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Looking for Solutions in Health Care for 2006 and Beyond

Our health care system needs to change to accommodate new demographics, new technologies and new pharmacologic advancement.

The roots of compassion and caring in health care should not change however, and it is with this in mind that the dialogue of change should be had surrounding health care.

How can we adapt to different needs that emerge as our population ages?

How can we  find sustainability in the midst of so many new advancements?

How can individuals become more empowered in serving their own health care needs?

What role does the individual have in enabling the  health care of others  beyond paying taxes?

Many questions like these need to be answered and if we are willing to look with open minds at the problems within our health care system, and beyond political posturing, then we can find new  solutions to take us further into this century. 

 

 

 

 

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Sunday
Aug142016

Wynne's Dysfunctional Approach to Solving Ontario's Healthcare Challenges

**Please note that the original journal entry from August 14 has been modified to reflect the vote result from  August 15.

 

 “Abdication, Distraction, and Deflection.”

 Ontario’s doctors voted NO to the tentative Physician Services Agreement between the Ontario Medical Association and the Wynne government that would have doctors co-manage the Province’s ailing health care system. The results of the vote from August 14 were shared the following day. Of voting OMA members, 63.1% voted Against the Agreement, 36.9% voting For the Agreement. The rejection is indicative of the negative view of Wynne’s overall approach to healthcare in the Province – one of abdication and deflection.

Given that Ontario is at a pivot point in health care that will affect patients, physicians, and the province for many years to come, the vote result will be important.  Simply stated: it is a bad deal, indicative of Wynne’s overall

 Abdication

The Wynne government has demonstrated its abdication of responsibility to patients by limiting the physician services budget for patient care below what can conceivably meet patient demand.  Instead of dealing honestly with the surge in health care need due to our growing population, new advances in science and technology, and an aging population with all of its associated requirements the Ontario Liberals are using health care to balance their budget. They have used rationing of patient care to offset the burgeoning debt that they have created through mismanagement and wasteful spending.

The centrepiece of the Liberal government-OMA deal was Wynne’s design to use  Ontario’s doctors as its collaborative rationing tool through co-management of the Physician Services Budget. This would have bureaucrats and doctors, together, deciding on the healthcare cuts to meet the government’s scheduled budget targets. Obviously, neither the OMA nor the Liberal government appear to have the interests of patients at heart. If they did, they would not be resorting to rationing under the guise of “co-management” and “collaboration”.

 Distraction

The Liberal government-OMA deal included components to address Relativity (the relative difference in the OHIP fee codes of some MD specialities compared to lower fee codes of other specialities). Although some physicians believed this was a positive attribute, it will require Ontario’s physicians to be internally focussed on slicing and dicing their profession – rather than spending time and resources on providing input into major structural issues that afflict health care delivery.

While the OMA is distracted with Relativity, the Wynne government master plan is to bring in more bureaucratic management in the form of Bill 210, The Patients First Act. Doctors kept busy with co-managing the rationing of care allows the government to move forward with minimal resistance to its major expansion of powers that allow it to unilaterally impose accountability agreements. Individual freedom for both patients and providers is at risk with this legislation.

 Deflection

The Ontario Liberals are intent on deflecting blame for costs of their own debt and waste onto the Province’s health care system and its providers. It is harder and harder to provide publicly funded patient services when the government is spending approximately one billion dollars a month on servicing the massive debt it created over the past decade through waste and mismanagement. Consider what can be paid for with a billion dollars per month: the medical staff, operations and procedures, the equipment. With the deal and physicians given a co-management role, the Wynne government has found a deceptive way to deflect public criticism from government decision-making.  

 As a disturbing aside, thousands of physicians who oppose the government’s current rationing plan are not “dissidents” as some government spokespersons and media have referred to them. By branding physicians who perceive solutions differently from the government as non-collaborative the government is attempting to quiet dissenting voices and deflect attention from its own failed policies. It’s a ruse. Differing perspectives could be used to create a more respectful and compassionate plan for health care transformation. It is often at the interface of opposing views that the best solutions will be found. It would be wise for our political and association leaders to do more listening and less deflecting.

The Liberal government’s approach has created a dysfunctional healthcare system

The Wynne Liberal government’s deal with the OMA suggests this government is clueless on how to proceed with its healthcare challenges. Constraining the freedom of physicians in a command and control system where they cannot meet patient demand and then labelling this as being in the “public interest” is disingenuous at best.

This is not the way to create a leaner and more efficient health care system or a way to meet the growing demand for patient care. Instead of squeezing the breath out of our public health care system, as our population grows and ages Kathleen Wynne should be answering the question “How can we provide more care to more people?” If we want innovation and “modernization” of care, it will not be found in rationing or managing wait lists. More management and more bureaucracy are not what we need.

As this deal so clearly illustrated, Wynne’s healthcare legacy is an abdication of duty, deflection of responsibility and distraction from her government’s wasteful ways. Hardly inspiring. Hardly a vision. Ontario can do better – it must do better.  The vision of health care in the future cannot be about rationing care, denying care, and limiting the freedoms of providers and patients.  It must be about empowering patients and empowering providers including Ontario’s physicians in providing more services and more care, not less.

The rejection of the deal was the ethical and appropriate response to a poorly considered health care rationing master plan pushed by the Wynne Liberals. Ontario doctors have spoken with resounding support for patients. However, any celebration of the rejection of this deal should be dampened by the reality that there is much work ahead to be done to shore up Ontario’s hobbling healthcare system. Let’s start with the resignation of Dr. Eric Hoskins.

 

 

 

Reader Comments (290)

“Let me assure you, if the OMA’s insistence that it be awarded the right of binding arbitration that we have provided to other public sector unions is so great that it is willing to be re-constituted formally as a union and accept all the obligations that other public sector unions have adopted – including withdrawing objections to salary disclosure that all other government unions are subject to and relinquishing the rights of members to incorporate individually – the government would be open to that discussion,” Hoskins wrote.
August 26, 2016 | Unregistered CommenterEklimek
Offer is clear from central.

Maintain status quo, with fixed pot of money.

Or unionized, and lose incorporation privilege, on fixed pot of money.

Guess is nothing changes.
August 26, 2016 | Unregistered CommenterMovingforwardOntario
Well played Hoskins, well played...
August 26, 2016 | Unregistered Commenterdocinthepark
So instead of backing down. Hoskins is turning up the rhetoric. Precisely what got him into this bind in the first place. Doubling down on a failed strategy - brilliant Will be interesting next election. I wonder how many MD's will actively campaign against him in his riding.

They can always legislate the right away (negotiated in good faith in exchange for fee concessions) but good luck retaining docs in Ontario when 50% are incorporated and every other province allows it and some with more favorable rules.
August 26, 2016 | Unregistered CommenterERdoc
Hoskins playing to the electorate.

Binding arbitration is used with public sector unions for public sector employees. Binding arbitration does not make one a public sector employee.

If this is an offer to make me a public sector employee with the benefits and salary disclosure and take over my office and overhead, where do I sign?

I don't have an objection to disclosure or loss of incorporation. I don't belong to the million dollar club. The loss of incorporation is a penalty less than 6.9% across the board fee discounts.

Keep beating us up. WE like it. When does the fun really start?
August 26, 2016 | Unregistered Commentereklimek
Centrals strategy has not failed. They have the doctors where they wanted. Stuck in a fixed pot of money, monopoly, with no coherent plan. No need to take any rash actions. The public wants the doctors reined in.
August 26, 2016 | Unregistered CommenterMovingforwardOntario
Central is winning by default ...the myopic credulous medical profession meandered into the mine field it now finds itself in , barely aware of the dangers around it.
August 26, 2016 | Unregistered CommenterAndris
mfo

agree on all counts. Now the ball is back in his court. Time to get out the popcorn.
August 26, 2016 | Unregistered Commentereklimek
Any way you look at it, the OMA-MOH-MD relationship is dysfunctional. Something has to give.
I don't believe Hoskins knows what he is doing except providing a show and occupying the Ministry dealing with the OMA means he doesn't have to deal with patients like Hector McMillan. Too bad the patients aren't truly informed....as Hector said on the radio the other day "I feel betrayed"..."You don't realize it until you are affected" (paraphrasing).

Expect more people to be affected.
The MOHLTC does not have to give anything. It owns the pot of money, andIis going to redistribute it. There are going to be winners and losers within the pool of doctors, but also overall, the physicians pool of resources is being reduced. All of the bun throwing, it just to get identified who owns the rationing that is going on.
August 26, 2016 | Unregistered CommenterMovingforwardOntario
Time to shut down the health-care system.

Strike three!
August 26, 2016 | Unregistered CommenterStephen Skyvington
In order to focus the OMA and the membership it is time to remove the RAND formula. With the RAND formula the MOH simply asks the OMA to jump, and the OMA replies, "how high". This and the OMA's extremely dysfunctional governance structure is what by and large has let to this mess where the OMA has always put its corporate interests ahead ot the membership's interests.

Get rid of the RAND formula and we'll see these issues sorted out very quickly including the OMA becoming a very lean mean fighting machine.

Can the OMA unilaterally request to have the formula terminated or does the MOH also have to agree?
August 26, 2016 | Unregistered CommenterCanary in a Coal Mine
Cicm

The OMA could choose to decline the role. There is, if I recall correctly, a fund set aside for winding up its corporate responsibility. But really, decline a heretofore sinecure leading sheep for tens of million dollars? Pull my other leg, its got a bell and it tinkles.

The more likely cause is the OMA does not resolve it's "internal issues" and no representation occurs. Then, derelict in its duty, either the membership can enmass rebel, or the Mnister can rescind he fundng for activity that does not occur. This, by the way, explains why so much money is spent, to my mind needlessly, simply to demonstrate "representative activity".

Hey, we're working here. It's the bloody doctors that are so recalcitrant. In fact given so much disharmony, wait fir it, a special negotiation levy will be needed in 2017. Yes folks, expect your OMA dues to go up to support the "good work" b the OMA.
August 26, 2016 | Unregistered CommenterEklimek
The OMA declining RAND is like a FHO physician going back to FFS. Not going to happen.
August 26, 2016 | Unregistered CommenterERDOC
Deranding requires legislation.Won't be happening.
August 26, 2016 | Unregistered CommenterMovingforwardOntario
Actually it doesn't. For 18 months back in the late 90s the OMA did not Rand Ontario's docs. They simply didn't hand the disk to OHIP of those who didn't pay, which meant OHIP didn't deduct the OMA dues from the May and June RAs.

They could do that again, or the new government could simply rescind the OMA Dues Act and put an end to it that way.

Remember, the govt doesn't have to touch Rand for everyone else. Just repeal the OMA Dues Act, 1991.
August 26, 2016 | Unregistered CommenterStephen Skyvington
Getting past the impasse.

Going to be complex moving ahead because of the differing agendas of the 3 groups: doctors,central, and clients

Budget: Budgeting is easy ,just a number you try to work towards

Overage/under-ages: Much tougher because central wants costs to be reduced, providers want more, and the bulk of the population do not want to pay anything more, if it is out of their pocket. In addition, all three are trying to load social determinants of health onto the acute care budget.Do safe injection sites in downtown Toronto win over clean water supply on reserves, vs. availability of needed drugs?

Relativity: Central has fees/services it wants to cut, and groups within the OMA want fee relativity. NO where near resolution. At the same time,the population wants more services, for free.

All of this occurring,in an era of huge provincial and federal deficit issues.

Going to be tough. The lifestyle expectations of physicians in Ontario will not be the same.
August 27, 2016 | Unregistered CommenterMovingforwardOntario
Hoskins' letter to OMA: https://news.ontario.ca/mohltc/en/2016/08/minister-hoskins-letter-to-oma.html

", I would be interested to know if their recent proposal to de-list services, expand the use of walk-in clinics and reform payments to disadvantage family doctors and other underpaid physicians in favour of high-billing specialists represents official OMA policy?"

Yeah man, throw some cash down here toward some of us lowly GPs. Divide and conquer strategy to pit the specialists vs. the FPs, again, well played...
August 27, 2016 | Unregistered Commenterdocinthepark
DITP, Don't forget Hoskin's wife is a practicing family doctor in a FHT so there is a potential optics of a COI much like McGuinty had with his wife who was a primary school teacher.
August 27, 2016 | Unregistered CommenterCanary in a Coal Mine
Certainly, one would expect that academic ivory towered FHTs will be treated like hand fed canaries, while the rest will get gruel and a kick in the teeth in Hoskins utopian Primary care world.
August 27, 2016 | Unregistered CommenterAndris
As the dust continues to settle, it remains interesting how this is used within the media.

Although 68% of the vote, voted down the tPSA, the other two issues on the ballot were at 92% pointing out the need for improved communication by the OMA. 92% of the voters! One can reasonably a assume the 8% rejecting the other 2 ballots were core OMA process supporters.

Those core supporters were then likely joined by some who decided at least get some money,based on personal position in lifestyle at this time.

Interesting how the vote on the other 2 issues are reported by the media. The deal was NOT supported by an overwhelming number of members. This wasn't a small small fringe group (COD), or the "high billers", despite the claims made.

The deal was poor, the processes,a disaster.
August 27, 2016 | Unregistered CommenterMovingforwardOntario
Andris one patient told me that their academic FHT doc is off traveling the world for a year on salary. Same perk the teachers have where one can get paid 80% for 5 years and then take a year sabbatical.

Those of us on FFS who have leases and staff to look after directly can only dream of taking a year's sabbatical.
August 27, 2016 | Unregistered CommenterCanary in a Coal Mine
Mfo many docs are making the necessary adjustments to their lifestyles as the net income falls. Morale is very poor so don't expect any assistance with implementing Bill 210 in fact I would expect many to try and sabotage its implementation.

Even at the specialist level I see many adjustments occurring. A lot more Dragon Naturally Speaking consult letters which have become far less detailed in order to save on time and let admin staff go.

There is so much bad blood now between Hoskins and the profession I really don't think a deal can be had with him at the helm.
August 27, 2016 | Unregistered CommenterCanary in a Coal Mine
Having closed the doors of my own practice of 45 years, paid severance etc., closing a practice is not inexpensive , I have moved to an organization with lots of clinics...however I am now my own secretary.

In the old days I would work on a letter to an insurance company/ lawyer by dictating it and have my secretary typing it....now I hand write it...and since my cursive script is encrypted and unintelligible to the younger generation, I hand write in print....as for Dragon letters , I love reading them as much for their unintended humour as their actual content ..."Billy Rubin" being one of my favourites.

As for the academic ivory towered FHTs that attracts those doctors who are more equal than the rest of us , who are more pious and saintly than their less equal and morally defective colleagues that they snobbishly patronize in letters to the media ....being more perfect , being more spiritually pure , must be very stressful hence their need for their paid year sabbatical.
They are safe, no worries for them, Napoleon will look after them.
August 27, 2016 | Unregistered CommenterAndris
"Doctors are not on the same team as government. Politicians are on their own team. As soon as their interests do not align with ours, doctors often lose.

Politicians do not hesitate. Doctors do not understand this. We think we are friends, and friends never put themselves before other friends."

http://shawnwhatley.com/identity-crisis/
August 28, 2016 | Unregistered CommenterCanary in a Coal Mine
We now live in a system where politicians set policies, and gather votes. Votes are gather by providing free things (time or money). Free health care means doctors must work harder for less money,and provide more of their time.

Social justice means doctors are widgets-to be dispersed as central needs (Bill 210).
August 28, 2016 | Unregistered CommenterMovingforwardOntario
Good luck implenting anything without a contract. Docs will fight to the bitter end with or without the OMA. 2018 is the endgame.
August 28, 2016 | Unregistered CommenterErdoc
Each unilateral cuts drives the widgets where they need to go.
August 28, 2016 | Unregistered CommenterMovingforwardOntario
Hoskins is using every weapon in his arsenal...the most effective being his deliberate use of disinformation in the media and cyberspace to undermine the medical profession, painting it in the most unfavourable light possible and to generate self doubt amongst its most vulnerable and gullible members...he is not ignorant of the truth, he is exhibiting a form of wilful ignorance being fully aware of the facts but refuses to acknowledge them.
August 28, 2016 | Unregistered CommenterAndris
"Willful ignorance"

Not sure how true this is. The Minister may be fully and completely aware but has wht the postmedern relatavists argue is a faultless disagreement. That is one in which the "truth" is conceptual but not absoute. Using this approach truth belongs to the winner, not by logic or ethics, rather by familiarity and acceptance of diversity. In politics that is perfectly acceptable. From the scientific perspective it is poppycock because competing contradictory theses (for example wave vs particle) refllect only incomplete understanding. (I ignore the possibility of fraud.)
August 28, 2016 | Unregistered CommenterEklimek
Looks like Hoskins has the legal shills out advocating for more of the same before the upcoming battle over who is going to own rationing. Let's see how much of that health care budget is going to administration of the system compared to other jurisdictions.

All he is doing is stiffening the spines of Ontario's physicians. He may have met mush previously but now has found his hard wall.

https://www.thestar.com/opinion/commentary/2016/08/28/forging-a-new-deal-for-doctors-requires-a-new-approach.html
August 28, 2016 | Unregistered CommenterCanary in a Coal Mine
"Earlier this month, Ontario’s doctors voted down their tentative physician services agreement. While most media coverage has focused on those doctors who rallied against the deal, the more important story is that 45 per cent of physicians didn’t even bother to participate. That is a lower turnout than the last federal election and the matter directly affected something important to them — their salaries.

Such levels of disengagement from important decisions about a contract encompassing 25 per cent of the total provincial health system expenditure raises concerns as to whether today’s doctors are ready to co-manage health systems as this agreement had unprecedentedly offered.

We need a new way to approach doctor negotiations — and we desperately need a new paradigm in the delivery of physician care in Ontario and across Canada. "
August 28, 2016 | Unregistered CommenterCanary in a Coal Mine
Maybe the lower turnout had something to do with the fact the vote was over the most likely time that doctors were away on summer vacation.
August 28, 2016 | Unregistered CommenterCanary in a Coal Mine
rationing = criminal negligence:

recklessly acting without reasonable caution and putting another person(s) at risk of injury or death (or failing to do something with the same consequences).
August 28, 2016 | Unregistered CommenterCanary in a Coal Mine
https://www.thestar.com/opinion/commentary/2016/08/28/forging-a-new-deal-for-doctors-requires-a-new-approach.html

" the tough rationing decisions needed in our resource-constrained world"

At least it is agreed,it is about whom gets to do the rationing. One is sure these lawyers have approached the judicial system to rewrite the liability issues, transferring to them, as advocates of rationing,and the politicians.
August 28, 2016 | Unregistered CommenterMovingforwardOntario
Appart from vacations the unanticipated two step voting might have been a factor...one suspects that a number voted at the first vote and then went on their way, unaware that that their vote had been scrapped and that they had to vote all over again.

As for the Star, it is the voice of the liberal government much like Pravda was to the soviet regime...the rationing hot potato issue has been raised informally...the dissidents raised the rationing issue and voiced their refusal to take ownership of rationing....it is going to be a ' tar baby' stuck to the government's claws going into 2018.
August 29, 2016 | Unregistered CommenterAndris
Now that there is public declaration from legal experts that rationing is occurring, one must assume, both the legal and judicial system, given their professional responsibility and accountabilty, are taking any medical legal case, where shortage of resources is under question, to the Supreme Court,to get a firm ruling, reversing the status quo?
August 29, 2016 | Unregistered CommenterMovingforwardOntario
"Maybe what we want to do is limit a la carte billing for doctor services in the first place, and have far clearer contractual directives against cost-ineffective treatments and towards quality, safe and high-value care."

Maybe poor proof reading, should this be followed a question mark?

Also please go ahead, blame the doctors for the experience in the waiting room. But how that translates into nearly the poorest quality health care is not clear to me. In my waiting room the trend is clear. The most unfortunate tend NOT to be the most demanding. They usually get it. The inverse is also true.
August 29, 2016 | Unregistered Commentereklimek
Is the trend for LHINs to come closer to the point of managing service delivery?

From http://www.hnhblhin.on.ca/Bill210.aspx

Identify LHIN sub-regions as the focal point for integrated service planning and delivery.
LHINs would take on accountability for sub-region health service planning, integration and quality improvements.
LHINs would take on responsibility for primary care planning and performance improvement, in partnership with local clinical leaders.
Transfer responsibility for service management and delivery of home and community care from Community Care Access Centres (CCACs) to the LHINs.
August 29, 2016 | Unregistered Commentereklimek
Ha!
My proxy ballot for August 14 just arrived in the mail yesterday! Good thing I voted already..
August 29, 2016 | Unregistered CommenterMerrilee Fullerton
https://www.thestar.com/opinion/commentary/2016/08/28/forging-a-new-deal-for-doctors-requires-a-new-approach.html

I recognize that this has been posted a couple of times already, but simply wanted to highlight the importance not of the content of the text but of its seemingly credible academic source, the Centre for Health Law, Policy & Ethics at the University of Ottawa.

Did you want to supersize your ethics?

At this point, the Minister of Health has planted the "greedy doctor" foundation and now only has to sit back and let organizations like this one do his bidding. The tone of this piece is set early in the first three paragraphs:

<<Ontario’s Health Minister Erik Hoskins is a brave man. He has attempted to wrestle a new agreement with Ontario doctors and to drive down outrageous billing — with some 500 doctors billing more than $1 million a year. Hoskins wanted to redistribute these health dollars for improved physician care.

The plan was to engage with doctors themselves on how to more fairly allocate billing codes, to reward better doctors who provide high-value care, and eventually to give less to those who don’t.

Earlier this month, Ontario’s doctors voted down their tentative physician services agreement. While most media coverage has focused on those doctors who rallied against the deal, the more important story is that 45 per cent of physicians didn’t even bother to participate. That is a lower turnout than the last federal election and the matter directly affected something important to them — their salaries.>>

That is all the doctors care about...and read in between the lines...one billion dollars was not enough for them!

And they took the Minister's bait, accepting the "500 doctors billing more than $1 million dollars a year line" without any clarification. You would figure that an associate professor of law and a university research chair would be more precise in their language - particularly in a national publication - but then again, why let the facts get in the way of a good set up?

Again, this only goes to underscore previous comments that the OMA and other associations representing physicians have lost the argument to the Minister in the court of public opinion.

The physician payment side of this story resonates strongly with the public and no one on the other side of the fence is seemingly doing anything to change the selection on the juke box.

The picture of the Minister that accompanies this opinion piece is quite appropos: although almost probably taken months ago, his fly away hair and his wry smile suggest that in this context he knows he has won this battle with the doctors and in the eyes of his Premier he is likely untouchable until the start of the next election.

Not saying that this is right - just saying that this is what it is.
August 29, 2016 | Unregistered CommenterExecutive Lead Blogger
<<Is the trend for LHINs to come closer to the point of managing service delivery?>> - eklimek

In a word, "yes".
August 29, 2016 | Unregistered CommenterExecutive Lead Blogger
Don't you love it.


" ... We rely on evidence; increasingly we rely on evidence. As we get the best value for our taxpayer dollars, we are prepared to fund those things that actually improve outcomes for people, but as we move forward, we’re going to have to rely increasingly on evidence." (Official Records for 19 April 2011)


But we don't have any?


"Without appropriate measurement of health care outcomes, we cannot know if cost control measures affect the quality of care. It is incumbent on both provincial governments and physicians to work together on evidence based evaluation of the effectiveness of health care services. Only then can we know if our money is well spent."

http://www.theglobeandmail.com/opinion/we-have-more-doctors-and-specialists-than-ever-but-is-that-good-news/article31558034/
August 29, 2016 | Unregistered Commentereklimek
What a great article by Dr. Ghandi who hits the nail on the head. We are at war with Hoskins the politician, and the sooner the OMA executive understands that Hoskins will take a ruthless no prisoners approach the sooner our strategy can be modified to match a very real threat to the profession.

This man's political future and self-identity entirely depends upon the implementation of Bill 210 hence all the profession has to do is prevent this from happening for the next 18 months. Sure he'll lash out with more unilateral cuts and threats, but in the end without Bill 210 on the books he'll die a psychic death.

Time to stonewall the implementation of Bill 210 and the creation of HMO Ontario at every opportunity and deal with the potential fallout after the next election.
August 29, 2016 | Unregistered CommenterCanary in a Coal Mine
"It is time to level the playing field between government and physicians by making politicians fearful of physician power again. I do not say that the physicians of Ontario should destroy every politician that they disagree with and on every issue: physicians just have to show that they CAN destroy politicians if they feel it necessary." Dr. G Goldlist comment here:
http://shawnwhatley.com/identity-crisis/#comments

We need to show the current health minister that we mean business.
August 29, 2016 | Unregistered CommenterCanary in a Coal Mine
At the same time, take the opportunity offered. The MOHLTC has opened, through their supporters, the option of discussing "rationing" (which is one of the core issues).

The issue for the public is,do you which the rationing to be control by your doctor, or a politician?

The silence from the OMA post vote is very concerning..
August 30, 2016 | Unregistered CommenterMovingforwardOntario
From TVO
http://tvo.org/blog/current-affairs/is-it-time-to-break-up-the-oma-

" Is it time to break up the organization into two groups ̶ one representing the specialists, another representing the family docs?

The Ontario government would probably approve, although its official position is it needs to give the OMA time to get its own house in order. Various Ontario governments have argued for years that it’s the OMA’s job to “rebalance” the fee structure, to end the favouritism shown specialists at the expense of general practitioners. But the province was unwilling to force any dramatic action on the OMA, preferring that the association resolve the matter internally.

That hasn’t happened.

But if the OMA split into two groups, the government could be more generous with the GPs (as it purports to want to do), and could take a much tougher line with the specialists (as it also purports to want to do). Their much-desired “rebalancing” could actually happen.

However, because of the massive antipathy among all doctors to both the OMA and the government these days, it’s highly unlikely that doctors will do anything the Liberals might prefer, even if it’s in their own interest. It seems to be a time for cutting off noses to spite faces.

So the timing is tough, the politics are brutal, but the logic of splitting up the OMA is still there. I’ve sniffed around the OMA this week and at the moment there appears to be no appetite at the upper levels to take this on.

And to be clear, I’m not advocating it, just giving voice to those who think it represents a road forward for addressing the long-held grievances family docs have, and who think those grievances are never going to be addressed as long as the specialists have undue sway within the OMA. "
August 30, 2016 | Unregistered Commentereklimek

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