Last week, the Supreme Court struck a victory for the public’s right to know when it refused to hear an appeal from physicians who want to keep the names of Ontario’s top 100 publicly-paid doctors secret.
Indeed, the court’s decision — which came after a five-year quest by the Star’s Theresa Boyle to obtain the records — is sure to lead to more transparency and accountability in how health care dollars are spent by doctors and the government that pays them.
At more than $12 billion, physician compensation is 7.5 per cent of the entire provincial budget. That is reason enough for the public to know a lot more about how that money is spent.
There are two things that must happen now.
First, the Ontario Ministry of Health must comply with a years-old order from the province’s information and privacy commissioner, Brian Beamish, to release physician-identified billing data as quickly as possible.
Unfortunately, though, it appears the Ontario Medical Association — which has fought the release of this information through the courts — is trying to stand in the way once again.
Its claims to be in “early discussions” with the health ministry on how this can be done implies that the association is the arbiter of how the information will be released and when, rather than the government.
And its argument in an email to doctors that the names of the top billers should only be disclosed by an act of the provincial legislature appears, on the face of it, to be another attempt to delay the release of this information.
As the earlier unanimous Ontario Divisional Court ruling on this case stated: “The public is entitled to information in the possession of their government so that the public may, among other things, hold their governments accountable.”
The government has the means to make this happen, without new legislation, and it should.
Secondly, Beamish’s office should move quickly on another information request by the Star seeking the release of physician-identified billings for all Ontario doctors, which he had put on hold pending the Supreme Court’s ruling on the top 100.
The fact is, releasing physician-identified billings is hardly groundbreaking. It already occurs in British Columbia, Manitoba and New Brunswick and in the United States.
But in Ontario, taxpayers have been left in the dark, wondering what to make of a health ministry audit conducted five years ago that raised some troubling questions.
Among them: How can one doctor bill for 100,000 patients in a single year? And why did the province’s top-billing doctors receive payments averaging $4 million apiece, with one billing $7 million?
The audit also unearthed these other worrisome facts: A handful of doctors allegedly charged for “services not rendered,” billed for procedures that cost more money than they should have and charged for services judged to be “medically unnecessary.”
Half a dozen also claimed to have worked 356 days — or more — in that one year period.
Allowing questionable billings to go unchallenged only serves to unfairly tarnish the reputations of all doctors. The fact is the average Ontario doctor bills $348,000 and family physicians bill even less at $275,000.
Out of that they must pay staff salaries, rent, equipment costs and other expenses before they can take anything home. So the majority of doctors are hardly overpaid.
In the end, with the Supreme Court siding with transparency over privacy the public is going to learn how much each of the province’s 28,100 practising doctors is billing OHIP.
The sooner the Ford government makes that happen, the better.
https://www.thestar.com/opinion/editorials/2019/04/14/time-to-reveal-individual-mds-ohip-billings.html