One of the most aggressively nefarious pieces of legislation has been presented with surprisingly little fanfare. My theory is that the Trump fiasco and COVID have proven too distracting for people to have much attention left for the next UCP train-wreck. Observe the following;
Now, prior to moving forward I would like to state two things;
1) Two-tiered healthcare already exists in Alberta
2) Not all privatization is intrinsically bad
While this statement sounds odd coming from me, I promise they have not kidnapped my family (that's coming in the NEXT Bill).
There are some things that people should have access to that the public shouldn't be obligated to pay for (cosmetic Botox, etc). Regarding the first statement, there are already private surgical clinics in Calgary.
Lets focus back.
Regarding Bill 30:
1) "Lets" doctors negotiate with the government directly
No sane physician is going to negotiate a contract with the government that tore up our previous contract unilaterally. Even if someone were to be that desperate, then that person would be negotiating as an individual, with much less effective bargaining power. The sheer mechanics of it are daunting; it took YEARS for the AMA to negotiate the contract with Worker's Compensation, which is a monstrosity of legal wording that physicians don't have time to navigate (that's why we have and entire team at the the AMA to do it).
Another recent travesty (Bill 21) lets them break new contracts regardless. This bill needs to get scrapped as well, but that's another post.
2) Opens "paid salary" options
ARP (Alternate Relationship Plans) are a version of a salary model that does work in some contexts, though usually in settings where patients regularly miss scheduled visits (ex: psychiatry). Again, you'd be crazy to let the government set the rate arbitrarily. Often these arrangements neglect to consider overhead, and aren't designed to suit a typical outpatient practice.
3) Changes the composition of professional college bodies
I'm of a split mind here. While public representation is important in CPSA proceedings (it is a organization that promotes patients safety), 50% representation is probably overkill. Physicians have generally had the promise of being judged "by a panel of peers", so that difficult decisions are evaluated on their professional merit as opposed to their outcome.
Don't think that the UCP plans to let the PUBLIC contribute, however. These "public members" will be government appointed, and thus will bring a political agenda to the process and are unlikely to be impartial. When the government files a complaint against a physician for objecting to unsound policy, they also get to effectively be the judge, jury, and executioner. Let the dissenter persecution begin.
4) Allows clinics to be run by private corporations
Fun fact: Telus has owned brick and mortar clinics for a few years! Costs to attend these clinics are roughly $2000/year (base package). However, Telus is beholden to its shareholders, and therefore obligated to maximize profit. There are really two ways to accomplish this: charge more, or cut corners.
When Telus bills the government taxpayers paying Telus a premium to do what physicians already do, and then paying physicians a lesser salary due to the middle-man.
Cutting corners means shorter visits, fewer services, or utilizing non-physician providers. Currently the government would be unable to recruit enough providers to make this strategy viable. Non-physician providers may have lower salaries (hence superficially lower cost), but they see fewer patients, they don't create jobs, they statistically make more referrals back to public specialists (incurring more taxpayer cost), and they get paid benefits, sick leave, pension, vacation, etc., which the government does not currently provide for physicians (again, all additional taxpayer expense). Data on health outcomes for non-physician providers is conflicting, mostly depending on who performed the study.
To maximize profit, private clinics have incentive to refuse taking on sick patients in favor of healthier (and faster) patients. Healthy patients with simple issues are quicker. Declining complex patients creates one of two outcomes; patients get substandard or no care and high costs, or patients are selectively referred back to the public system where their relatively high costs are absorbed by taxpayers. Private clinics can therefore 'skim' the easiest patients for profit. Additionally, the average patient outcome in the public system will then decline due to treating complex patients disproportionately, which the government will point to as a metric to further reduce funding and effectiveness of public healthcare.
I could go on at length, but this is the sampler of what has been called the "cartoonishly evil" machinations of the UCP in this Bill. If ever there was a time to speak up, this would be it. Make yourself heard!
How do I help?
Remember to send your concerns to; Premier Jason Kenney
Health Minister Tyler Shandro
MLA Jason Copping
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