Be careful what you wish for on doctors’ billings
TheStar.com – Opinion/Commentary – Ontario’s doctors would welcome having their OHIP billings made public. Because the care we provide the people of Ontario is one of the best bargains going.
Dec 15 2014. By: Douglas Mark
It must be that time again. Every three or four years, when the Government of Ontario enters into negotiations with the province’s doctors, the Toronto Star rolls out the obligatory physician billing stories. Like death and taxes, it’s something you can count on.
In the interest of transparency, we urge the government to pull back the curtain of secrecy, let the sunshine in, and make doctors’ OHIP billings public. It’s good for taxpayers, it’s good for patients, and ultimately it’s good for our healthcare system. I’m paraphrasing here, but that’s pretty much the gist of the argument.
After all, some doctors are billing as much as $4 million to $6 million a year. Surely, that can’t be right. How on earth could an individual doctor gobble up so many of our tax dollars? It seems almost—dare I say it?—criminal. At least, that’s what it feels like the Star is implying to me.
Well, here’s a newsflash for you . . . Ontario’s doctors would actually welcome having their OHIP billings made public. Because the fact is, the care we provide the people of Ontario is actually one of the best bargains going.
Let me tell you why.
Ontario’s doctors provide more than a billion dollars’ worth of free healthcare infrastructure. When you visit a family doctor’s office, for instance, or a cardiac clinic, or have a colonoscopy outside the hospital environment, you are in reality visiting a facility bought and paid for not by the government but by physicians.
Doctors are also one of the province’s largest employers. In my clinic alone, we employ eight people – paid for by my colleagues and me, out of our OHIP billings. But wait, there’s more. It’s estimated that medical practitioners in Ontario are responsible for the creation of some 200,000 jobs, both direct and indirect. Those jobs generate a lot of taxes, which ultimately find their way back into the hands of the Government of Ontario.
And while many of you assume doctors are Government employees, with rich benefit packages, pensions and vacation plans, the truth is we’re not. We’re independent contractors. We don’t receive benefits, we don’t have pensions, and nobody pays for us to go on vacation. In fact, if you’ve ever wondered why so many doctors keep working into their seventies and eighties, it’s because we can’t afford to retire. And that’s reality.
To mention nothing of the crippling cost of medical school. The average medical student graduates with debt loads in excess of $100,000. To make matters worse, most of us are in our early- to mid-thirties by the time we set up our practices and start billing OHIP because of the length of time it takes to become a doctor.
All of which would be bad enough, but here’s something else you probably don’t know. Ontario’s doctors receive only 50 per cent of what the Ontario Medical Association’s own fee schedule recommends we should be compensated for our work. That’s right, 50 per cent.
Imagine, if you will, being hired by a company to do a job in which you’re supposed to be paid $20 an hour, only to discover that you’re going to receive $10 an hour because your employer can’t afford to pay you what they agreed to pay you.
I don’t think there are too many companies out there who would be able to get away with that. Certainly not where there was a strong union to do battle and stand up for its members. Unfortunately, for doctors, we don’t have someone to stand up for us—at least, not yet.
Another little-known fact. The body that negotiates our agreements with the province receives something on the order of $50 million a year in mandatory membership dues – all as a result of the Government of Ontario passing a piece of legislation in 1991 giving the Ontario Medical Association the right to collect dues from doctors so that they can represent us.
Not surprisingly, the OMA is reluctant to bite the hand that feeds it. To the detriment of the rank-and-file, I might add.
So go ahead and make our OHIP billings public. We really won’t mind. But if you do so, beware of the law of unintended consequences. For you see, if you shine a spotlight on doctors and show what they bill the government for looking after you, the patient, then it’s only fair that doctors get to reveal what they take home after covering office expenses, staff salaries and benefits, and medical supplies.
In my case, as a family doctor, my take-home pay is slightly more than that of your typical school teacher . . . but without the perks, the pension and the summers off. Oh, and by the way, no Freedom 55 either.
And don’t even get me started on what hospital administrators and politicians are paid. None of whom has ever saved a life, last time I checked. How’s that for a little sunshine?
Dr. Douglas Mark is the Interim President of DoctorsOntario. @DocsOntario.
< http://www.thestar.com/opinion/commentary/2014/12/15/be_careful_what_you_wish_for_on_doctors_billings.html >
Tags: budget, economy, Health, pensions, privatization
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