Ontarians are about to get more bang for their health care buck. As reported by Torstar this week, Wednesday's Fall Economic Statement will include an ambitious plan to improve oversight of the $16 billion Ontario Health Insurance Plan (OHIP). This government plan will increase accountability and transparency of health-care spending - especially related to physician compensation.

This is important because Ontario citizens enjoy some of the best health-care outcomes in the world. Ontarians know this is in part due to the excellence of care provided by our physicians and we want to compensate them well and fairly. Doctors are paid on an honour system, submitting their bills for services rendered to OHIP and generally receiving full payment within a few weeks.

The Ford government deserves credit for recognizing that, although the vast majority of doctors bill appropriately, a very small number may take advantage of the honour system. The Auditor General of Ontario reported that in 2016, nine specialists billed for services on more than 360 days per year and one doctor billed for six times the average amount of services provided by similar specialists in a year

Furthermore, the Auditor General's 2016 report on OHIP showed that the ministry of health had very weak authority to recover money that was improperly paid to physicians. The report identified inappropriate physician billings totalling hundreds of thousands of dollars that were not recovered. The auditor criticized the ministry for emphasizing education of physicians who were billing unacceptably rather than recovering excessive billings.

The auditor's report describes the weakening of the ministry's inspection and audit capabilities following implementation of the Cory report in 2005. Justice Cory found at that time that the ministry's audit function had a negative impact on physicians which could have tragic consequences- one physician committed suicide following a ministry audit.

However, the government did not enact some recommendations of the Cory report that would give the ministry inspection power to visit doctors' offices and review their medical records and eventually recover inappropriate bills. The auditor urged reinstating an inspector in the ministry as part of a more effective audit process.

The Kaplan Arbitration Panel, which settled a long-standing dispute about compensation between the Ontario Medical Association (OMA) and the ministry, also recommended that the audit process should be streamlined and modernized.

In introducing legislation to protect OHIP against misuse, the government will ensure that OHIP only pays for appropriate, delivered services and will make it easier for the government to recover funds when billings are incorrect. The legislation promises to educate the public on what OHIP is paying for. It will also reduce the risk of OHIP fraud by uninsured individuals by eliminating the old red and white OHIP cards and requiring use of photo identification cards to obtain health services.

The new legislation will increase transparency of health payments by requiring the ministry to publish all funding paid to OHIP practitioners. This is consistent with the OMA's position that any publication of physician payments should be enabled through legislation.

The proposed legislation will not impact the vast majority of Ontario physicians. The use of statistical analysis to identify unusual billing practices will likely identify fewer than 1 per cent of doctors as requiring practice inspection. Most of those anomalous billings will be found to be appropriate or the result of honest correctable mistakes. However, this legislation, in concert with another initiative being worked on by the OMA and government, is essential to maintaining a sustainable publicly funded health system.

Responding to a recommendation of the Kaplan Panel, the OMA and government are now collaborating to identify more than $400 million of inappropriate OHIP services. This work is based on the finding of Choosing Wisely Canada (a physician led group) that up to 30 per cent of medical services provided in Canada are inappropriate.

If Ontario is going to enjoy a sustainable publicly funded health system that provides excellent care at an affordable cost, tough decisions must be made to ensure that public money is being spent wisely. The Ford government deserves credit for increasing oversight for OHIP billings. The OMA should also be congratulated for working with the government to ensure that inappropriate care is reduced so that we can afford innovative and better treatment in the future.

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Bob Bell worked in Ontario health care for more than 40 years as a GP, surgeon, hospital CEO and Deputy Minister of Health. Follow him on Twitter: @drbobbell

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