The Ontario Medical Association is decapitated, its membership divided.
Its full executive resigned this week after barely surviving a vote of non-confidence, which amounted to a public repudiation and humiliation. With the lame duck leadership gutted, dissidents are now mobilizing to take over the OMA.
Once they triumph, doctors will marshal for a final confrontation with Ontario’s Liberal government.
The good news for patients, the press, and our politicians? This climactic struggle for our cash-starved $52-billion health-care system will yield a happy ending for us all, rich and poor, sick and able-bodied, each and every one.
You needn’t be a brain surgeon to understand the plan, because it’s elegantly self-evident. Here’s how:
Better-paid doctors means happier doctors, which leads to healthier patients, yields a more efficient health-care system, produces shorter wait times for family doctors, and guarantees faster referrals to specialists. More inputs equals better outcomes.
More doctors, higher fees, fewer bureaucrats. If only we could rid ourselves of the pigheaded politicians and the army of overpaid civil servants who don’t understand this the way doctors do.
Like the health minister, Dr. Eric Hoskins. And his deputy, Dr. Bob Bell.
Never mind that they went to medical school. They obviously don’t understand doctors because they are self-hating doctors who hate other doctors.
And they are Liberals, so they are prima facie anti-doctor. Oh wait, Dr. Bell is the non-partisan bureaucrat who used to run the mega-hospitals in Toronto’s University Health Network, but never mind that.
He’s not the only one.
All the former leaders of the OMA are also infected by self-loathing, for they were surely in league with the Liberals when negotiating a contract last summer that would have brought stability to the system after a two-year standoff. Self-hating sellouts.
A cash infusion is the solution, an OMA housecleaning is the remedy, and a change of government is the prescription. It’s not just doctors who need a change of leadership, but all Ontarians, which is why a reinvigorated OMA will work to elect Progressive Conservative Leader Patrick Brown as the province’s next premier.
Not just because a number of Brown’s people were involved in the insurrection at the OMA, but because the leader himself has led doctors to believe that he will accede to their main demand: Arbitration is their precondition, without which doctors will never return to the bargaining table.
They believe it’s only fair for an outsider to decide what doctors deserve, and dictate to the government what they must pay. Do physicians not work long hours, spend years in medical school, and face rising overhead costs?
That’s the story — their narrative — so far. But here is how it really ends:
Brown will break their heart if he ever becomes premier, because he will never agree to arbitration — it is long-standing PC policy to rein in arbitration, not expand it. No premier has acceded, and no premier will, because doctors are not like you and me.
They are, in large measure, gatekeepers to the health-care system — major drivers of usage and rising costs. Through no fault of their own, many are still incentivized by a fee-for-service system that needs to be recalibrated to take account of technological advances and human nature.
If doctors have their way, who will pay? Taxpayers will just have to cough up more cash to get rid of that annoying cough, or make do with less in other areas — from education to transportation.
Doctors demand fair play, but they like to have it both ways. The OMA may be riven by personality conflicts among members, but doctors are also personally conflicted — unable to decide if they belong to a professional movement or a labour union.
On the one hand, they seek arbitration like any other union that delivers what is essentially an essential service. After all, the OMA bargains on behalf of its 34,000 members, speaking out for their monetary demands and conditions of work.
On the other hand, doctors insist they are not unionized employees, merely outside contractors working on a fee for service basis. They are reluctant to surrender the temptations of incorporation, by which they gain major tax advantages by sheltering their income from the regular taxes that other unionized employees pay.
Today, the OMA is not just rudderless but leaderless, on the verge of a hostile takeover. The vocal doctors who have seized the megaphone — in the mainstream media, social media, and proxy battles — are no mere dissidents, they are maximalists whose demands will never be met, neither by Liberals nor Tories.
The doctors’ precondition — arbitration or nothing — is reminiscent of doomed Middle East peace negotiations, where one side refuses to come to the table unless its demands are met in advance. And so the war of attrition and contrition will continue — pitting OMA doctors against themselves, and against the doctors at the health ministry.
Patients will be bystanders, wooed by both sides but also wounded by the collateral damage. In this war of bombast, co-operation and communication — the prerequisites for any partnership to improve our health-care system — will be unavoidable casualties.
Martin Regg Cohn’s political column appears Tuesday, Thursday and Saturday. mcohn@thestar.ca , Twitter: @reggcohn
Martin Regg Cohn’s political column appears Tuesday, Thursday and Saturday. mcohn@thestar.ca , Twitter: @reggcohn
The Toronto Star and thestar.com, each property of Toronto Star Newspapers Limited, One Yonge Street, 4th Floor, Toronto, ON, M5E 1E6. You can unsubscribe at any time. Please contact us or see our privacy policy for more information.
Our editors found this article on this site using Google and regenerated it for our readers.
