Healing our Health Care

The association representing Ontario's 25,000 doctors and Health Minister are talking again, finally. Thafs a good thing for health care in this province.
Ontarians will never have easy access to a strong and sustainable health care system unless doctors are active players  working with the government  in the hunt for innovative ways to provide better care, at lower cost.

Yet the purpose of resumed negotiations should not be to find system efficiencies simply to fund an increase in the $11 billion Ontario currently pays doctors. Their total billings have risen 75 per cent since 2003. 

Health care already consumes 42 cents of every Health Provincial Program dollar.  The Province's doctors have  cannot be allowed to continue contract negotiations or it will undermine every other service Ontarians rely on.

Going forward, the key to providing the improved system that Ontarians want at a price taxpayers can afford is to make sure that patients get the right care, at the right time, in the right place.That means having a family doctor, and being able to get an appointment in the evening or on a weekend rather than going to an emergency room unnecessarily. It means not paying a doctor to do something that a nurse is qualified to do. It means providing enhanced home care so that frail, elderly Ontarians can stay at home longer, and out of expensive hospitals and nursing home beds. A sustainable health care system also means keeping up with advances in technology and medical evidence about what improves patient outcomes. That means getting rid of things that don't work and reducing fees for medical procedures like cataract surgery that technology has made faster and cheaper to perform. That frees up taxpayer dollars to invest in areas of health care that are underfunded, including health promotion and home care. Pretty much everyone agrees, in principle, with all of this. But as the province discovered earlier this year when it tried to reduce some fees, primarily for highly paid specialists, principle is a long way from practice.

When talks broke down, fee changes by regulation the doctors responded by filling a court challenge claiming bad faith bargaining. The court is not the place to settle this dispute or to ensure quality health care for all The OMA is not dropping its court case and the province's fiscal reality a $15 billion deficit is unchanged.  The challenges are easy to see; the solutions less so. But the bargaining table is the best place to find them.