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Article
October 16, 1991

Caring for the Uninsured and Underinsured-Reply

Author Affiliations

National Organization of Physicians Who Care San Antonio, Tex

National Organization of Physicians Who Care San Antonio, Tex

JAMA. 1991;266(15):2078. doi:10.1001/jama.1991.03470150050018
Abstract

In Reply.  —Dr Frankford suggests that relations between the Ontario government and its physicians have improved since the election of a socialist government in September 1990. It should be instructive to American physicians to examine the terms of the April 1991 agreement between the OMA and the Province of Ontario:

  1. In 1988, the Ministry of Health, despite a prior agreement, unilaterally refused to grant cost-of-living fee increases to provincial physicians. The new agreement gives physicians a 2% lump sum payment for 1989-1990 and 1991-1992 gross billings (approximately one third of the increase in cost of living).

  1. For the fiscal year 1991-1992, there is a 3.95% increase in fees for physicians' services—about 2% less than the rise in last year's consumer price index.

  2. The OMA was forced to accept a "global utilization pool" (a euphemism for global income capping). This creates a pool of funds available to fee-for-service physicians. If total

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