Contract talks between the province and the Ontario Medical Association fell apart because the organization representing doctors refused not to overspend beyond a fixed budget, a government source close to the negotiations said.
“The OMA did not want to be held accountable to a budget,” he said.
The government wanted to include a clawback provision if doctors went over budget, the source said.
“I would say where the deal fell apart was the concept of reconciliation. At the end of the day, if all of our good work doesn’t realize the economic results that we planned on, we still need to find a way to bring those savings out,” the source said.
It’s difficult for the province to keep a lid on physician spending because most doctors are essentially independent contractors, who bill the Ontario Health Insurance Plan for the patients they see. They can always see more patients and bill for more.
The imposed payment scheme sets a hard limit on how doctors will be paid in each of the next three years. They will get $ 11.4 billion this year with increases of 1.25 per cent in each of the two years.
This discount will rise if doctors go overbudget. OMA president Dr. Ved Tandan called the annual allotments “arbitrary” and said they are driven by the province’s budget pressures rather than the health-care needs of Ontarians.
Tandan said the spending ceilings will limit how many patients doctors can see and how many medical procedures they can provide.
“They (government) said they are going to pay up to a certain level of services and then after that they will penalize physicians,” he said, warning that patients will end up waiting longer to see doctors, get tests done and have surgery.