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HomeMy WebLinkAboutThe Goderich Signal-Star, 1986-01-29, Page 17Comrnunit News Extra-billiilg is not the issue in dispute ®® ® in a country which purports to have a for it. • from page 1A Socialized National Health System there is fectively shut off any competition that a lack of uniform accessibility and a very might have lowetred rates and saved the definite two tiered system. The OMA for 11,11 taxpayer dollars. years now has implored the government to k When the government became the sole allow private insurance back into the insuring agent for health services in 1969, scheme of things in Ontario. The unions they. agreed by legislation to pay 90% of would leap at this as a negotiable work . the Ontario Medical Association fee in benefit and this certainly would free up their Schedule of Benefits. This quickly government health dollars for necessary kwent by the Beard and by 1979, the ihysi- and urgent funding of not only hospitals cians were receiving only 65% of what they and needed equipment, but also public should have been receiving under, a fair health and teaching programs including ; .: tariff. This has improved slightly so that research that g'umply cannot be funded now the benefits cover approximately 75% under our present system. f of the OMA fee. Nevertheless, I dare say The vast majority of opted -out direct s. we are the only group of people in Canada, billing physicians and surgeons charge . professional or otherwise, who are virtual- their patients far less that the Ontario ly taxed at 25% before being paid.•Can you - Medical Association fee for service. Many 1- conceive of the Bar Association entering of us feel obligated to deal with our pa- into any such agreement? tients directly simply to maintain our in- In any form of insurance such as car or dependence. As you can See from the flyer house insurance, one can never expect to that' all my patients receive, I am, in fact, receive full compensation. The insured losing money because a 2% surcharge does t_ person always has to pay out of pocket in not cover my bookkeeping and mailing addition to the insurance payment to get costs. 'full value. Medical insurance is similar in I am pleased to report however, that our • that your OHIP insurance only covers 75% surgical equipment fund has received of the doctor's fee. It means simply that several hundred dollars in donations, so the government is not offering you good in- that many ofmy patients, 1' have to $ surance value. Those physicians who are believe, feel that the Ontario Medical w. opted -out of OHIP and bill their patients up Association fees are not outrageous and at to the OMA fee are not "Extra Billing" at the same time recognize the problems that all. The government is simply, by lack of community hospitals are having in main - funds, underpaying physicians for their taining up to�late equipment and facilities. 1 services. Finally, the issue before us is purely one t It also means that 88% of the Medical of health care funding. The issue of "extra Profession in Ontario, at this time, are billing" is a total obfuscation of the truth of willing to forgo 25% of their fair fee to the matter and that is simply, that if you avoid the added stress of dealing directly want quality care (hospitals, facilities, with their patients over financial issues. research, nursing homes, preventive This, of .course, means that the patient has medicine program then you have to pay no sense of the value of the service that has been rendered and judges that the service is free. Almost always anything that is free is overused, There is no question that some patients, knowing that their medical pro- blems are being paid for by a third party (OHIP), have no compunction about call- ing their physicians for trivial complaints. Direct billing 'with the knowledge that there will be a nominal fee helps to discourage this kind of misuse. The cor- ollary to this is the fact that direct billing lets the patient know what professional medical care and.services have been given and what they are worth. It assures that - there will not be a physician overutiliza- tion of the system. Being opted -out and billing a fair fee (at, or below the OMA tariff) makes for honesty, and responsibili- ty by both the patient and doctor and tends to prevent the insuring third party from,' being exploited. The proposed legislation states that a physician, dentist or optometrist shall not charge more or accept payment for more than the amount payable under the plan for rendering an insured service to an in- sured person. In fact, that makes a hither- to independent and honourable profes- sional nothing more than a Civil Servant to be paid at a rate to be determined by a Government Bureaucrat. Once this has happened there is nothing to prevent that • same bureaucratic process from imposing economic sanctions as happened in Quebec, where patients of direct billing doctors receive no insurance payments from their government insurance plan. In- deed in Quebec, a ceiling has been placed on doctor's earnings, so that no matter `• how conscientious and hard working a doe- ' for may be, his income is limited. The result of this is that many physicians in Quebec simply stop working for the rest of the year if they have reached that ceiling. Once the government has a total finan- cial hold on physicians then they can by : coercion and legislative means determine where a Doctor` shall practice, how many physicians there shall be in a certain area and how many specialists of one sort or another shall be allowed to practice in a certain location. The independence and . freedom of the medical community will have been lost, and professional care and service as we know it today, will be gone forever. The patients' freedom of choice as far as selecting a physician will be in jeopardy and I suspect that meaningful . conscientious care on the part of many physicians wilt be a thing of the past. The ban on billing a fair fee for services will certainly affect many of the major centres where there are super specialists of extremely high caliber. Many of these qualified, irreplaceable specialists will un- questionably leave the country leaving a , large void in certain areas, not only in technical expertise but also in teaching and research. The public is simply not aware of many of the unpaid hours that physicians work largely on a voluntary basis to insure quality care in community hospitals such as ours or in a teaching capacity in Univer- s sity centres. Once we have become, in ef- feet and by legislation, Civil Servants, then much of the incentive for reaching for ex- cellence will be gone. The public's health • needs and the quality of care cannot help but suffer. ' • One of the alleged aims of the govern- ment is to. do away with MVP premiums altogether. For a majority of the working population this will make no impression whatsoever because their OHIP premiums . y are,being paid by the companies that they w work for as a contract benefit. Many peo- ple do not know what their premiums cost. What it may do is to allow big business to get off the hook for millions of dollars worth of premium payments. It will cer- tainly increase general taxation in all in - Come brackets. It will put even more of a squeeze on the health care dollar and k reduce still further essential and im- mediate funding for necessary facilities. It is a fact that in any country that has taken on socialized medicine in its entirety (the United Kingdom's- National Health Ser- vice) the health carp has deteriorated to . the point where the public has demanded reintroduction of private insurance to pay t for essential health care. In Britain, over 6 million people are covered by, private in -1 surance and have access to private hospitals and private physicians and surgeons working o°n$side of the_system. ,: There is a waiting list of over twin years for a hip replacement in Britain under the Na- tional with Health Service. Patient n al do private insurance can have their opera- tions within a month. So you see that even The povernntent constantly refers to the 50 million dollars per annum that they will receive from the federal coffers, if they can either opt all physicians into thepHIP • scheme or disallow any form of direct bill- ing that exceeds the OHIP rate. As I have mentioned the government refers to this as extra billing. In virtually 100% of the cases we are not dealing with extra billing at all, but simple underpayment by the public's medical insurance plan of a fair fee for services. As I have pointed out there are many opted -ort physicians who charge far below the full OMA rate. The 50 million dollars is a grossly inflated figure based on assuming that all opted out physicians charge the maximum OMA fee. This is pure blackmail on the part of the govern- ment. The issue is not a monetary one as far as physicians are concerned. It is simp- ly an endeavour to maintain excellence for our patients and to ensure independence and freedom not only for the physicians but for our patients in maintaining the right to deal honourably witheach other. • The reason the OMA has not negotiated with the government over this issue is simply that there is nothing to negotiate since the government will do what it wishes in any case. It is a bit°like asking a condemned man whether he would like to be shot with a .22 or a shot gun. Over the years we have come to realize that con- tracts with government cannot be trusted and that they can be broken at will by the whims of the politicians for expendiency sake. If this legislation goes ' through, we predict that the future standard of medical care in this province will continue to slide downhill. - Kenton C. Lambert, M.D., FRCS(C ,mnav, GODERICH SIGNAL -STAR, WEDNESDAY. JANUARY 29,1986—PAGE 3A Nobody knows home comfort like a home comfort professional. 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