“The crisis we have in health care, rural included, is a void of leadership by the UCP government. They were voted in with a majority government, but do not seem to understand the difference between leadership and power.” — Dr Ed Aasman
The Greeks defined hubris is a character flaw, a combination of pride and ambition so great they offend the gods and lead to one’s downfall.
What level of hubris led Jason Kenney and his health minister, Tyler Shandro, to believe they could get away with passing legislation giving them the power to rip up the Master Agreement with Alberta’s doctors, violate the doctors’ right to fair negotiation and binding arbitration, and unilaterally impose a new fee structure that would dramatically cut physician compensation, without any pushback?
Then when the doctors begged Kenney and Shandro to hold off implementing the fee changes until after the pandemic passed, why did Kenney and Shandro double down?
The Kenney government’s draconian behavior is inexcusable and Alberta’s doctors, with the support of their patients, fought back.
It was a tough slog.
It took hundreds of doctors telling Kenney and Shandro that over 400 community clinics would close or lay off staff, and countless doctors announcing they would leave Alberta after the pandemic was over, and thousands of Albertans flooding their MLAs with letters demanding the government reverse course, before the government paid attention.
Not my fault (again)
On Apr 24, Shandro gave a press conference. He was flanked by some rural MLAs (but no doctors) when he unveiled a $81 million package to support rural doctors.
He said the government:
- would cancel rural fee changes because they didn’t realize an unintended consequence was a reduction in access to healthcare in rural areas (if they’d listened to the doctors, they might have had a clue),
- was permanently reversing the fee changes for rural areas (that promise is as binding as the Master Agreement they ripped up in February)
- would pause the fee changes in urban areas, pending further review (what’s to review? An appendectomy is an appendectomy regardless of where it’s performed; if the government wants to incentivize rural practice provide incentives, don’t mess with the urban fee)
- was adding $57 million to top-up rural service (because if rural doctors distrust Kenney so much they leave, Kenney’s rural base will desert him in 2023)
Shandro stated repeatedly that the $81 million plan was the result of concrete proposals from the rural MLAs and was not, repeat, not, the result of consultation with the AMA. Furthermore the plan proceeded on an expedited basis because his government ripped up the AMA Master Agreement, and (here’s the icing on the cake), the government would not take responsibility for causing “anxiety” in the middle of the pandemic, it was the AMA’s fault, they spread “misinformation” to the doctors.
The entire press conference felt like an effort to sweeten the pot for rural doctors, pit them against urban doctors, weaken the AMA and shore up Kenney’s rural base.
Doctors are unimpressed
This is shameful and Alberta’s doctors are not buying it.
The rural physicians (represented by the Rural Sustainability Group) issued a letter saying they appreciated the government’s support of rural medicine, but the government still wasn’t listening. What the rural doctors want is an agreement that allows for arbitration, thereby avoiding unilateral decision making by the government.
The president of the Section for Rural Medicine is squarely behind the AMA, noting the AMA is the “venue for physician leadership and the vehicle through which Alberta’s physicians have worked with the government for 114 years.”
The AMA said the temporary suspension of fee changes during the pandemic is a positive step, but if the government wants to find long term solutions to healthcare challenges it should work with doctors, not rip up their contract, continually misrepresent their compensation and take away their right to binding arbitration.
Kenney’s attempt to pit rural doctors against urban doctors did not succeed, but it does raise the question: Why did Kenney do it?
What drove him to pass legislation allowing him to rip up the AMA Master Agreement and impose his own fee structure on Alberta’s doctors? What caused him to ram this ill-conceived plan down the doctors’ throats in the middle of a global pandemic?
Was it a desire to teach the doctors a lesson after the AMA refused to bow to Kenney’s demands for cuts? Was it resentment that Rachel Notley was able to negotiate doctors’ fees without a ripple of discontent?
Was it plain old hubris?
One thing is clear, if the Kenney government is prepared to go after our doctors in the middle of a pandemic, then none of us are safe.