In this corner we have Dr Michael Giuffre, the new President of the Alberta Medical Association (AMA). He’s a pediatric cardiologist who was dubbed the Baby Whisperer by a frantic parent after he’d soothed a screaming baby.
In the opposite corner we have the Health Minister Fred Horne, a health consultant turned politician. We’ll call him the Bully Boy in recognition of his skill at the all out frontal assault.
The latest round of the AMA contract negotiations started on a high note. Instead of pointing the finger of blame Dr Giuffre extended an olive branch. He said the AMA wanted to be a “willing partner” with the government and Alberta Health Services in the decision making process before decisions were made and policies put in place.
The Baby Whisperer’s gambit was reasonable…but hopelessly naive.
The applause had barely died down at Dr Giuffre’s installation dinner when Minister Horne fired the first volley—he tabled the government’s “best offer” (translation: take it or leave it because it ain’t getting any better than this).**
But wait, that’s not all—the “best offer” came with strings attached. Certain preconditions had to be met before the government would deign to continue negotiations. ***The AMA dutifully presented its response to the preconditions at a meeting with the Minister…who refused to consider them.
Apparently the negotiations were over. The next morning Minister Horne announced a “my way or the highway” unilateral settlement offer.
The Baby Whisperer and the AMA were furious and with good reason.
Firstly, the government reneged on not one but two agreements in principle. In the private sector when two companies sign an agreement in principle, one can’t back out simply because he feels like it. That’s called bad faith and it’s grounds for a lawsuit.
Secondly, the Bully Boy is framing this dispute as a fight over money when it’s not. He said the government’s offer reflects “…the value we place on our physicians and the fiscal reality facing our province”.****
What Minister Horne doesn’t say is that the doctors had already accepted a 0% pay increase for 2012 and 2013 and a cost of living adjustment (COLA) increase for 2014 under the original agreement in principle. When it became obvious that the AMA would be problematic in the April 2012 election the Bully Boy unexpectedly dropped an additional $181 million into the AMA’s lap—a $12 per head increase (from $50 to $62) for each patient in a primary care network and a 2% increase in insured services fees. Both of which were welcome but did little to offset skyrocketing overhead costs.
With the election safely behind the them, the health minister tore up the agreement in principle. The result:
- the government’s promise to allow consensus-based decision making? Gone. It’s replaced by ministerial authority over virtually everything.
- the references to primary care networks (PCNs)? Gone. The government wants to replace PCNs with 140 Family Care Clinics (FCCs) at 5 times the cost with no input from the AMA.
- the 2.5% fee increases promised for 2011-12 and 2012-13? Gone.
- the two programs that support community doctors? Gone within 2 years, creating a $30,000/year drop in compensation with a vague promise that funds will be recouped somehow. (I’m sorry but the “trust me” rationale just doesn’t cut it anymore).
- the pre-election bump of $12/patient for primary care networks (PCNs)? Gone in 3 years.
Furthermore fees will be adjusted downward without a transparent process for how these fees will be reviewed and adjusted.
And all of this will take place without any input from the doctors.
But never mind, the Cost of Living Allowance continues until 2016.
The Baby Whisperer learned a harsh lesson. Bully Boys don’t play by the rules. Minister Horne acts like he’s got the AMA on the ropes and to some extent he does because he knows that the doctors won’t abandon their sick and dying patients in order to make a point.
Nevertheless it’s time for Dr Giuffe to take that olive branch he so generously extended and whack the Health Minister upside the head. How? By following Dr Slocombe’s lead and engaging with Albertans in a media campaign to educate us on the issues and get our support. What is fee relativity? Why is it important? Are PCNs better than FCCs?
Meanwhile here’s what you can do.
Send Mr Horne and Ms Redford an email with a copy to the others. Tell them you’re appalled by the government’s bad faith in this round of contract negotiation with the AMA and unless the government returns to the bargaining table with a more palatable offer, you’ll vote against the PCs in the next election.
This won’t be 100% successful but it’s a way to show the government that the Baby Whisperer has friends and we’re not going to let the Bully Boy pummel our doctors any longer. Bullies win only if we don’t stand up to them.
Here are some email addresses:
Fred Horne: firstname.lastname@example.org
Alison Redford: email@example.com
Raj Sherman: firstname.lastname@example.org
Brian Mason: email@example.com
Dr Giuffe: firstname.lastname@example.org
*Installation Remarks Sept 22, 2012
**Calgary Herald, Oct 25, p A5
***AMA President’s Letter dated Nov 9, 2012
****Alberta Gov’t Press Release Nov 16, 2012