Hoskins Announces a Draft Proposal

December 15, 2016

Hoskins Announcement Attacks State-Of-The-Art Medical Care

Health Minister Needs to Go

Dear Colleagues:

In an unscheduled statement Wednesday morning, Health Minister Hoskins announced a draft proposal to the media had just been shared with the OMA Board of Directors at 8am.  His media announcement was deliberately timed to not give the OMA an opportunity to consider its contents, further reflecting the Minister’s disrespect for front line doctors.  The apparent changes, many are not officially confirmed, would have a severe and damaging impact on Ontario radiologists and their patients. 

The same state-of-the-art medicine that millions of Ontario patients are dependent upon for an earlier diagnosis, less invasive procedures and better patient outcomes have been put in the crosshairs of proposed funding cuts based on uninformed and unproven health economics folklore.  Warnings from so many medical quarters about how endless Liberal government waste was compromising patient care became apparent once again by a Health Minister who recklessly refuses to consult with medical experts.  Non-medical experts deliberately cause confusion by refusing to recognise that the diagnostic interpretation times are either unchanged or are significantly longer due to technology that has produced significantly more images and much more diagnostic information on those images. 

“This is Strike 3 for Health Minister Hoskins.  He must resign immediately.   Hoskins has repeatedly failed to gain the confidence of practising doctors in his ability to manage the delivery of patient care”, said Drs. Mark Prieditis, OAR President and OMA Section Chair David Jacobs.  First, doctors have rejected his irretrievably flawed July 2016 PSA offer.  Second, they rejected his Bill 41 legislation that increases bureaucracy at the expense of less front line patient care.  Third, they will now reject the recycled and re-packaged PSA, which exposes Ontario doctors to cover up to $2B of annual unfunded patient services.

To cap that off, a recent Coalition of Ontario Doctors’ survey found that 94% of respondents said they had no confidence in Hoskins’ ability to manage the Ontario health care system. 

The detailed contents of the draft 8-page proposal have not been released but they appear to be a crude re-hash of the failed 2016 proposal that was rejected by 63% of Ontario doctors.  What is different is a new and arbitrary re-shuffling of the same funding among physicians in a deliberate attempt to divide doctors by creating winners and losers.  The Health Minister is once again communicating to Ontario doctors via the media maintaining his disrespect for doctors and a disregard for a fair process. The necessary engagement of a binding arbitration process to ensure evenness and fairness is something he is unwilling to provide.  Requests posed directly to Hoskins by the OAR to meet have been twice rejected by the Health Minister despite a promise he made to the OAR in July.  It’s clear that a new Minister must be appointed to regain doctors’ confidence.

The following items appear to be in the draft proposal:

  • The re-introduction of punishing clawbacks at unprecedented levels - 10% cut to physicians billing over $1M and $20% over $2M.  It is unclear if this includes technical fee billings
  • Hoskins appears to have indicated, according to some media reports, that a large portion of diagnostic fees (x-ray, CT, MRI) will be slashed by 10%.  It is unclear how T fees will be impacted.  It is also unclear if this is a unilateral cut or whether it refers to some comment Hoskins made regarding a forthcoming review of the entire OHIP SOB.  This will lead to chaos.
  • An impact of this magnitude would suggest that Ontario radiologists would be bearing 40% or more of the alleged reduction of physician fees
  • No new money will be added to the physician services funding pool
  • The same anemic 2.5% growth that fails to keep pace with the aging and growing population remains even though it is falsely presented as new money and an increase
  • The announcement also fails to come clean that this would be the third successive cut to diagnostic imaging professional fees already experienced by radiologists - ~15% cut since 2012
  • Queen’s Park is no longer in session until March 2017.  The Liberals will not have to be accountable in the Legislature.  They could again seek to impose a unilateral cut to doctors when no one is watching
  • No patient care impact analysis to our knowledge has been carried out by MOH
  • Hoskins is again trying the divide and conquer strategy.  This time it is between GP’s and specialists

The OMA Board passed a motion expressing “its outrage with today’s action by the MOHLTC that is disrespectful of, and totally unacceptable to, the physicians of Ontario.”  The OMA also recognized that this draft proposal did not contain a Binding Arbitration mechanism, which the OMA has accepted as a mandatory element of any new PSA.

The Coalition of Ontario Doctors and Concerned Ontario Doctors is holding a teleconference to discuss appropriate actions in response to the incomplete information available to doctors.

At the very least, it is clear that the turbulence and distrust that the Wynne government has created in our publicly funded health care system is getting worse for Ontario patients.