Democracy Gone Astray

Democracy, being a human construct, needs to be thought of as directionality rather than an object. As such, to understand it requires not so much a description of existing structures and/or other related phenomena but a declaration of intentionality.
This blog aims at creating labeled lists of published infringements of such intentionality, of points in time where democracy strays from its intended directionality. In addition to outright infringements, this blog also collects important contemporary information and/or discussions that impact our socio-political landscape.

All the posts here were published in the electronic media – main-stream as well as fringe, and maintain links to the original texts.

[NOTE: Due to changes I haven't caught on time in the blogging software, all of the 'Original Article' links were nullified between September 11, 2012 and December 11, 2012. My apologies.]

Wednesday, April 27, 2016

Ontario’s top-billing doctor charged OHIP $6.6M last year

A specialist who charged the Ontario Health Insurance Plan a “staggering” $6.6 million last year is one of 500 doctors billing more than $1 million annually, Health Minister Eric Hoskins said Friday.

Hoskins is refusing to release the doctors’ names for privacy reasons, but is calling on the Ontario Medical Association to come back to the negotiating table to rework outdated fee codes that make it possible for some to snap up 10 per cent of the $11.6 billion budget for paying doctors.

“The current structure allows certain high-billing physicians to generate income many times the average doctor’s salary, which is due, in part, to the fact that the fee structure has not kept pace with medical and technological advances,” he said.

The top-billing doctor is an ophthalmologist – one of three specialties that take in the most cash, with 85 of the eye specialists billing more than $1 million last year, Hoskins said.

In top spot were diagnostic radiologists, 154 of whom billed $1 million or more. Another 57 cardiologists hit or surpassed the same threshold.

The top-billing diagnostic radiologist charged $5.1 million and the highest-billing anesthesiologist $3.8 million.

None were named as the government released details aimed at putting public pressure on the OMA.

Officials from the association could not immediately be reached for comment but doctors are still angry that the province unilaterally chopped all fees charged by physicians by 1.3 per in September cent last year.

The Star is attempting to get the names of the highest-billing physicians through an appeal to the province’s information and privacy commission and has been told that a decision is expected soon.

An attempt to get them in 2014 was denied. The health ministry’s privacy office said the release would be considered an unjustified invasion of privacy.

Manitoba and British Columbia make physician-identified billings public and Ontario releases an annual list of public servants earning more than $100,000.

The OMA has argued that physicians are independent contractors, not public servants. As well, the organization says that billings are not the same as earnings because they do not reflect how much doctors have to pay in overhead costs.

Hoskins said the budget for paying doctors was increased by $140 million this year and that the average physician in the province bills $368,000, out of which they must pay their expenses.

That makes them “the best paid doctors in Canada,” said Hoskins, who is a physician.

He said the government has asked the OMA to help modernize fee codes, of which there are 7,000, to make the system more fair and sustainable given pressures on the public purse as the government seeks to eliminate annual deficits by 2018.

Doctors have billed $744 million more than the budget set for them in the last four years, Hoskins added.

“When they bill more than the budget, the money has to come from elsewhere in the health-care system, limiting our ability to invest in home care, hospitals, mental health and other services.”

The fee cuts for doctors last September were on top of a 2.65 per cent across-the-board cut the previous February. There have also been fee cuts targeted at different specialties, and taken together they add up to 6.9 per cent in cuts, the OMA has said.

The government cut fees because it is trying to cap the annual physician services budget at $11.6 billion.

Doctors argue that they are charging beyond the cap because they are doing more work by treating a growing and aging population.

The government contends the physician services budget was set taking demographic changes into account. As well, it argues that a negotiating framework created at the insistence of the OMA allowed it to take unilateral action.

A breakaway group of physicians, Concerned Doctors of Ontario, is planning to hold a rally at Queen's Park on Saturday.

Original Article
Author:  Rob Ferguson, Theresa Boyle

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