How far are Ontario doctors prepared to push their demands?

Posted on August 17, 2016 in Health Delivery System – Opinion/Editorials – Those who cheer on the Ontario’s doctors’ vote as a defeat for the Wynne government and the OMA’s much-criticized leadership must say how much they willing to pay to satisfy the doctors.
Aug. 16, 2016.   Editorial

It’s no great shock that Ontario’s doctors have turned thumbs down on the deal their medical association negotiated with the province.

The Ontario Medical Association favoured the tentative four-year agreement but conceded upfront that it was “imperfect.” On the other side, many doctors were furious that the deal offered only modest increases of 2.5 per cent a year in overall payments to physicians.

As often happens, those who were most passionate carried the day. Just 55 per cent of the OMA’s 42,000 members voted, and almost two-thirds of them decisively rejected the offer.

That’s democracy, but those who are cheering on the vote as a defeat for the Wynne government and the OMA’s much-criticized leadership must answer this:

How much more are they willing to pay to satisfy the doctors? If they complain that the Liberals too often “buy off” teachers with generous wage settlements, why are they so eager to see the same government buy off doctors with a bigger budget for their services to secure peace on the health front?

More to the point: are Ontario’s doctors themselves willing to support higher taxes in order to finance the higher fees they feel they need to provide proper services?

Alternatively, what would they suggest the government cut in order to give them a bigger budget for their services? Education? Social welfare? Spending on infrastructure? There are pressing needs in all these areas, and many more.

Are doctors willing to accept any responsibility for keeping health costs under control, or will they just step away and blame the government?

As everyone knows, Ontario’s finances are tight and there’s no spare money slopping around in the system to be had for the asking. The province already spends $11.5 billion a year to pay for physicians’ services, the biggest single chunk of the overall $51-billion health budget.

The OMA’s leadership is now badly discredited among its members. It’s not clear quite what it can do to get negotiations back on track.

One of the association’s key demands has been for binding arbitration if it and the government can’t agree on a deal. It didn’t get that in the rejected agreement, and it will in all likelihood revive that demand.

The government has resisted, and for good reason. Binding arbitration in the public sector has generally led to very generous settlements, since arbitrators conclude that the government’s ability to pay need not limit the award. After all, in the end it can just raise taxes.

Progressive Conservative leader Patrick Brown has gone on record as saying binding arbitration should be “on the table” when talks resume. That will no doubt make him popular among doctors, but taxpayers should consider what such a promise might cost them down the road.

In the meantime, there’s no pressing rush for a new deal. Doctors have already gone two years without a contract, and both sides should show maturity and patience while they ponder their next moves.

The government should not impose a deal, which would further inflame a tense situation. Restraining physicians’ pay can only be part of a health-care solution; Ontario will need doctors as key partners as it reshapes the system to meet growing challenges.

And the doctors themselves should carefully consider how far they want to push their demands. The well-being of our health-care system is at stake.

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