OLDS – The UCP government’s decision to end its agreement with the Alberta Medical Association (AMA) and impose a new framework effective April 1 has been met with widespread consternation from area physicians and others concerned about the future of health care in rural Alberta.
Calls to area UCP MLAs Jason Nixon and Nathan Cooper seeking comment were not immediatley returned at press time Monday.
Olds physician Martha Ingles, with Wild Rose Medical Centre, says she is very worried about the impacts on patient care.
“This will lead to physicians changing how they practise,” said Ingles. “Every physician I have spoken with has looked at other practice opportunities. I am sure Alberta will lose excellent physicians through this process and sadly I’m not sure the government sees that as a negative.
“I am scared over what this means to me as a patient within the system as a mother accessing care for my medically complex child.”
Announced on Feb. 20, ending the contract with AMA and instituting a new framework will help avoid $2 billion in cost overruns. The move came after negotiations between the association and the government broke off.
“Despite repeated efforts, the AMA failed to put forward alternatives that would hold the line on physician compensation,” said Health Minister Tyler Shandro.
“The new framework will prevent cost overruns, allow our province to improve services for patients, and still ensure that Alberta’s doctors are amongst the highest paid physicians in all of Canada.”
Changes under the new framework include a reduction in charges for complex modifiers (fees charged for advanced service) from $18 to $9 for a period of one year before being removed in 2021-22. After that time physicians will be able to bill an additional fee after spending 25 minutes with complex patient cases.
The framework will also implement a daily cap of 65 patients per day, remove physician overhead subsidies from all hospital-based services, and remove the comprehensive annual care plan from the list of insured services.
It will also give physicians 90 days to submit their payment claims, instead of the current 180 days, and end the practice of submitting claims for services provided to patients that cannot provide proof of AHCIP coverage or Alberta residency.
The province says it will introduce a new alternative relationship plan with “built-in transition benefits to encourage physicians to move from fee-for-service to a three-year contract.”
Under the changes the province will maintain the current level of spending on physicians at $5.4 billion.
“Our province is facing cost overruns of $2 billion over the next three years due solely to physician compensation,” said Shandro. “If left unaddressed, these costs will impede efforts to reduce surgical wait times, improve mental health and addiction services, and expand the number of continuing care beds.”
AMA president Christine Molnar says the government decision to tear up the contract with doctors is an “outrage.”
“It defies logic, “ said Molnar. “It’s an unprecedented move. This has never happened in Canada during the whole duration of medicare.
“Most Albertans, you know, if you think about democracy, the sanctity of law is pretty fundamental to the democratic environment. When you make a contract with someone and you sign it, it’s a legal agreement. To just legislate the power of a contract away, it fundamentally disables the democratic process.”
The official Opposition health critic David Sheppard says the changes will negatively impact patients across Alberta.
“First it was hospitals, now it’s doctor’s offices and primary care clinics, and it’s families who will pay the price,” said Sheppard.
“This is going to have a serious impact on patient care. This chaos is going to be felt most especially in rural areas. Family physicians warned Jason Kenney in November that his plan would devastate rural care, with job losses and the closure of entire clinics.”
Both the Alberta Teachers' Association and the Alberta Federation of Labour have also come out against the Kenney government’s moves.
“In its dealings with our province’s doctors, this government has shown no respect or regard for fair negotiations,” said ATA president Jason Schilling.
For her part, Dr. Ingles says, “We now have proof that we cannot trust any contract signed with our current government, past or future. They have no interest in collaboration or they would not have blindsided us with the announcement (on Feb. 20).”
An Olds physician delegation was scheduled to appear before town council on Monday (Feb. 24) to speak on billing changes.
