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.
Gordon Guyatt, M.D.
Rosana Pellizzari, M.D.
Mimi Divinsky, M.D.
Medical Reform Group of Ontario
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