Doctors' malpractice premiums are going to jump tens of millions of dollars in Ontario because a review found damages paid to patients in the province are 45 per cent above the national average, The Globe and Mail has learned.
Taxpayers will foot most of the bill under a 1986 agreement between the provincial government and the Ontario Medical Association. The province pays roughly 70 per cent of the malpractice premiums, and doctors pay the remainder.
This year, Ontario taxpayers will shell out $73-million for malpractice premiums for the 22,000 doctors in the province covered by the Canadian Medical Protective Association, a physicians defence fund. But a special OMA bulletin, sent to members this week, estimates that effective next year, the cost of the premiums to physicians and the public will increase more than $40-million in the first year alone.
The ramifications will be far greater than merely financial, the OMA warns.
The association predicts the decision to increase premiums will mean doctors will retire early, new medical graduates will flee the province and access to brain surgeons, doctors who deliver babies and orthopedic surgeons will be threatened.
"This fee increase could have a significant impact on Ontario physicians' ability to continue to provide certain medical services, particularly high-risk procedures," OMA president Dr. Ronald Wexler wrote in the bulletin, adding that the decision to increase premiums came as a "complete surprise."
Provincial governments decided to pay part of the premiums years ago in lieu of giving doctors a raise, not anticipating increases that sometimes have reached 20 per cent a year.
Reached yesterday, Canadian Medical Protective Association spokeswoman Françoise Parent confirmed Ontario's doctors will face the steepest increase of all, but she didn't know how much, except to say, "It's bad news."
She said court awards and medical malpractice settlements in Ontario are 45 per cent above those in the rest of the country.
Ontario has been the home of some of Canada's biggest settlements.
A baby boy left quadriplegic, blind and mute due to the negligence of two Toronto doctors was awarded more than $5-million last year, one of the largest malpractice judgments ever in Canada.
In another recent case, a Barrie woman spent 13 years and endured three operations and two malpractice trials before finally winning her case of negligence against a doctor who performed a hip operation on her. The total bill for both sides was estimated at roughly $2.5-million.
While the news isn't good for Ontario's doctors and taxpayers, elsewhere in Canada the malpractice premiums could drop to bargain-basement levels.
Quebec will see its rates reduced the most; its awards and settlements are 63 per cent below those in the rest of the country. Quebec paid an average $67,000 on malpractice awards and settlements from 1989 to 1999, Ms. Parent said. That compares to Ontario's $172,000 average malpractice award in the same time period.
Provinces with malpractice awards and settlements below the national average include British Columbia, 11 per cent lower; Alberta, 14 per cent lower, and the Atlantic provinces, 18 per cent lower.
Saskatchewan and Manitoba had awards and settlements 11 per cent higher than those in the rest of the country; their malpractice premiums will increase.
Ms. Parent said the new premiums have not been determined because cost varies depending on the province and the specialty the physician practises. She said setting premiums will involve a complicated formula that actuaries have yet to determine.
The decision to increase premiums in some provinces and decrease those in others was made after the malpractice body reviewed court awards and settlements over the past decade, and, to a lesser degree, reviewed legal fees and administrative costs, Ms. Parent said.
Malpractice premiums for Canadian obstetricians now average $31,000 a year. Neurosurgeons pay $27,900 and orthopedic surgeons $24,288. Each province and medical association has its own agreement on how the cost is split between the taxpayer and physician.
"We've just learned of this," said Barry Wilson, speaking for Ontario Health Minister Elizabeth Witmer. "We are concerned and disappointed regarding the lack of consultation on the part of the CMPA [malpractice body]and the financial impact that this may have on Ontario's taxpayers."
Mr. Wilson said the Ontario government will be looking at the issue closely and may have to explore other alternatives.
ONTARIO MALPRACTICE
What premiums cost taxpayers
1995 $43-million 1996 $52-million 1997 $57-million 1998 $60-million 1999 $66-million 2000 $73-million
Source: Government of Ontario