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Letter: UCP claims Alberta doctors overpaid don't standup to scrutiny

Editor: On May 19 Health Minister Tyler Shandro addressed Alberta physicians’ concerns regarding fee cuts. Here is my response to some of the minister’s talking points: 1. "[The AMA says] government failed to negotiate in good faith.

Editor: 

On May 19 Health Minister Tyler Shandro addressed Alberta physicians’ concerns regarding fee cuts. Here is my response to some of the minister’s talking points:

1. "[The AMA says] government failed to negotiate in good faith. This is a serious allegation and one our government vigorously denies." 

The government's action of ripping up a previously negotiated non-expired contract is the definition of bad faith and questionable legality.

2. "The AMA says we walked away from the table. We didn’t." 

Up until Feb. 20, negotiations continued. The AMA had offered solutions that would have provided $150 million in savings, and had provided notification that they were going to present further savings during the scheduled Feb. 21 meeting. However, on Feb. 20, the Minister announced cessation of negotiations. The AMA negotiating team learned the government had walked away from the table through media reports.

3. "Not having a contract does not mean a threat to public health care." 

It most certainly does. No business can function in an unstable environment where anything can be taken away, with no recourse. Contracts matter to our Albertan way of life and business.

4. "Our government continues to support physicians by: announcing an $81 million investment to protect access to rural health care ..." 

Cutting funding due to lack of understanding of how health care works, then restoring only some of it, and that only under mounting public pressure, is not "support," nor an "investment."

5. "Our government is committed to maintaining spending on physicians at $5.4 billion."

The AMA and Alberta physicians understand fiscal realities. We are taxpayers too. We know that Alberta faces dire economic straits and we want to help squeeze every last dollar of value out of our system; we know painful decisions have to be made, including those painful to us personally.

We can be partners in this with our expertise and our heart and soul passion for patient care. To this end the AMA proposed across-the-board fee cuts, greater than from any other public sector workers. In the past 10 or so years, Alberta and the AMA have built the nationally acknowledged best Canadian medical home for patients.

Best care and best savings are the non-debatable results of patient attachment to continuous primary care; it is by far the health care policy with the biggest bang for the buck. The government is threatening to demolish all the painstaking work and achievements we have made thus far. It is incredibly and heart-breakingly short-sighted, for fiscal as well as quality of care reasons, to target family physicians. 

Alberta doctors are paid "... the highest per capita in Canada." 

The McKinnon Report used old data, and in a way specifically cautioned against by the source of the data, CIHI, to argue that Alberta physicians are paid 35 per cent more than in comparator provinces. If that were true, there would be good reason to drastically reduce physician payments.

But it is not true. Invictus Analytics & Strategy (an independent consultancy that government hired during the negotiation of two previous AMA agreements), has calculated that Alberta physicians are paid 5.7 per cent more than the comparator provinces of B.C., Saskatchewan and Ontario.

By the 2021-22 fiscal year, Alberta physicians will be paid 2.5 per cent less on average than these provinces – that's with the most recent fee schedule. Obviously it will be much worse if the government proceeds with announced changes.

In 2017-18, Alberta’s industrial aggregate wage level was 15.4 per cent higher than the averages in B.C., Saskatchewan and Ontario. As employers themselves, physicians are directly impacted by these higher wages through increased staff/overhead costs.

And if inter-provincial comparisons are needed, note that Alberta is the only province wherein essential workers, who cannot strike, do not have access to binding third-party arbitration. Alberta physicians would gladly accept arbitration. That we cannot do so, suggests the government knows and is afraid of the likely result.

I ask that the government re-enter negotiations with the AMA. As I will soon retire, it matters little to me what the fee schedule is.

But it matters greatly to me that Albertans have the best physicians and the best value health care.
 

Heather Reese, MD

Canmore

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