Thursday, January 27, 2011

The OMA's policy recommendations

The OMA has released a new set of policy recommendations. Although I have a few quibbles - mostly about advocating policies for countering obesity for which the evidence base seems weak (school exercise programs) or equivocal (calories on menus, see also this article) - the report is notable for a few other reasons.

First, there is notably no call for increased privatization of the health care system. The closest the report comes is calling for "Providing funding to identify ways to reduce the administrative burden in the health-care system so that patients will have better care, and the system will operate more efficiently". That statement is so broad it could be read in many different ways. But in other sections, the report calls for more public investment in long-term care, mental health, and chronic disease management.

Second, the report embraces the concept of family health teams and calls for their expansion. This is a dramatic shift from the rather tenuous and tepid support the OMA gave such initiatives previously. However, the evidence that primary care reform has improved quality, efficiency, or equity is more equivocal.

There is also a recommendation "that all patients have equal access to publicly-funded health professionals and services regardless of their physician practice model. Examples include but are not limited to: nurses (RN, RPN, NP), dieticians, pharmacists, psychiatrists, internal medicine specialists, pediatricians and physician assistants." Note that NPs are included (in contrast to what the Ontario Health Coalition has stated), if under-emphasized. Still, this also represents a change from past perspectives.

There have recently been calls for an "adult discussion" about health care - which I think means opening the privatization debate. It's good to see the OMA's positions "maturing" in a different direction.