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The growing hunger of the health system for public dollars is the single scariest thing in Canadian public budgeting

Your lousy budget estimates aren’t our fault, the medical association pointed out, especially if we’re billing more because we’re meeting patients’ demand for health services. And by slashing our fees, you’re basically punishing us for finding more efficient ways to do things. Generally, these are reasonable objections.

Negotiations broke down, an attempt at mediation by respected former chief justice Warren Winkler failed, the government imposed fee cuts of over six per cent, the OMA started a pressure campaign, and Health Minister Eric Hoskins released a bunch of data on top-billing doctors meant to shame high-billing docs who supposedly take unfair advantage of the obsolete fees.

To the extent that the new deal — pending a vote by the medical association’s members in the next couple of weeks — puts an end to that, it’s a good thing. The growing hunger of the health system for public dollars is the single scariest thing in Canadian public budgeting these days and on the whole it’s better to have the doctors who send the bills and the governments that pay them getting along than to have them fighting.

It promises co-operation on getting family doctors for every Ontarian who wants one (on which the the Liberal government has already made a lot of progress, at great expense, but on which it has more to do) and in staffing after-hours appointments, saving strain on hospital emergency rooms.

However.

The precise terms of the deal are secret till after that OMA vote. In the meantime, a joint statement says the agreement will not end a constitutional challenge the OMA filed last fall, asking for a judicial rulingthat the association has a right to binding arbitration on all pay matters. As it is, the government decides what it’s willing to pay for doctors’ work and doctors decide how much work they’re willing to do at that price. That allows the unilateral cuts the government imposed earlier in this fight. The OMA wants to be treated more like a union of public employees who provide an essential service, though they’re also sort of independent contractors and small business operators and mostly set their own hours.