Last week, the union representing Ontario’s Catholic teachers demonstrated the merits of engaging with that province’s government as it seeks to bring its finances under control – negotiating a deal that replaced one cost-cutting proposal with another that its membership might find more palatable. That should serve as a lesson for the association representing the province’s doctors.
When negotiations with the Ontario Medical Association broke down this spring, Premier Dalton McGuinty’s deficit-plagued government imposed through regulation a round of fee cuts aimed at meeting immediate fiscal targets. Now, the OMA has launched a constitutional challenge aimed at overturning them, mostly on the basis that the government did not negotiate in good faith. That’s likely to be an uphill legal battle, given that the OMA is not a certified union. But the OMA’s president, Doug Weir, argues that the association has nothing to lose, since the government couldn’t treat it any more harshly than it already has.
In fact, doctors stand to lose a great deal more. Ontario is expected to be in the red until at least 2017, and doctors’ fees account for roughly 10 per cent of the province’s total program spending. So this spring’s cost-cutting measures, targeted heavily at a few specialist groups, were only the first round. If the OMA were to adopt a more constructive approach and return to the table, it could at least help shape future funding decisions. If not, the government will unilaterally impose further measures.
This involves more than just haggling over numbers. The province has little choice in the years ahead but to make structural reforms to the way health care is delivered. To get those reforms right, Ontario will need the engagement of doctors, who after all know the system better than anyone else.
To some extent, it’s incumbent on Mr. McGuinty – who allowed wages to skyrocket during better times, and is now abruptly trying to make up for it – to extend olive branches as he tries to sort through the country’s biggest fiscal challenge. But those who benefited from generous settlements in the past need to accept new realities, and make the best of them. Lawyering up is not the answer.