Deb Matthews slashes fees for OHIP services to save $338 million

Posted on May 9, 2012 in Health Delivery System

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TheStar.com – news/canada/politics
Published On Mon May 07 2012.   Tanya Talaga and Robert Benzie, Queen’s Park Bureau

Ontario’s doctors complain of being “deceived” by the Liberal government after several hundred fees paid for services were slashed to save $338.3 million this year.

Health Minister Deb Matthews announced Monday there would be 37 changes to the OHIP fee schedule, targeting hundreds of services provided by cardiologists, radiologists and ophthalmologists.

The doctors claim this will mean longer waits in emergency wards and for test results — and warn that patients could expect a harder time finding a family doctor or a specialist because of fewer physicians.

“Our doctors are the best paid in Canada,” said Matthews, whose gambit comes as the province’s bitter negotiations with the Ontario Medical Association, which represents 25,000 doctors, have stalled.

“Instead of another raise for doctors, we need a real wage freeze so we can invest in more home care,” she told a press conference at Toronto Rehab, a continuing-care hospital. “I was left with no choice.”

Dr. Doug Weir, the new president of the OMA, accused Matthews of not negotiating fairly because she has not moved from her initial bargaining stance yet now wants to slash $1 billion in fees and programs.

“Where I come from, holding your breath until you get what you want is not negotiating,” said Weir, who was on his first day on the job. “This is not a wage freeze, it is a cut.”

Matthews argues the OMA is looking for a $700 million boost and what is the equivalent of a 5 per cent raise for physicians, which works out to about $20,000 per doctor.

The OMA says this is false; they will take a two-year fee freeze and help find another $250 million in savings.

Weir, a Toronto child psychiatrist, said it is clear the government never had any intention of really negotiating with Ontario’s doctors.

“We have been deceived. In doing so, they have chosen confrontation over collaboration.”

The OMA has launched a $1.5 million print, radio, TV and online advertisement campaign in an attempt to arouse public sympathy.

While the doctors have promised not to stage a job action, such as a strike or working to rule, Weir predicted patients would feel the pain of the changes.

“Patients in Ontario, particularly seniors, will suffer from reduced access to medical care for blinding conditions like macular degeneration, glaucoma and diabetes,” he said, adding ultrasound and mammography waits could return to levels not seen for decades.

The changes, which affect several hundred of the 4,500 OHIP services, were filed Monday and are retroactive to April 1, said Matthews.

Insisting that she is choosing “seniors over specialists,” the minister stressed she still wants to work with doctors to hammer out an agreement.

“Our budget was explicit; we were looking for a real wage freeze. This comes as no surprise to doctors. I am hoping they will now come back to the table so we can continue to work.”

Weir’s predecessor, Dr. Stewart Kennedy, angrily denied on Friday that all the doctors want is a raise. They say this is a fight about the future of the health system as the boomer population rapidly greys and demands more services.

With 407 specialists billing OHIP more than $1 million each a year, the Liberals believe vast savings can, and must, be found as the province faces a $15-billion deficit.

Conciliation, first refused by the government but pushed for by the doctors, was agreed to late Friday. However, the Health Ministry placed a 48-hour time limit on talks, saying the OMA had until only Sunday night.

The doctors would not accept this, saying they would talk to Matthews about conciliation Monday.

She responded by regulating fees.

Payments for cataract surgeries will be cut to $397.75 from $441 — surgeries that took two hours in the 1980s now take 15 minutes, thanks to technological improvements. Fees for eye injections for retinal diseases will be cut to $90 from $189 over four years.

“Specialties have seen tremendous windfall profits because of enhanced technology. We need to share in some of those productivity changes. It is only appropriate we update fees to reflect reality,” said Matthews.

In some specialties, new technologies have boosted doctors’ pay to $700,000 a year on average, she said.

Payments for 250 different diagnostic radiology tests, such as X-rays, CT/MRI scans and ultrasound will be reduced by 11 per cent over four years.

Self-referrals — the practice of doctors referring patients back to themselves for additional procedures — will be curbed. Currently $88 million is spent on that, but the government wants that reduced to $44 million.

Matthews noted doctors’ pay has risen an average of 75 per cent since the Liberals were elected in 2003 — from $220,000 to $385,000.

Progressive Conservative Leader Tim Hudak supported her move to impose the fee cuts and to freeze the total compensation package for doctors because “something has to happen.”

But Hudak said he’d go further by introducing a bill soon to impose a mandatory wage freeze on all public-sector workers with “no exceptions, no special deals” instead of waiting for wage freezes to be negotiated.

Premier Dalton McGuinty told Hudak that wage freeze legislation is too provocative, saying “we’re not going out there looking for a fight.”

NDP Leader Andrea Horwath chastised the government for taking the “my way or the highway” approach and not engaging the doctors in a more meaningful dialogue.

“The patients have become the ping pong ball in this high-stakes game.”

With files from Rob Ferguson

• Fee per service for any combination of retinal disease or glaucoma will be reduced to $25 from $63, and service will be limited to four times a year.

• Fees for anesthesia for conscious sedation (colonoscopies, cataracts, etc.) will be reduced to a combined fee of about $60 from $120.

• Electrocardiogram fees are being reduced to $4.95 from $9.90.

• Complete colonoscopy fee is being reduced to $197 from $218.90.

• Payments for cataract surgeries will be cut to $397.75 from $441.

• Fees for eye injections for retinal diseases will be cut to $90 from $189, over four years.

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