Taxpayers on hook for most of MD insurance hike

Health Minister Eric Hoskins said he's concerned about the sustainability of ongoing CMPA fee hikes.

Thestar.com
Sept. 16, 2015
By Theresa Boyle and Robert Cribb

Ontario doctors are facing a 29 per cent hike in legal insurance fees next year, and taxpayers will be on the hook for most of it.

Health Minister Eric Hoskins says the province simply can’t afford it and that representatives from his government are meeting with the insurer, the Canadian Medical Protective Association, to tackle the problem.

“I am certainly concerned about the sustainability of the program,” Hoskins said in an interview Wednesday.

The province began subsidizing CMPA fees in 1987 and since that time the cost to taxpayers has grown by more than 3,200 per cent, a Star investigation has shown. Taxpayers now pay 81 per cent of the total insurance bill and the latest fee increase will see that amount jump to more than $200 million annually.

The CMPA pays financial awards to injured patients and helps doctors accused of medical negligence, regulatory offences and criminal wrongdoing arising from the practice of medicine.

While most people look at it as an insurer, the CMPA describes itself as a “non-profit mutual defence organization.” It says its charges to doctors are for “membership fees,” not “insurance fees.”

At its annual meeting last month, the CMPA announced that Ontario doctors will see a 29 per cent hike in fees next year, the highest of any region in the country.

In contrast, fees for British Columbia doctors are going up 10 per cent while fees for physicians in Saskatchewan, Manitoba, the Atlantic provinces and territories are dropping by 40 per cent. Quebec doctors will see no changes.

In a previous interview, CMPA associate executive director Dr. Douglas Bell said Ontario doctors pay the highest fees because compensation payouts to patients who have been harmed through medical negligence are highest here.

The fee increase is also meant to address a deficit, he said. Under the organization’s financial model, it needs enough assets to cover off future liabilities for Ontario doctors, and currently there is a deficit of $360 million.

Ontario physicians will pay an average fee of $9,853 next year, up from $7,628 this year. Physicians in higher-risk specialties pay more and those in lower-risk specialties may pay less.

Hoskins said that for the past month, the ministry has been in discussions with the association “about how we might make changes to the CMPA, not in terms of the level of protection that it provides for doctors and for Ontarians, but to look at the financial sustainability aspect of it.”

The minister said the Ontario Medical Association, which represents the province’s 28,000 doctors, joined the discussions in just the last week. (The CMPA subsidies have been used as bargaining chips during contract negotiations between the province and doctors, in lieu of compensation increases.)

Hoskins said that in a 2012 agreement with the OMA, the province committed to reimbursing doctors for a portion of their CMPA fees for a decade, and it plans to keep that promise.

Bell said the rising cost of court awards has been driving up fees and has asked the province to undertake reforms to the civil justice system to address that.

Hoskins said the government is looking into the request.

The minister said his government is also looking into the fairness of the medical malpractice system, which has often been described as unbalanced in favour of doctors. A Star investigation revealed how difficult it can be for patients injured though malpractice to sue physicians.

“That is a preoccupation of mine as well. I want to make sure that the balance is there, that it is fair to all parties,” he said.