History of general healthcare restructuring in Alberta

Government Backs Down on Doctor Fees

• On December 16, 1995 the Edmonton Journal reported that the government has backed down on its threat to cut $100 million from doctors' pay. Besides granting doctors no reduction in fee payments for three years, the deal also gives doctors more power over future health care restructuring.

  Last year doctors billed the government on average $201,394, with a range of $160,000 for general practitioners to $384,000 for heart surgeons. Twenty-nine doctors billed more than $1 million.

  The president of the Alberta Medical Association is quoted as saying, "I don't think we gave up any of our key principles. Our main goal was quality health care and the AMA having a strong voice in the planning. We were also saying doctors were working very hard and their fee schedule should not be compromised with this new agreement."

  The deal with the doctors does not sit well with union leaders representing other workers who have endured pay cuts and job losses. The president of the Health Sciences Association of Alberta, which represents laboratory technologists and other allied health professionals, is quoted as saying, " There needs to be an equal distribution of the pain."

Doctors Get Chance to Make -Not Lose-Extra Money

• On December 19, 1995 the Edmonton Journal reported on the government's confidential deal with Alberta's doctors. Instead of losing money, doctors will have a chance to make $17 million or more for the AMA. Here's the deal. Instead of taking $100 million from doctors' fees, $50 million will come from unspecified reforms that the doctors agree to support in exchange for sharing in the savings. If $50 million is saved, doctors will get one-third or nearly $17 million; if savings exceed $50 million, the doctors will get half. The other half of the $100 million saving will come from government programs which pay prescription drugs for groups including seniors and welfare recipients. Here too the doctors get a chance to cash in. If savings top $50 million, the medical association and Alberta's pharmacists will share in the surplus.

MDs Blitz Klein's Cuts

• As reported in the Edmonton Journal, Nov. 17, 1995, the Alberta Medical Association (AMA) representing Alberta's 4500 doctors has just started a province-wide blitz with the theme, "Tell us Where It Hurts." The message will be on posters and brochures in doctors' offices; physicians and their staff will wear Patient First buttons; there's a 1-800 number and e-mail address for people to voice their concerns. The AMA is hoping that a high response rate will force the government to halt further cuts.

  Coincidence or not, the AMA action comes at a time when the doctors' negotiations with the government over fees have been stalled for 10 months due to the province's plan to cut another $100 million from the system, this time from physician's income. ($600 million have already been cut from Alberta's health care system since 1993-4.)

  In reply to the AMA blitz, Premier Klein said that it was a mistake not to include doctors when changes to health care began and agreed to give doctors more input on regional health authorities. Klein also said that the $100 million cut to doctors' salaries won't necessarily come from annual fee-for-service payments.

Government Decrees RNs not Needed in ORs

• On 22 July,1995 the Edmonton Journal reported that during the week of July 17, 1995 the Alberta Cabinet approved changes to the Hospital Act--without public discussion--that revoked the need for graduate or registered nurses (RNs) in operating rooms and changed the requirement for "special training" in operating room management to merely "training." 

• A public outcry ensued and Alberta's 4500 doctors pledged not to work in any hospital that does not employ RNs. The Health Minister Shirley McClellan has been forced to issue a public apology for any confusion that the changes caused and has said that she is prepared to "revisit these regulation changes, if discussions indicate a need to do so." An Alberta Health official insisted that the changes were only "housekeeping" to allow the regional health authorities to make their own staffing decisions and were not intended as a deskilling exercise.

• The president of the Alberta Medical Association is quoted as stating, " Obviously we have been too soft in articulating our concern for patient care."

Oops! -- RNs Needed After All

• Up-date: On 25 July, the Cabinet rescinded its decision. It appears that RNs will still be in charge of Alberta's ORs. Premier Klein is quoted as saying, " I wouldn't call it a gaffe. But like everyone else we are not perfect. If we see there is a problem, we go back and fix it and try and make it better."