“How can you trust a man who wears both a belt and suspenders? The man can’t even trust his own pants.”—a line from the spaghetti western Once Upon a Time in the West.
If the government’s attacks on Alberta’s doctors are any indication, anyone up for contract renewal this year will have a more luck trusting their own pants than trusting the government to negotiate in good faith.
(Non)Negotiations with the doctors
A quick recap, negotiations have dragged on since Mar 2011. You’re forgiven if you lost track of all this, it’s been almost 2 years.
By Nov 2012 the government had signed and discarded two “agreements in principle”. Then Health Minister Horne surprised everyone with his “best offer”. It reflected the “value” the government placed on the doctors and Alberta’s “fiscal reality”; which at that time was a distant rumble on the horizon. The $6 billion bitumen bubble had not yet sprung from the fertile imagination of Ms Redford’s speech writer.
What Mr Horne failed to say was that the “offer” was an edict with no input from the doctors and stripped out the very thing the doctors had been fighting for—the right to participate in decision making.
Mr Horne’s “offer” coincided with the kick-off of the government’s “blame-the-doctors, shame-the-doctors” campaign,*a concerted effort to discredit Alberta’s doctors by flooding the media with misinformation.
Twisting the “facts” to divide and conquer
The Premier’s and Health Minister’s statements might, in another context, be considered unfair practices. They include:
- The “best offer” is around $181 million, oh and by the way Alberta doctors are paid 20% to 29% more than the rest of Canada’s doctors (not true, they are paid 14% more and guess what, so are the rest of us)
- In order to meet the doctors’ demands we’d have to resurrect the healthcare premium. (This is killing a fly with a sledge hammer because it would bring in an extra $1 billion in revenue to cover the doctors’ $50 to $60 million inflation increase).
The doctors reacted as one would expect. They reached out to Albertans with summits on key issues like Redford’s plan to replace Primary Care Networks with Family Care Clinics at five times the cost. Meanwhile Dr Giuffre, president of the AMA, challenged the premier’s misinformation with data from Stats Canada and CIHI. The government lambasted the AMA for going to the press but the doctors refused to be swiftboated.
Who do we trust?
How do we decide who to trust? It’s easy. Test the veracity of the doctors’ case by going to the AMA website. Ask yourself: does the statistical information make sense?
But what about Health Minister Horne? We’re in luck. We can test his honesty by reviewing the transcript of his evidence in the Preferential Access (Queue Jumping) Inquiry. True, Mr Horne’s testimony relates to queue jumping not doctors contracts, but it’s enlightening not because of what he said but how he said it. Giving evidence under oath is the ultimate litmus test.
The highlight is Mr Horne’s answers to questions about the “Duckett memo”; a memo prepared by the former CEO of Alberta Health Services in which he warned that queue jumping would no longer be tolerated. The “Duckett memo” surfaced in 2011. The media and the opposition parties had a field day.
Stephen Duckett,ex-CEO, Alberta Health Services (Photo credit: Wikipedia)
Mr Horne was asked a very broad question, was there “discussion within the ministry” of the memo. Nope. (1504)**
Really? This answer troubled Justice Vertes who asked (1520): ”Did I understand you correctly to say that there was no discussion about that Duckett memo when it arose in the media?” “None that I was involved in, sir, in my capacity…” Mr Horne was an MLA with additional duties as a parliamentary assistant to the Health Minister but what does that have to do with anything?
Justice Vertes found Mr Horne’s answer “somewhat surprising”. He said he’d have thought that the accusations “would have been quite the topic of conversation” within the health ministry.
Finally Mr Horne buckled. “Okay. I’m sorry, I thought you meant sort of like a formal discussion in association with my role, so no. But, you know, in terms of general discussion about—about it with people, yes. Certainly people were talking about the memo.” (1520-21)
Hallelujah! The truth at last. After evading the question twice, Mr Horne was forced to admit that yes, there had been discussion about the Duckett memo, he’d just sorta misunderstood the question (Oh you’re asking whether there was any water-cooler talk, not whether I had a formal discussion in association with my role as parliamentary assistant to the health minister). Good grief, this isn’t the Watergate inquiry.
So do I trust the politician who “misunderstands” a question (twice) in order to avoid answering it or the doctors who publish statistical data on an open website? Three guesses.
What does this say about leadership?
Good leaders lead by creating consensus and alignment, not conflict and animosity. The premier’s “blame the doctors, shame the doctors” strategy turned the AMA contract negotiation into a personal attack on the doctors leading to a “I win/you lose” outcome.
It signals what we can expect from this government in the coming year. Crush the doctors, and the nurses, teachers, and public servants will fall into line. We’ll still have a $6 billion hole in our revenues, Albertans will learn to live with substandard healthcare, education and infrastructure, but corporations can rest assured that their tax and royalty structures will not be touched.
To paraphrase Sophocles, trust dies but mistrust blossoms…it’s great for the lawyers but it’s no way to run the richest province in Canada.
*AMA President’s Letter Feb 6, 2013
**All page references from the Hearing Transcripts
—Health Services Preferential Access Inquiry
Susan on the Soapbox 
Susan I do not trust either one of them. If I had to take sides, I trust the doctors more.
Doctors are this interesting group of people that seem to believe that they have this semi-god status. Once you become a doctor you have to have priviledge and money. It is somehow an entitlement. They are not the only class of people that believe and impose this on society but they are clearly in that domain.
Furthermore when we had the nurses disputes with the government years ago, they not only did not support them but they danced with the government in order to get a better standing and possible more money.
The government is what we know and so what is happening is not new. Ralph Klein who has now acquired also a semi-god status, treated doctors, nurses and teachers with so much disdain that bordered the absurd.
This is just another example of a government that thrives on total lack of competence. In the meantime the so called progressives all want to be in control and there is no genuine apetite whatsoever to do what is right and beneficial for all of us. It is a game for power, control and privilege.
Carlos, you’re not alone when you suggest that the doctors may bear part of the blame in this mess. I’ve heard similar comments from others as well. The example you give about the doctors failing to fully support the nurses is a good one. I’ve often wondered why the doctors don’t recognize that solidarity among healthcare professionals would increase their leverage against the government in times like these. I worry that their training has blinded them to the value of teamwork. It may not take a village to raise a child but it certainly takes teamwork among healthcare professionals to get us out of this healthcare morass.
Your final comment intrigued me. I’ve been following the discussion among the progressives about a potential merger or even just cooperation in the next election. While it got off to a good start it hasn’t progressed very far. The parties seem to be saying merger/cooperation is good but you have to merge with me, not the other way around. Not very promising.
Susan your comment that ‘training has blinded them to the value of teamwork is’ is exactly right. That is caused in my opinion not just by the training but also their obvious feelings of superiority towards nurses. Their years of training has always been the excuse to make more money and have more privilege and although I have never agreed with that excuse, today there are many people that have as many and more years of education and do not even know if they can get a decent paying job.
As far as the merger/cooperation I am curious why it intrigued you. I clarify my comment. I have noticed that at provincial and federal level the poltical quality standards are poor. This is the reason I agree with Manning. I never do otherwise 🙂
Most parties are only interested in power because it gives them privilege and control over the rest of us. I do not see in Alberta any of the leaders genuinely interested in fixing anything. I truly believe this. I do not have one reason to believe otherwise. If they had a true interest in running this province for the benefit of Albertans a merger/cooperation would be easy to contemplate especially in Alberta where there is no other solution to get out of the impasse of a one party system. Without Proportional Representation we are stuck with what we have which means more power and money to the elites and corporate sector and more and more cuts to social programs and the privatization of everything.
Carlos, I met some interesting people the other day who suggested a different approach to working together, one that started with leaving one’s party affiliations at the door and working on clarifying our shared values. The suggestion was that there were more things that unified the progressive left than split it apart. I think this is true at a theoretical level, but agree with you that the minute one slaps a party label on a group they get stuck on what they think is best for the party not what’s best for the province. I’m not sure all of it is based in pride or a desire for power, I think there’s a good deal of idealism mixed in there as well (every party thinks that the public will finally see the error of its ways and vote for them). As we’ve seen time and time again, this is hopelessly naive.
Susan I am glad it is not only me that thinks so
http://www.huffingtonpost.ca/2013/02/13/preston-manning-politicians-canada_n_2678524.html
Who’d have thought that I find myself in agreement with Preston Manning, but he’s right, we need better quality politicians. For me “quality” in this case means intelligence, integrity and compassion.
I actually trust doctors.
I even trust lawyers.
I trust nearly everyone who is an ordinary citizen.
But I no longer trust government.
I may trust doctors because I have doctors in the family but there you go. Asians are obsessed with getting their children into medicine.
As for all the yapping about how much doctors cost us –they are worth it and certainly they should make a good return on their investment of time, labor and energy.
The average doctor does not make as much as MLAs make and certainly some doctors make big bucks but you can’t convince me that the fact that doctors get paid well— for their long term investment in their educations (which is a considerably longer period of education time than most of the incompetent folks we have hired to be our MLAs) –is a reason to distrust them.
When I look at the value my doctors give my family versus the non-existent value my MLAs give me well there is no contest in who I trust more.
In addition I am glad the doctors are fighting with the government.
It is about time.
Almost two years of this abuse is enough for any group of employees–it is harassment on the job.
The politicians are hoping that a long drawn out ugly battle will wear the physicians down and I hope they do not cave in to the politicians. I hope they won’t back down because bullies are to be faced and pushed back. This is what we have in government right now–bully boys and bully girls.
If our politicians followed the laws of the land (as in giving back money they got illegally from folks in the last election) and if they were accountable for failures in governance such as the sad case of Samantha Martin in the foster care system —well then–I might believe some of their blathering about the bitumen bubble and all that rot.
The fact is this government needs to wake up to the fact we are no longer fooled by their yapping about the oil companies and their troubles. The oil companies are making billions of dollars. We now realize where the real problem is. The real problem is that our government will not increase the oil royalty rate which gives our oil companies a massive return on investments in the tarsands.
Why don’t they increase the oil royalty rate? The Tories are funded by big oil. And why would they bother to tick off their sponsors?
They are getting the citizens to pay for electricity grids that power big oil’s extraction and transport of bitumen, they are getting citizens to pay back favors to Katz and crew and they are getting citizens to pay for their lavish AHS expense accounts (currently 100 million in the recent report by the Auditor General—“The report says AHS spent $100 million during 17 months on travel, purchase card transactions and other travel expenses. “If it does not implement this recommendation, it may pay expenses that do not comply with policies,” the report said.”).
The report is here:
Click to access OAGFeb2013report.pdf
We are so mismanaged and hoodwinked and the strategy of divide and conquer the citizen is neat–it is outlined in the book–by Tom Flanagan –“Harper’s Team Behind the Scenes in the Conservative Rise to Power.” Chapter 9 is especially interesting for citizens to review-“The Ten Commandments of Conservative Campaigning”. A good antidote to this horror is Elizabeth May’s book –“How to Save the World In Your Spare Time”. Sigh. We’re such naive folks.
Julie, I too worry that our doctors will buckle under the stress of trying to do their jobs in the hostile environment created by the government. It would be very sad to see more great physicians follow in the footsteps of Dr Ciaran McNamee, the respected thoracic surgeon, who criticized cuts to resources for lung cancer patients and was bullied out of the province. A great loss for Albertans but a win for Harvard where he ended up.
Dr Linda Slocombe, past president of the AMA, once said that doctors see themselves as civil servants because they depend on the government and the institutions that the government can influence, for their livelihoods. It’s time for them to think of themselves as medical practitioners who, like the nurses, will stand up for themselves and their patients.
This is extremely difficult in the PC political environment. Past history has shown that those who dared advocate for their patients will be accused of being mentally incompetent and if worse comes to worse will lose their jobs. But if they act in concert the government will stand down…it can’t drive them all out of the province!
This negotiation has turned into an appalling mess. It has negatively impacted the doctors’ ability to take care of their patients and for that I hold the PC government and each and every one of its MLAs personally responsible.
Thanks for the book suggestions…I’ll put them on my list.