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  • mmantha-co

May 17, 2024

Premier Ford can't see the forest for the trees


I am a firm believer in taking a balanced approach in life. Whether discussing healthy lifestyles, marriage and relationships or education, a balanced approach will most likely lead to success. The need for balance is even greater when it comes to policy or decision-making at a government level.

The people I talk to in my work understand this need for balance and appreciate it when policy is discussed from the average Ontarian's perspective. I'm no Rhodes Scholar, but rather a graduate of the school of hard knocks. In my lifetime, I have lived in many places and benefited from numerous employment experiences and leadership roles.

 As readers know, many politicians are well-schooled in the legal field or political sciences. This is a good thing. We need politicians who know how to read, interpret and create legislation. However, we also need input from other perspectives to ensure that laws and policies will benefit the people they are meant to govern. So there must be space for a wide range of perspectives at the table, speaking for average Ontarians.

I've worn many hats in my lifetime, including as a negotiator. My approach in these situations has been to speak honestly and demonstrate respect. 

As our moms taught us, we should treat others the way we want to be treated.

The Ministry of Health (MoH) has been negotiating a new Physician Services Agreement (PSA) with the Ontario Medical Association (OMA), which represents the doctors of Ontario. The negotiated PSA will determine how doctors will be compensated over the next four years. At the beginning of March this year, the parties agreed on most parts of the PSA. However, One section that went to arbitration was the compensation for physicians under OHIP.

Part of the arbitration process is for each negotiating party to provide the arbitrators with arguments that support the bottom-line offers they have put forward.

The OMA submission is based on the argument that Ontario is in the midst of an absolute healthcare crisis because there are in excess of 2 million Ontarians in the province without primary care right now. The sheer number is dangerously high and frightening, especially if you or a loved one is among the 2 million. Steps to avoid catastrophe are long overdue, and we are operating on borrowed time.

VillageMedia's digital news, The Trillium.ca, summarized the OMA submission as a "catch-up" increase that would compensate them for historically high inflation over the period of their previous contract. It would also help to make up for what they argue they were denied due to wage restraint Bill 124, which the courts ruled was unconstitutional. The doctors claim the law limited their negotiating power even though they weren't strictly covered by it. 

The OMA proposal is for 15.2 percent over 4 years, while the government's bottom line is 3 percent. So, the spread of the discrepancy is significant and will be a challenge for the arbitrators to resolve.

With the above in mind, I was shocked when I heard Premier Ford and Health Minister Jones supported and echoed the arguments submitted by the Ministry.

A  May 8, 2024, CBC News article entitled "No concern about 'diminished supply' of doctors" reported, "The OMA is proposing a five percent general price increase for the year, a 10.2 percent "catch up" to account for inflation and "low price increases" since 2012, as well as 7.7 percent to be directed to various health system programs."

The government's submission states that, from their perspective, there is no need for any "catch-up." They wrote, "The average physician income adjustments compared favourably with other settlements where retention and recruitment is not a major concern." They added also that "Ontario has enjoyed a growth in physicians that far outstrips population growth."

The Ministry's submission argues that while physician incomes have risen and the number of doctors practicing in the province has outpaced population growth, their surveys indicate that patient access to family doctors has worsened. So, the Premier and Minister Jones have determined that the blame is on doctors because they must not be working hard enough. To state this in the Ministry's arbitration submissions is like crossing paths with a bear in the bush, believing the best strategy to tweak the bear's nose. The trajectory of their arguments is incomplete and misleading, and the tactic is misguided if they want to come to a fair and reasonable agreement that all parties can live with. It is not an election in which there is a winner and a loser. Ultimately, it's not about the government or doctors "winning"; it's about ensuring the People of Ontario win. 

I can't help but ask if the Ministry's submission meets the level of speaking honestly and demonstrating respect and sincerity. They are putting down on paper that there is no shortage of physicians now and no concern for the future.

Ontarians know that this is not true.

In Ontario, the population of people over 80 is expected to double by 2050. You don't need to be a doctor or analyst to understand the medical services and treatments that people of that age increase. So, it should be of no surprise that as our population ages, the amount of time a physician must devote to any one patient will increase, meaning they will have less time to see other patients each year.

OMA President Dr. David Barber says that the government's approach and arguments to arbitration are offensive to doctors. "The numbers are one thing, right, but ... the government's approach here is their briefing essentially says there's nothing wrong. I get there's posturing, but this is actually quite dangerous posturing on the side of the government."

On May 10, 2024, The Trillium News confirmed Barber's comments, reporting, "The government's position doesn't actually deny that patients' access to physicians is worsening it just blames doctors for it, saying they may be seeking a better "work-life" balance and are paid enough not to work as hard as they used to." Members of the Ontario Union of Family Physicians were so outraged that they began to circulate a petition calling for the Minister's resignation, calling the accusation a slap in the face of Ontarians, especially the 2.3 million who do not have access to a family doctor.

The above article also quoted Healthcare economist Boris Kralj, who believes the Ministry's attack tactics are unwise. Further, he said, "The Ministry went out of its way to kind of disparage, or slag, physicians…it's frankly ridiculous. I was just shocked that they would do that, and they do it in a public, written document. I can see them doing that in a closed room, but I can't see them putting it on paper for everyone to see what they think."

Premier Ford prides himself on having long-term experience running a very successful family business. Considering that he has endless research, strategists, and negotiation resources at his fingertips, it is bad enough that the government had to resort to binding arbitration to resolve outstanding PSA issues with Ontario doctors. However, this inexcusable fumble can only damage the government's reputation and relationship with the medical profession. In the end, it will be the People of Ontario who will suffer the consequences.

It's entirely understandable for a ministry advisor or official to operate from the perspective of their portfolio. But when you are a cabinet minister or the premier, you must commit to seeing things from several perspectives, especially from the standpoint of doing what is right for the People of Ontario. It is the voices of such people that I will continue to take into the  Ontario Legislature.

As always, I invite you to contact my office about these issues or any other provincial matters. You can reach my constituency office by email at mmantha-co@ola.org or call Toll-free 1-800-831-1899.

Michael Mantha, MPP

Algoma-Manitoulin  

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