Half a dozen doctors in Ontario each billed taxpayers more than $3-million last year, ranking them the province's highest paid public-sector workers. The gap between doctors and the rest of the public sector is expected to widen even further under proposed wage-freeze legislation.
The government announced on Wednesday that it is imposing a two-year pay freeze on just under 500,000 workers in the broader public sector – hospitals, long-term-care homes, universities, colleges and electricity utilities. Ontario's 25,000 doctors are the only provincial workers excluded from the draft legislation.
The restraint measure would generate $2.8-billion in savings for a government facing a $14.8-billion deficit. But labour leaders say it will create tensions between the haves and have-nots because the lowest-paid workers would be hardest hit.
"People at the very high end of the pay scale are going to escape any meaningful contribution for resolving this crisis," Warren (Smokey)Thomas, president of the Ontario Public Service Employees Union, said in an interview. "And people on the bottom who can least afford [it] are being asked to pay a burdensome amount."
Finance Minister Dwight Duncan said doctors are exempt because they are subject to "a whole range of other things" through the medicare fee schedule. The government sparked a showdown with doctors last April by unilaterally cutting fees on services provided by specialists such as radiologists, ophthalmologists and cardiologists as part of a plan to freeze the total pay envelope for doctors. The two sides returned to the bargaining table last week.
The billings and identities of doctors are kept private in Ontario, much like most other provinces. As a result, taxpayers have no idea whether the $11-billion paid to Ontario physicians last year was spent wisely.
According to figures obtained by The Globe and Mail under freedom of information legislation, 27 doctors each charged the health-care system more than $2-million in the fiscal year ending March 31, 2011, up from 20 the previous year. The billings do not represent a doctor's take-home pay. On average, 35 to 40 per cent of billings pay for overhead expenses, such as office rent and salaries.
Nearly one in every two doctors who made the list were ophthalmologists. The government cut the fee last April for a cataract removal and lens implantation by 10 per cent to $398, to reflect the fact that improvements in technology have made the surgery quicker and safer.
The specialties for the six highest ranking doctors, with billings ranging from $3.1-million to $6.4-million, were not revealed for privacy reasons. Because of the small number of doctors involved, the Ministry of Health's access and privacy office told The Globe, the information is "protected as the doctors that billed these amounts could be easily identified within their specialty."
Health Minister Deb Matthews said there are no plans to include doctors in the province's annual Sunshine List of public sector workers who earn more than $100,000 because they do not earn salaries.
"Doctors' billings in some cases reflect their income," Ms. Matthews said. "In other cases, they have expenses that come out of that."
The wage-freeze legislation for other workers paves the way for income disparities between doctors and other senior health-care workers. The annual pay for future executives in hospitals and elsewhere would be permanently capped at two times the salary of the Ontario premier, currently $209,000. In all, 150 employees were above that threshold in 2011. The highest-paid executive was paid a total of $1.8-million.