Taxpayers set to cough up more cash

On­tario doc­tors fac­ing hike in their le­gal in­sur­ance fees

Toronto Star - - NEWS - THERESA BOYLE AND ROBERT CRIBB STAFF RE­PORTERS

On­tario doc­tors are fac­ing a 29-per­cent hike in le­gal in­sur­ance fees next year, and taxpayers will be on the hook for most of it.

Health Min­is­ter Eric Hoskins says the province sim­ply can’t af­ford it and that rep­re­sen­ta­tives from his gov­ern­ment are meet­ing with the in­surer, the Cana­dian Med­i­cal Pro­tec­tive As­so­ci­a­tion (CMPA), to tackle the prob­lem.

“I am cer­tainly con­cerned about the sus­tain­abil­ity of the pro­gram,” Hoskins said in an in­ter­view Wed­nes­day.

The province be­gan sub­si­diz­ing CMPA fees in 1987 and since that time the cost to taxpayers has grown by more than 3,200 per cent, a Star in­ves­ti­ga­tion has shown.

Taxpayers now pay 81 per cent of the to­tal in­sur­ance bill and the latest fee in­crease will see that amount jump to more than $200 mil­lion an­nu­ally.

The CMPA pays fi­nan­cial awards to in­jured pa­tients and helps doc­tors ac­cused of med­i­cal neg­li­gence, reg­u­la­tory of­fences and crim­i­nal wrong­do­ing aris­ing from the prac­tice of medicine.

While most peo­ple look at it as an in­surer, the CMPA de­scribes it­self as a“non-profit mu­tual de­fence or­ga­ni­za­tion.” It says its charges to doc­tors are for “mem­ber­ship fees,” not “in­sur­ance fees.”

At its an­nual meet­ing last month, the CMPA an­nounced that On­tario doc­tors will see a 29-per-cent hike in fees next year, the high­est of any re­gion in the coun­try.

In con­trast, fees for Bri­tish Columbia doc­tors are go­ing up 10 per cent, while fees for physi­cians in Saskatchewan, Man­i­toba, the At­lantic prov­inces and ter­ri­to­ries are drop­ping by 40 per cent. Que­bec doc­tors will see no changes.

In a pre­vi­ous in­ter­view, CMPA as­so­ciate ex­ec­u­tive di­rec­tor Dr. Dou­glas Bell said On­tario doc­tors pay the high­est fees be­cause com­pen­sa­tion pay­outs to pa­tients who have been harmed through med­i­cal neg­li­gence are high­est here.

The fee in­crease is also meant to ad­dress a deficit, he said. Un­der the or­ga­ni­za­tion’s fi­nan­cial model, it needs enough as­sets to cover off fu­ture li­a­bil­i­ties for On­tario doc­tors, and cur­rently there is a deficit of $360 mil­lion.

On­tario physi­cians will pay an av­er­age fee of $9,853 next year, up from $7,628 this year. Physi­cians in higher-risk spe­cial­ties pay more and those in lower-risk spe­cial­ties may pay less.

Hoskins said that, for the past month, the min­istry has been in dis­cus­sions with the as­so­ci­a­tion “about how we might make changes to the CMPA, not in terms of the level of pro­tec­tion that it pro­vides for doc­tors and for On­tar­i­ans, but to look at the fi­nan­cial sus­tain­abil­ity as­pect of it.”

The min­is­ter said the On­tario Med­i­cal As­so­ci­a­tion, which rep­re­sents the province’s 28,000 doc­tors, joined the dis­cus­sions in just the last week. (The CMPA sub­si­dies have been used as bar­gain­ing chips dur­ing con- tract ne­go­ti­a­tions be­tween the province and doc­tors, in lieu of com­pen­sa­tion in­creases.)

Hoskins said that in a 2012 agree­ment with the OMA, the province com­mit­ted to re­im­burs­ing doc­tors for a por­tion of their CMPA fees for a decade, and it plans to keep that prom­ise.

Bell said the ris­ing cost of court awards has been driv­ing up fees and has asked the province to un­der­take re­forms to the civil jus­tice sys­tem to ad­dress that.

Hoskins said the gov­ern­ment is look­ing into the re­quest.

The min­is­ter said his gov­ern­ment is also look­ing into the fair­ness of the med­i­cal mal­prac­tice sys­tem, which has of­ten been de­scribed as un­bal­anced in favour of doc­tors.

A Star in­ves­ti­ga­tion re­vealed how dif­fi­cult it can be for pa­tients in­jured though mal­prac­tice to sue physi­cians.

“That is a pre­oc­cu­pa­tion of mine as well. I want to make sure that the bal­ance is there, that it is fair to all par­ties,” he said. Theresa Boyle can be reached at tboyle@thes­tar.ca and 416-869-5915. Robert Cribb can be reached at rcribb@thes­tar.ca and 416-869-4411.

Health Min­is­ter Eric Hoskins is meet­ing with the CMPA to tackle the prob­lem of ris­ing le­gal in­sur­ance fees.

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