Usually when spending announcements come out of Premier McGuinty's office, taxpayers cringe. Make no mistake: in his first year in office, taxpayers have had plenty of reasons to complain, including $500 million in corporate welfare for the auto industry and tens of millions spent on tourism advertising in glossy American magazines.

Yet this week, when it was announced that the province will be giving doctors a raise of between 18 and 24%, taxpayers actually have reason to approve. Why Quite simply, because for once, money is part of the answer to a serious problem: a physician shortage that is crippling the health care system, and forcing some communities to offer outrageous perks just to get a doctor on their doorstep.

The plain truth is that doctors are underpaid in Ontario. In September, the Fraser Institute released an in-depth report on the wages of health care workers in this province. It shows that many doctors, in particular general practitioners, are not receiving fair compensation for their services. Relative to other professions, their wages have been declining since the 1970's, and they receive roughly half the compensation of their colleagues in the United States, once the exchange rate is factored in. (Hmm - if you were a recent medical school grad with big loans to pay off, where would you choose to practice )

The same report shows that many hospital employees, such as food care workers and cleaners, receive more money (in some cases one-and-a-half times the going wage) than workers performing comparable jobs in other sectors. They are also overpaid compared with hospital workers in other provinces. And another report commissioned by the provincial government found that cumulatively, Ontario's hospitals could save $200 million were they to emulate the best practices of the province's most efficient hospitals. Those practices would involve contracting out union jobs in support and administrative services to the private sector.

So when Conservative MPPs berated the government this week for giving raises to doctors while forcing hospitals to tighten their belts, they should have thought twice. Especially if they are not prepared to go the distance and posit the real and only long-term solution to the physician shortage and spiraling health care costs: ending the state health care monopoly.

Both the government and the opposition continue to ignore the main issue, which is that allowing a parallel private health care system to develop is the real answer to the province's - and the country's - health care crisis. While Conservative Leader John Tory has advocated the development of more public-private partnerships in health care, he has not gone the distance that one of his leadership rivals, Frank Klees, proposed during the recent Tory leadership race, advocating full choice between public and private services.

Ontario should take a page from its neighbour, Quebec, where the first completely for-profit health care clinic just opened to public acclaim. Instead, in Ontario, the government is buying out private MRI clinics with public money and preventing private providers from the US from offering services that hundreds of Ontarians were prepared to pay for. All this while imposing an onerous health tax and delisting services in the bargain.

It's time to move beyond spending to a discussion of real solutions in the health care arena. Until we do, at least Ontario's doctors will be getting a competitive wage for the valuable services they provide.