Social Policy in Ontario

End the secrecy over doctors’ billings

Posted on June 5, 2016 in Health Policy Context

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TheStar.com – Opinion/Editorials – Ontario’s privacy commission was right in ordering disclosure of doctors’ OHIP billings. Transparency and accountability demand it.
June 4, 2016.   Editorial

It’s not what doctors want to hear. But Ontario’s privacy watchdog has growled, and for good reason.

In a landmark ruling, John Higgins, an adjudicator with the Office of the Information and Privacy Commissioner, found that the public has a right to see individual physicians’ revenues paid by the province.

He specifically ordered the release of names, specialties and the OHIP earnings of Ontario’s top 100 billers. The province had previously disclosed some eye-opening numbers, such as the fact that one ophthalmologist had charged the Ontario Health Insurance Plan an impressive $6.6 million last year. But the identity of that physician — and those of several other big billers — was kept secret.

Higgins ruled that the public should be allowed to know who such people are and what they’re charging the province for their services. He correctly found in favour of transparency and accountability.

“It is an inescapable fact that these payments consume a substantial amount of the Ontario government’s budget,” Higgins wrote in his June 1 ruling. “Regardless of the fact that physicians are not public servants, these amounts reflect payments for public services…paid for by taxpayers.”

The Ontario Medical Association, representing the province’s 29,000 physicians, had forcefully argued against disclosure. Submissions were also received from two doctors’ associations and 79 individual physicians, some presenting their view through lawyers.

They are entitled to seek a judicial review, and Higgins’ ruling is widely expected to be challenged. Ontarians, however, would be better served if critics recognized the wisdom of his finding and the broad social benefit that flows from disclosure.

Higgins’ decision comes two years after the Star’s Theresa Boyle asked the health ministry for physician-identified billings. A freedom of information request was filed seeking the identity of Ontario’s top 100 OHIP billers, plus the amount each had received from the system, in each of the previous five years.

The ministry responded by disclosing amounts that were billed but refused to reveal doctors’ names, arguing this would represent an “unjustified invasion of personal privacy.” The Star appealed that decision to the privacy commission, where Higgins ruled in favour of openness, ordering the ministry to release the requested information by July 8.

Another appeal launched by the Star, seeking physician-identified billings for every doctor in the province, is also before the privacy commission. But it was put on hold until after Higgins’ ruling.

A strong case can be made for lifting the curtain of secrecy hiding what individual physicians are paid through OHIP. It’s hardly a novel concept. British Columbia has revealed physician-identified billings since 1971, and Manitoba has been doing so since 1996. There’s public benefit in disclosure.

As a Star editorial argued in 2014, people stuck in a waiting room only to be seen for a minute or two while their doctor scrawls out a prescription might benefit from knowing if their physician is an unusually high biller. It could signal substandard care from a doctor pumping up revenues by churning patients though the office.

And revealing the revenue of physicians in certain specialties that are — frankly — overpaid could help build momentum for reform. That would ultimately benefit the medical profession as a whole.

It’s important to note that revenue from OHIP isn’t a salary. Physicians’ billings cover a wide variety of expenses including the cost of running an office, paying staff and buying equipment that can be extremely expensive. Doctors worry that disclosure of their yearly billings will simply confuse the public about their actual income, but people are capable of putting OHIP revenue in context.

Higgins was right in concluding that “the concept of transparency, and in particular, the closely related goal of accountability, requires identification of parties who receive substantial payments from the public purse.” His ruling should be allowed to stand.

< https://www.thestar.com/opinion/editorials/2016/06/04/end-the-secrecy-over-doctors-billings-editorial.html >

Tags: budget, Health, ideology, mental Health, privatization, rights, standard of living

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