchewan?)

Ontario is running out of money because they built their economy on
Manufacturing. A huge portion of that industry left or died in the latest recession.

[aaronjw]

Originally Posted by future_doc

You cannot tar physicians with the same brush, although some are expert at playing the system not interested in their patients.

There is no tarring. All groups pursue in their self-interest. This is a fact and Physicians are no different. There is history of greed and leveraging their power base.

I jist wish we could cut the crap and call a spade a spade but instead we have to endure nonsense after nonsense to show they care about the public.

NPS indicates that physician work hours around 53 hours per week. Given their salary, politicians can paint a pretty picture of justification to reducimg physician fees and it's one the public would likely buy.

The flip side is an Ontario gov't that has completely and utterly mismanaged finances and spending. Their screw ups are being forced upon others to deal with the problems they created. Their screwups offer no accountability to those who created them.

I don't know what the solution is but I am tired of the games. Do Physicians deserve more money? On one hand I tend to think yes but on the other hand I know of no starving physicians so what will giving them more accomplish?

I'd rather see physicians use their I credible leverage and push for system wide changes. If they have to accept reductions or freezes, fine but use their clout to force change for the future.

[aaronjw]

Originally Posted by NLengr

Ontario is running out of money because they built their economy on
Manufacturing. A huge portion of that industry left or died in the latest recession.

Lets not forget a completely incompetent Liberal party.

I'd say their excess spending was a far worse problem then our manufacturing economy and if spending had been tighter, we might have been able to offer innovation support to the manufacturing sector which might be paying dividends today.

God I hate my gov't lol

[lostintime]

I dunno, sure every group lobbies for their own interests (obviously), but at least there is a regulatory body for physicians (yeah could be argued punishments are not harsh enough blah blah), whereas for politicians, there is very minimal accountability for corruption and the only thing voters can do is not vote them in FOUR years and even then, the next group of politicians suck too.

Sure, maybe I'm biased as a future physician, but I would rather see the money going to doctors than politicians. This is going to cause a brain drain (and yeah yeah it's selfish of physicians blah blah, but that's basically what's going to happen).