OVERHAUL NEEDED: Why the Ministry of Health needs to modernize its controls of physician billings

OHIP billing system is antiquated and needs to be updated, as the monitoring costs were developed in the 1980s, writes Peter Watson. 

A recent report by the Ontario Auditor General revealed new information involving physician billings.

However, some of the issues identified as problems were highlighted in a previous auditor’s report nearly 10 years ago.

During the last three years, 59 doctors reported working more than 24 hours a day. The Ministry of Health has not determined if that information is true because of the codes used and whether those codes need to be updated.

More than 100 doctors worked every day of the year and some doctors billed for more than 500 patients in a single day. Why would this data not be flagged as suspicious and then investigated?

Apparently, the Ministry of Health only investigates billing issues if there is a complaint. For many, that policy is viewed as unacceptable.

Well-run organizations have management systems that measure key items, whether there is a complaint or not.

The reason for the questionable findings could be, according to the audit, the current system for monitoring costs was developed in the 1980s. The report said the Ministry of Health’s payment-monitoring system is unable to flag high-risk billings.

Health-care expenses in Ontario account for about 40 per cent of our province’s spending. Failing to manage those costs is a mistake that has persisted for years and should be rectified.

Many people do not respect how the government is run and the Ontario Auditor General’s findings reinforce those opinions.

If a company had a financial control system as bad as it appears to be with the Ontario bureaucracy, that company would likely go out of business.

When that organization is the government, the result is wasted money.

Peter Watson, of Watson Investments MBA, CFP®, R.F.P., CIM®, FCSI offers a weekly financial planning column, Dollars & Sense. He can be contacted through www.watsoninvestments.com.