In the aftermath of Ontario
doctors' stinging rebuke to the Ontario Medical Association
(OMA)-brokered agreement with the province, it looks like
the folks at Queen's Park are losing patience. A long
and bitter dispute, which saw the OMA membership reject
a four-year tentative agreement worth $6.9 billion over
four years, came to an explosive denouement on November
26 when the Ontario government presented a revamped take-it-or-leave-it
offer to the province's physicians.
Health Minister George Smitherman
says he's through negotiating and is eager to implement
the new, revised deal, which he claims addresses the
major concerns of the disenchanted docs.
WHAT'S
ON THE TABLE
The basic premise of the government's deal was to change
the way primary healthcare should be delivered, using
an incentive-based method of payment for doctors. The
contract was to provide incentives such as fee increases
of up to 35% for physicians who moved to underserviced
areas, for those who chose to specialize in demand areas
like cardiac and cancer, and to doctors who worked in
multidisciplinary group practices designed to serve
more patients.
The OMA was concerned about the
lack of incentives for older doctors and solo practitioners,
who work on the traditional fee-for-service basis, as
well as physician retention and patient waiting times.
One important concession in the
new deal is that the government will scrap a controversial
$50 million bonus for doctors conditional upon them
saving $200 million by prescribing fewer prescriptions
to seniors, the disabled and welfare recipients. Doctors
will still get this money, but there will be no strings
attached.
The other significant bone of contention
was the proposed $30 million reassessment study of the
deal after two years. That idea was thrown out, and
the money will be injected into doctors' raises immediately.
Additionally, the plan will lift fee caps for five medical
procedures that have long waiting lists: cardiac care,
cancer surgery, hip and knee replacements, cataract
surgery and MRI/CT scans.
OMA President Dr John Rapin said
they needed more time to examine the new deal, which
he said is a little short on details. He ruled out a
physician strike as consequence of the fiat, but admitted
a work-to-rule option is being considered. A mostly-conciliatory
Mr Smitherman took the opportunity to restate his willingness
to impose the deal if the OMA's membership refuses it
again.
|
