Will the Ontario government extend binding arbitration to the OSA?
Yes, according to informal discussions that have occurred at senior levels with the Ontario government. Binding arbitration (BA) has been recognised as an integral element of a relationship between the OSA and the Ontario government. The OSA stated at the inception of these discussions that BA was a mandatory requirement to assure specialists that it would permit the kind of balanced negotiating environment that was previously lacking when a hostile government and MOH unilaterally made changes that marginalised specialists. A strong referendum result for the OSA will further ensure that BA and the many other important facets (e.g. CMPA, etc.) associated with negotiations are granted to OSA members. The OSA has communicated that anything less will undermine their strong desire to work with Ontario specialists to fix the problems created over the last 15 years.
BA is clearly an important issue to all doctors. There are other elements in previous OMA deals such as CMPA, maternity benefits, HOCC and other matters that have been addressed as requirements. No objections have been raised since they already exist for specialists in the current OMA framework. Following a positive Referendum vote outcome, the OSA Board of Directors plan to meet with the Premier’s office to discuss several key matters including representation rights, removal of RAND for OSA specialists and Binding Arbitration rights. The above issues are widely seen to be essential elements for an OSA agreement with government. We sincerely believe the government shares that same view.
A separate statement clarifying our intentions will be issued immediately following the referendum. This will include striking an OSA negotiation committee, identification of section priorities and engaging government to address pressing issues. We can state unequivocally that the first order of business will be to confirm BA as a fixed point essential to all future negotiations.
What Physician groups are Voting to join the OSA?
The following 15 sections have expressed an interest in conducting a referendum for its members to withdraw from the OMA and join the OSA:
Cardiac Surgery o Cardiology o Dermatology o Diagnostic Imaging o Emergency Medicine o Eye Physicians/Surgeons of Ontario o Gastroenterology o Nephrology o Neuroradiology o Nuclear Medicine o Occupational Medicine o Otolaryngology o Plastic Surgery o Vascular Surgery
What if only a few sections withdraw from the OMA and join the OSA?
Already 15 separate groups of specialty groups representing thousands of specialists have indicated strong interest in the concept of an OSA. The OSA Board feels it has already achieved critical mass support in an incredibly short period of time. Once the results of the referendum are tabulated, the OSA Board of Directors will reaffirm that there is enough support for the organization to proceed with its mandate.
We expect that other specialty sections that have decided not to participate in this referendum will re-consider and will likely seek an opportunity to participate in the future. The OSA Board understands and respectfully accepts that there are different views and that some sections are adopting a wait and see approach.
What if an individual specialist chooses to remain in the OMA but the majority of members of his/her section chooses to join the OSA?
If a section votes by a majority of 50.1% of its voting members to withdraw from the OMA, then that section’s members will be represented by the OSA in fee negotiations with the provincial government. At the individual level, specialist physicians may choose to remain with the OMA even if the majority of their section has chosen to withdraw and join the OSA. The OMA will notbe able to negotiate fees for them. That will be done by the OSA working in conjunction with all OSA section members.
Are family practice/general practice physicians welcome to join the OSA?
The OSA was created to represent the interests and needs of medical, surgical and diagnostic specialists and their patients in negotiations with the provincial government. We believe the OMA is best suited to represent family and general practice physicians unless they elect to choose a different organisation. Since some specialist sections have general practitioners as primary members of their specialty, the OSA Board has already recognised that the decision for their continued involvement will be determined by those relevant sections.
If a section decides to withdraw from the OMA, are its members still forced to pay OMA dues (i.e. subject to the RAND formula)?
No. It is expected that the government will repeal both the Representation Rights Agreement Actand the OMA Dues Actfor specialist sections that have voluntarily decided by a majority vote to leave the OMA. This would then allow the government to recognize the OSA as the body that negotiates fees for its members. Membership in the OSA is purely on a voluntary basis to better focus the attention of the OSA to respond to members’ needs and priorities. There will be no RANDing of Ontario specialists in the OSA.
How Much Will It Cost to Join the OSA?
· Membership in the OSA is voluntary (i.e. there is no RAND formula). The annual fees for OSA membership have yet to be established by the OSA Board of Directors that represents all of its members. They are expected to cost less than what OMA members currently pay because the OSA’s mandate is focused on negotiation and fee matters. The OSA will not have a large bureaucracy favouring instead certain key resources e.g. cost accounting for fee setting, economic analysis, negotiation experts, and strategic legal advice.
Is it not advantageous to government to divide and conquer Ontario physicians in negotiations?
NO. The new government recognises the need to work with specialists to fix major problems produced by divide and conquer and shame and blame tactics. OSA representatives have had several interactions with the new provincial government. In each circumstance, they have acknowledged the value medical specialists bring to the health care system and indicated a desire to work in partnership with us to achieve objectives based on quality and the long-term financial sustainability of the health care system. The OSA is confident that it can deliver better results for its members and their patients by negotiating directly with government, outside of the OMA.
Will I be Able to Convert my OMA Insurance Coverage to the OSA?
The OSA’s insurance advisor is finalizing an offer that will allow OSA specialists to replace their life, disability and critical illness in a simple process. All policies will be individually owned with policy provisions that are locked in and guaranteed. An OSA Insurance website will be set up very shortly with complete details. Below is a brief overview. Complete details will follow when the offer is finalized shortly.
Will the OSA be Able to Control my Insurance Coverage in the Same Way as the OMA?
NO. Unlike the OMA insurance which is controlled by the OMA, the OSA insurance will be individually owned insurance that you own and control.
The OMA offers a Group term plus to age 75 and Group flex term 10/20. The OMA plan is group insurance. The OSA insurance will be individually owned insurance that you own and control. OSA policies will have guarantees on cost and quality and policies will include an option to convert to permanent insurance. In most cases rates will be less expensive than the OMA group term plus 75 (even after OMA rebate).
Disability and office overhead insurance
The OMA disability insurance is group insurance. The OSA insurance will be individually owned insurance that you own and control. OSA rates in some cases may be more expensive than the OMA disability insurance, however definitions are more extensive from a quality and benefits perspective.
Critical illness insurance
OMA critical illness is offered through Sun life. The OSA plan will have similar definitions and cover up to 25 critical illnesses. The primary difference is cost; the OMA Sun life plan is more expensive than the offering through the OSA.
If I have OMA coverage on my spouse/partner, will they be eligible to replace their coverage too?
Will this insurance be group life insurance?
NO. The OSA offering is individual insurance where you own and control the policy.
Will I be able to I cancel my insurance if I no longer want it?
Will the coverage be portable?
What is the Ontario Specialists Association?
The Ontario Specialists Association (OSA) is a recently formed entity to represent the interests of Ontario specialists in contract negotiations with the new Ontario government. It is also an advocacy organization for specialty medical care providers and their patients.
Why is the OSA Needed?
The OSA is needed because the interests of specialist physicians in contract negotiations with the Ontario government have not been represented for well over a decade. That is evident by way of no increases; specific and across-the-board fee decreases; no new fee codes to the OHIP schedule in the past decade; no successful contractual negotiations; and divisive discussion about relativity that has weakened our collective ability to challenge MOH belligerence at negotiations. The time has come for specialists, who have unique needs and perspectives on how specialty care should be funded and delivered in the province, to be represented by an independent organization composed and governed exclusively by specialist physicians. We need different legal and other professional advisors who will take fresh approaches to regain the momentum of leading negotiations rather becoming victims of them.
Who can join the OSA?
A referendum will be held by current OMA sections to determine interest in joining the OSA. To become a member, support of 50.1% of the voting members of a current OMA medical/surgical section must be achieved. A section may withdraw from the OSA on the same basis.
Will OSA members be required to pay membership dues to the organization?
OSA members will not be subject to the RAND formula. The organization is premised on a voluntary membership-funded basis with reasonable dues set annually by the OSA Board.
While specialists who choose not to become members of the OSA will not be forced to pay dues to the OSA, only those specialists who pay OSA dues as members will have membership rights, including the right to vote in board elections, to vote for/against a proposed PSA, to participate on OSA committees. The OSA is guided by a bottom-up approach designed to fairly enhance the needs of its members, not the corporate interests of the organisation. This is believed to be the best way to align interests constructively.
What happens if an OSA member section is unable to pay its fair share for running the organization?
The intent of the OSA bottom-up approach is to demonstrate that it is working in direct alignment with them as specialty physicians. The purpose is that doctors will recognise this marked change in direction and will be willing to voluntarily pay a reasonable membership fee knowing that it will take time for the many issues to gain traction after years of inertia. The right not to participate will be balanced with the concern that no specialist section “free-load” off the funding of others. If a percentage (to be determined) of a specialist section’s membership choose not to become members of the OSA and not to pay dues, then that section’s board seat and/or right to participate in board elections will be suspended until such time as the section returns to the minimum participation threshold for membership. The thrust of the OSA is to earn trust and to demonstrate measurable ways of showing progress and a genuine interest in advancing the individual and collective specialist interest.
How will the OSA be governed?
The OSA will be governed by an elected Board of Directors. Larger specialist sections will directly elect their own nominee(s) to the board. Small specialist sections could be grouped together, and that group(s) will directly elect a nominee(s) to the OSA board.Sections and groups will only be able to vote for their specific board nominee(s). They will not be able to vote for or against the nominees of other sections or groups.This more representative approach is currently lacking in OMA governance and a topic of longstanding irritation.Board members will serve a maximum of three two-year terms.The OSA’s Governance Principles document provides further details. Click here to view.
If my section joins the OSA, what will happen to my OMA benefits (e.g. insurance)?
All current OMA membership benefits including insurance will continue to be offered. Insurance carriers will not let insurance coverage be interrupted and the OMA is expected to maintain stability in insurance coverage they have offered doctors for many years. While not an immediate priority compared to the organisational work that must be done, OSA members should expect that major benefit programs like insurance will be offered with major carriers through comparable programs and more attractive rates. This is one of many topics the OSA will be closely listening to members to establish OSA priorities. The plan is to not create an OSA bureaucracy but rather engage competent and conservative partners to manage these services cost-effectively on our members’ behalf.