Open up on billing

From assessing newborns to monitoring seniors with complex conditions, Ontario’s doctors provide an incredible range of vital services. And collectively they bill OHIP billions each year for those services.

But the Ontario Medical Association thinks the details of those payments — specifically who Ontario’s highest billing doctors are — is information the public just can’t handle.

So much so that it is continuing its misguided fight against public disclosure, ordered by the provincial information and privacy commissioner and two Ontario courts, all the way to the Supreme Court of Canada. There’s little sense in this, as many doctors are now saying. This all stems from a Toronto Star freedom-of-information request for Ontario’s 100 top-billing doctors in 2014. The OMA has fought, and lost, at every step so far to keep that information from coming to light.

The association argues that physican billing is protected private information, and reporting it “without context provides an incomplete and sometimes misleading picture of Ontario’s physician pay structure.”

On the first point, the courts have repeatedly ruled the public’s right to know how substantial government funds are spent trumps privacy. And the second is simply nonsensical.

Ontarians are perfectly capable of understanding that doctors are essentially small business owners and a good chunk of what they bill OHIP — about 30 per cent on average, according to the OMA — goes to pay staff and office costs.

That’s a simple piece of context that B.C. (which, along with Manitoba and New Brunswick, already publishes all physician billings) manages with an explanatory paragraph.

Beyond that, some doctors have compellingly argued that more transparency around OHIP billing would help start a discussion around pay gaps between specialities and whether change is needed. Doctors in ophthalmology, cardiology and radiology are among the highest billers, while geriatricians, psychiatrists and family doctors are among the lowest.

Revealing what doctors receive from OHIP would provide much-needed transparency that could ultimately help build a stronger health-care system for doctors and patients alike.