The release of Ontario’s budget last week prompted comment from the president of the Ontario Medical Association, Dr. Ved Tandan, that the government’s policy of taking from the health care system to balance its budget is putting the healthcare system in jeopardy. Population growth and unmet needs for family doctors and other services are being ignored, he says. This is certainly an important and complex issue. That said, budgeting requires a careful look at unnecessary spending to determine where cuts can be made. Can the Ontario government find ways to spend less, or alternatively, spend more efficiently, on healthcare?
We have adopted a publicly funded medicare system in this province that allows access to healthcare for all citizens, regardless of their means. That system compensates doctors for the very important work they do. In fact, part of the doctors’ publicly funded compensation package includes a subsidy of their premiums paid to the Canadian Medical Protective Association (CMPA). The CMPA is not an insurer, but membership in the organization includes benefits to cover, for example, legal costs in defending claims of negligence made by patients and to pay out claims that are found to be meritorious. The amount paid annually from the public purse for premiums is substantial. This is not necessarily a bad thing. The CMPA was founded to protect the doctors that work hard for us from frivolous or unmeritorious claims.
Generally, other professionals must pay for their own errors and omissions insurance. Should doctors pay their own CMPA premiums instead of the taxpayer? Consider that, unlike many other professions whose fees are market driven, our public system also restricts what doctors can charge for services. For that reason, arguably providing the premium subsidy is appropriate. Ultimately, society benefits from efforts to ensure that our doctors can and do focus on providing quality medical care.
Query then why a doctor who faces criminal charges should have his defence funded by the taxpayer. The CMPA may, in its discretion, pay the doctor’s legal costs in criminal proceedings if he has, for example, been charged with sexual assault of a patient.
Does this improve medical care to the citizens of Ontario? Does it help to instill confidence in our medicare system? Is this a form of compensation that we, as a society, feel is important to provide to doctors?
Bearing in mind that we already have a publicly funded legal aid system for those who do not have the means to pay for their own defence, is there really a good policy reason to support a separate legal aid system for doctors?
There is no question that reducing funding for medical care to balance the budget is concerning. We all want and deserve quality medical care. Perhaps, however, we need a good hard look at where our money is spent. Perhaps publicly-funded subsidies should come with some restrictions about how they may be used. Cutting the fat doesn’t always mean cutting necessary services. Sometimes cutting the fat means health is improved.
This blog post was contributed by Joni Dobson, OTLA Director and Lawyer with Legate & Associates LLP.
