Joint report says tackle doc salaries and move to central bargaining in hospitals

A new report suggests a number of radical ways of bringing down health care costs, including reducing the cost of doctors and moving to central bargaining for health care contracts.

The report, Ideas and Opportunities for Bending The Cost Curve, was published by the Ontario Hospital Assocation, the Ontario Association of Community Care Access Centres and the Ontario Federation of Community Mental Health and Addictions Programs.

The report complains of the “whip-saw” effect of hospital negotiating separately with bargaining agents, suggesting those outside of central bargaining are driving up labour costs.

The OHA estimates that central bargaining saves them as much as $27 million, and that another $10 million could be saved if the OHA became the exclusive bargaining agent for all hospitals.

Similarly the OHA would like all hospitals to participate in the OHA benefits plan and to opt out of premiums under the Workplace Safety and Insurance Act, instead paying the benefit costs directly to the workers. The OHA estimates it could save a further $31 million from these changes.

 The three groups say the province could save $2.2 billion annually if Ontario’s spending on doctors was in line with those of other provinces. At present, Ontario spends $842 per capita on physician services, compared to $675 per capita in the rest of the country. They say that difference amounts to $2.2 billion.

The OHA has been pushing for an amendment to the Public Hospitals Act that will move away from the current physician privileges system to a hospital-physician contract model.

The Health Minister responded to the report by suggesting the province has no plan “right now” to do battle with doctors over how much they are paid. However, the Toronto Star reports that insiders told the newspaper that Matthews’ tough stance in the fight with pharmacies is intended “to send a out a clear message” to other players in the health system.

OPSEU’s Hospital Professional Division is expected to enter into central bargaining next year. Their contract expires at the end of March, 2011.

With regards to drugs, the report suggests Ontario can better leverage its size to achieve better pricing and purchasing arrangements. The Ontario spends $310 per capita on drugs compared to $280 in other provinces. BC is the lowest at $222 per capita.