Ontario Health Minister Eric Hoskins insists that the strife between physicians and government is all about paycheques.
Yes, physician compensation is one of the issues. But it’s not the most important one. And it’s definitely not the reason why after a year of tough negotiating, the Ontario Medical Association rejected Minister Hoskins’ “reasonable” offer. That was January 2015.
Since then, in an unprecedented dramatization of “absolute power corrupts absolutely”, the province has gone ahead and unilaterally imposed their contract terms without consent onto Ontario physicians. With utter disregard for logic and reasoning, they have enforced three rounds of sweeping fee cuts first in January, then June, and now in October. Although this is not the first such transgression in the past 3 years, this is certainly the worst.
However, physician compensation is just the tip of the iceberg.
Minister Hoskins fails to mention that his government flat-out refused to fund “expected growth in health-care utilization”. What does this mean? Ontario’s population is aging and growing in number. Older people accumulate more illnesses; they need more care. Similarly, as the population expands through childbirth and immigration, more people seek medical care provided by physicians, and not surprisingly, physician billings increase; when physicians work more, they bill more. Overall, these health-care costs increase at a predictable rate of 2.7% each year — so say the province’s own economists.
So how much did the government commit for this increase? Certainly not the 2.7% it knows it must. The government offered a paltry 1.25%, not even half the projected cost. In effect, the government is saying: “Dear Ontarians, say you need $100 more to continue making OHIP universally accessible and universally effective this year. Even though your government has promised to fully fund your health-care system, let’s give you $46.30 instead of the $100 we actually owe and call it even. Make it work.”
Come what may — a disease outbreak, natural disaster or say, a refugee immigration crisis — the government is unwilling to pay a penny more. So where will the rest come from? Physicians. Seriously. It’s called a fee cut and a clawback. Might as well ask teachers to bankroll the education budget.
Minister Hoskins does not mention that this faulty logic was — and still is — the major reason why the OMA walked away from the table. This failure of the Liberal government to deliver on its promise to adequately fund health-care was the last straw.
There’s more. Even though there is still no actual contract between the MOH and Ontario physicians, the government has gone ahead and unilaterally imposed their contract terms without consent onto Ontario physicians.
Let’s continue with our straight talk.
Health-care funding relies on two sources: provincial taxes and the Canada Health Transfer, federal cash given to each province for health-care. In fact, the federal government gave 3.4% more to Ontario in 2014–2015. Yet, the Ontario Liberals filtered only part of the CHT into Ontario’s health-care system. Where is the rest? It’s not in physician pockets, nor is it in our hospitals or our nursing homes or our drug benefit program. Think about it: the money given by the Canadian government to the Ontario government specifically for health-care funding is being funnelled — somewhere else. Ontario’s Health Minister Eric Hoskins has remained strangely silent on the subject even during the September Legislature’s Question Period, choosing instead to divert attention back to physician paycheques.
As doctors in Ontario take down their shingles and close practices, Minister Hoskins continues to reassure the public that all is business as usual. However, the Liberal legacy will be a mass exodus of physicians fleeing from the hostile work conditions in Ontario into the friendlier arms of neighbouring provinces — all of which have collaborated with their own physicians to reach proper agreements. For the physicians who remain in Ontario, they will do what any small business does when income drops precipitously: they will cut costs and dismiss administrative and nursing staff.
Unemployment will rise.
The resulting office inefficiencies will cause patients to suffer longer wait-times, lack of accessibility and even worse.
The insidious effects of chronically under-funding the health-care system will not be felt this year, but they will become more pronounced as money runs out.
Finally, Ontario’s physicians will burn out serving under such an iron-fisted regime.
Reading this, one wonders why the Ontario Liberals are so openly abusing the right of their physicians to fair bargaining. After all, Wynne’s government did give their teachers a raise. Ditto for their home-care nurses, their police and the Hydro One workers.
Ontario physicians never even asked for a raise; they wanted a pay freeze. So why aim at them? Because physicians make easy targets. For one, they are wholly dependent on the province for their livelihood. If the province chooses not to pay and refuses to negotiate, there is no recourse; physicians do not have the right to strike. Look at Quebec: physicians went on strike for 24 hours and were slapped with a $2 million dollar lawsuit; and that was better than the original $10 million figure.
So all we do — all we can do is speak up.
Minister Hoskins is right about one thing: nine months after talks broke down, and patients have not felt the impact — largely because our fight is with the Ontario government, not with our patients.
This is a story about a provincial government that bullies people who cannot fight back.
This is a story about a government that mishandles tax-payer money.
This is a story about a government that has abandoned its duty to fund health-care.
This is a story of David and Goliath. Although this time, I fear that David may just lay down his sword and walk away. Ontario’s health-care system is about to collapse under Liberal rule.