Dr Michael Giuffre
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.
Fred Horne (Photo credit: Wikipedia)
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: edmonton.rutherford@assembly.ab.ca
Alison Redford: calgary.elbow@assembly.ab.ca
Raj Sherman: edmonton.meadowlark@assembly.ab.ca
Brian Mason: edmonton.highlandsnorwood@assembly.ab.ca
Dr Giuffe: president@albertadoctors.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
Susan on the Soapbox 
Really none of this sort of behavior in health care is new but just a continuation of the tactics that the Tories are using to gut the health care system and move it to complete privitization. It has been going on from the Klein error onwards.
We will see more of this bully boy activity until just before the next election when again we will be given the same generous and responsive governance that we expected at the beginning of the Redford error.
What are we to do?
I suggest that we all begin to provide opposition parties with our cold hard cash so that they can begin to advise voters of the poor and disrespectful tactics of our governments at all levels that make a mockery of democracy.
Why do they do this?
This is the way it is in Alberta and voters have given the Tories tenure and so they think they can do it.
The only way to end this sort of crap is to vote them all out.
The next election is a long four years away and writing to them is still a productive exercise. It at least gives the spin doctors they have hired to respond to our letters of complaint some work and so we are not entirely wasting our tax payer dollars on the Orwellian machinery that currently operates as government in Alberta and Ottawa.
Julie, I agree with you on all counts…letter writing is a small step which signals that public opinion is shifting and dissatisfaction is rising. A more effective move is to do as you suggest and vote the Tories out of office. I fully support your suggestion that the best way to make this happen is to give financial support to the opposition parties. It’s the only way to stop the inexorable slide into a poorly thought out mish-mash of public funding for private health care which only a few can afford. Thanks for your comments and welcome to the soapbox!
I have some difficulty garnering a great deal of sympathy for the Docs over this issue. Please don’t get me wrong, I have a tremendous amount of respect for the medical profession and my family and I have received nothing but the finest of care, but I have always wondered why they have remained so silent through all of the cuts and attacks on our public health system beginning in the reign of our most recent recipient of the Order of Canada. While Mr. Klein was firing nurses and blowing up hospitals, where was the AMA then? Even as individual doctors, (David Swann, Raj Sherman, Paul Parks, John O’Conner, Stan Houston, Ciran McNamee and others) had the courage to speak out, the AMA seemed to be absent in rushing to their defence. It has always been my assertion that meaningful improvement to our healthcare system will never occur without support of the doctors. When I raised that point at a College of Physicians and Surgeons meeting in 2010, I was very quickly and pointedly dismissed by the registrar.
It appears that Mr. Horne is taking a different approach to “negotiations” this time. At the start of every other legislative mandate, one of the first orders of business of the PC’s was to give the docs a big fat pay raise while the government slowly moved forward their agenda of privatization. Seems that the docs are no longer seen as allies of the PC’s as evidenced by the full page ads placed by Dr. Slocombe attacking the Conservatives just before the last election.
I know it is a long shot, but just possibly Mr. Horne’s latest tactic may inadvertently bring those physicians supportive of public healthcare into the discussion where they belong.
Susan, you are absolutely right about the bully tactics of the government and the deliberate obfuscation of the issues around the funding and delivery of our health care. We’ve seen the government withdraw from public discourse in every sector of our public services – I wonder what Alison and Fred mean when they talk about “having a conversation”? OR what they think “transparency” means?
As far as negotiations are concerned, the docs now might have a sense of the frustration of staff at Revera Riverbend and Hardisty Care Centre and Monterey Place – or, for that matter, at XL Foods.
Neil makes a very important point; the docs have been taking care of their own (vested) interests, frequently at the expense of the public interest (see, for example, the Auditor General’s assessment of the PCNs).
When I hear about significance of the doc’s support for our public health care system, I keep in mind that we have a public health care system in spite of the docs (think 1962 in Saskatchewan) and most of the CMA and AMA positions about reforming our system with the expansion of the “partnership” of the private sector involvement. There are some brave voices from the medical professions supporting really public health care – but the AMA doesn’t pay any more attention to them than Fred did to the dissenting voices at the Alberta Health Act forums.
A pox on both their houses.
Kudos to Susan!
Susan, I am with Neal on this issue and I doubt that the doctors would get a lot of public support if they even had the motivation to do anything about this. Neal is absolutely correct about what happened with the nurses during the paradise years of Ralph Klein and because I am not as nice as Neal, I would venture to say that the doctors not only gave NO support at all to the nurses but they also showed that they were more interested to dance with the govenment if given a chance that would benefit them. At least this is my interpretation at the time. We saw an article or two of doctors talking positively about the nurses but I believe they did not want to be seen as ‘friends’ of the Union as they really are not that ‘type’ of people. I am a regular Canadian and I have no Union or rich Association behind me and I know that people like myself do not trust the doctors to protect our Public Health Care System.
Furthermore Carol’s sentence ‘.. we have a public system in spite of the doctors…..’ is to me the crucial issue here. I totally agree with Carol. I truly believe that given a chance a lot of doctors would just love to privatize everything and allow their salaries through the roof and forget about the patients. We are all human and we know where we would be without rules and regulations. I think that sooner or later this is going to happen because people like Bully Boy are piece by piece fast tracking the destruction of the little we have left.
Carlos, Carol and Neil, all three of you raised a critical point that I hadn’t considered, namely that the AMA may be the author of its own misfortune. You’re right, it did fail to vigorously defend the healthcare profession (including the nurses and other care workers) during the Klein era and it ceded even more power to the government and the bureaucracy when it failed to defend brave doctors like Swann, Sherman, etc who suffered at the hands of the government, the AHS, the College of Physicians and Surgeons and others for daring to speak out against injustice.
Horne obviously feels he can act with impunity and it will be very difficult to reel him in. As a result we’ll all suffer.
There is a silver lining in all this (Carlos will chuckle at my eternal optimism) and that’s Neil’s point that Horne’s bullying may finally force the AMA to side with the public on the issue of publicly delivered healthcare.
Thank you all for your great comments. And thank you Carol for not poxing my house…!
🙂 Yes I did chuckle but in a good way. You are a very hopeful person with our present political system but I am not. I have lost complete confidence in the system itself because it is basically paralysed.
Even if the NDP was to win a election at either the Federal or the provincial level nothing or almost nothing would change. Corporations and Big banks and powerful financial institutions are so interconnected with governments and politicians that it is basically impossible to change anything without creating a difficult situation for people that are not willing at all to make any kind of sacrifices. If you think of it, what would Mulcair do if he becomes prime minister? He will shift quickly to the center and just continue the same old same old.
That is what Harper did in order to survive and they will all do the same to remain in power. Of course Harper is pushing ever so slowly to the right but I still think that he has limitations there and he knows it. I mean Canadians are not going to put up with sentences like ‘Women that are raped should not have an abortion because somehow that is what God intended…’ 🙂 This is after all why Danielle Smith did not win and she is already moving to the center because she wants power just like all of them. She will do what Harper did. No communication with the media and full silence until they win the election.
Their only problem is that people have now understood this and I think that politics are going to see a massive change soon and I for one am working for that. We need a real change in order to build a better future for all of us and those that will come after us and this system will not be able to do that. If we do not change we will self destruct.
Alison Redford is the cover girl for the kind of bad politics and undemocratic values we have witnessed for a long time now and I will make a prediction that she will not survive the 4 years.
By the way the type of ideology I mentioned above about abortion is not just a US occurrence. In Canada we are less showy but here is from the new book by Warren Kinsella ‘Fight the Right’ – This is at the Alberta Progressive Conservative Party convention in June of 1995 by Stockwell Day – “Women who become pregnant through rape or incest should not qualify for government funded abortions”
These are interesting observations Carlos…and raise issues that I’d like to explore in greater detail in the future. Just getting back to the AMA negotiations for a minute. I’m very disturbed by Horne’s deviousness. He implies that the doctors will come out financially ahead but that’s not true. A friend who’s a GI specialist says that Horne’s funny math will result in a 10% reduction in his compensation.
Another thing to consider is this may be the last straw for many doctors. Older doctors who’ve had it with the Tories’ abuse will simply retire and younger doctors who see more strife in their future will simply move to a “friendlier” province.
The sad thing is that Horne doesn’t care one way or another. He just wants to win at all costs. In order for him to win, we all lose. Very shabby treatment from someone elected to serve the public.
PS. Carlos, I’ve just finished the Kinsella book, it was fascinating.
Yes I am finding Kinsella’s book fascinating as well. What is most interesting about Canadian politics in general is that we have amazingly smart and educated people everywhere and still our political life is mediocre to say the least. One great example here in Alberta is Kevin Taft, a very smart man with great commpon sense and still was not able to do anything. The problem is the system, it is undemocratic and controlled by external forces. A separation of state and business is what we need just like we did with religion.
I absolutely agree with you about doctors getting fed up and it is not just the doctors. Many other professionals and especially the younger generation are looking for better pastures. I do not blame them I would be doing the same right now. Alberta is becoming a dead star and politicians are uncapable of change. Revolutions, either violent or peaceful have a purpose and Alberta is now the best producer of radicals that will do just that. If Alison Redford and company think that in such a powerful province people will forever live under this cloud of mediocrity it is only because they have never seen a real revolution of ideas. She will soon be another name in an ancient book of memoirs.
Susan I apologize for being blunt but Horne is just not competent to run the Alberta Health Care system period. It is so clear and obvious to me. I am sure we have people in Alberta that can do it and I do not think we have to go to Australia to get people that like cookies. Yes he does not care at all and that alone is a reason why he should not be there.