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OMA suspending negotiations with the government: Good Riddance

March 5, 1995

The Ontario Medical Association has suspended its participation in the Joint Management Committee (JMC), a bilateral committee the government and the OMA established to address health issues.

The effects of the JMC have, from the beginning, been destructive. The JMC has reinforced the disproportionate power physicians have in influencing health care decisions. Groups such as nurses, physiotherapists, social workers, health consumer groups and the general public have traditionally had too little power, relative to physicians, in influencing health care decisions. The JMC has made that power imbalance worse.

Solutions to health care problems will not come from closeted negotiations between physicians and government. Rather, they will come from open debate involving numerous groups working together. Of the various groups with a stake in health care decisions, physicians tend to be the most resistant to change. This makes the disproportionate power of physicians through the JMC even more problematic.

The OMA cited three reasons for suspending negotiations. The first is the cap on physicians' billing. The cap is necessary to limit costs in a public health care system under tremendous stress. The OMA says that because of the cap "a large number of doctors will be close to bankruptcy". While this statement is silly exaggeration, there is a problem. The cap has disproportionately penalized conscientious primary care practitioners who spend extra time with their patients. It is the OMA, not the government, that has resisted the solution to this problem, which is to protect lower-billing physicians from the clawback.

The second reason the OMA cited was the government's failure to allow the doctors to incorporate. Incorporation would again favour high-billing physicians, and the government is making the right decision in not allowing this to happen.

The OMA's third reason is the government's failure to enact legislation to force third parties to pay for medical examinations which they require but which are not medically necessary. This might be a progressive step. If the OMA would ally itself with consumers' groups who, in this instance, share its interests, it might achieve its goal of forcing government action.

The JMC has been an undemocratic and unproductive bureaucratic structure. We call on the government to respond to the OMA pulling out of the JMC by abolishing the committee. As an alternative, government should bring together representatives of a variety of groups to work toward protecting universal health care and instituting positive reform in health care delivery.

Contact:

Gordon Guyatt, M.D.
Rosana Pellizzari, M.D.
Mimi Divinsky, M.D.

Medical Reform Group of Ontario

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