Gov­ern­ment plans are be­tween a rock and a hard place

Prairie Post (East Edition) - - OPINION - By Ryan Dahlman

It would be easy to say Tommy Dou­glas would be hor­ri­fied at what is go­ing on in health care, pan­demic or no pan­demic, the times are a chang­ing in health.

For many peo­ple, we are rel­a­tively healthy. We go through life with­out hav­ing any­thing ma­jor health wise. Those are the for­tu­nate ones.

But at some point, the clock will strike mid­night and you will need ma­jor med­i­cal as­sis­tance, whether it is ill­ness, dis­ease or deal with a ma­jor in­jury.

There needs to be ini­tial di­ag­no­sis made and if spe­cial­ists are needed then you re­ceive treat­ment. This is all very ex­pen­sive.

Wouldn’t you just know it? The Al­berta pro­vin­cial gov­ern­ment wanted to re­duce the costs of the health care sys­tem by slash­ing the num­ber of nurses and cut­ting the amount of money doc­tors earn by pass­ing Bill 21 and in essence uni­lat­er­ally ter­mi­nat­ing the con­tract be­tween the Al­berta Med­i­cal As­so­ci­a­tion and Al­berta Health… dur­ing the mid­dle of a mas­sive global pan­demic.

One might think that is to put it mildly ques­tion­able but in terms of ne­go­ti­a­tions and con­tracts errr… uni­lat­er­ally deal­ing with a union, this is a great time to do it. You are forc­ing the doc­tors to stay.

They have taken the Hip­po­cratic Oath and they are not go­ing to run out on peo­ple who are suf­fer­ing with the prov­ince/coun­try/ world watch­ing peo­ple die. Buys time for ne­go­ti­a­tions. Gauge the pub­lic mood. Test the poll­sters, use your mas­sive so­cial me­dia staff to find out what is go­ing on or if need be in­flu­ence those who are neg­a­tive to your plans.

Af­ter fol­low­ing the rec­om­men­da­tions of an Ernst & Young re­port (cost: $2 mil­lion), there was also talk of pri­va­tiz­ing a lot of ser­vices like home care and laun­dry for ex­am­ple not to men­tion sell­ing off long term care spa­ces to the pri­vate sec­tor.

Whether you agree or not, the gov­ern­ment is look­ing at at least par­tially pri­va­tiz­ing what it can and re­duc­ing gov­ern­ment costs in health which are unar­guably the big­gest cut of the pro­vin­cial bud­get.

As a non-med­i­cal pro­fes­sional, it def­i­nitely has been an at­tack at the un­ortho­dox time. Doc­tors have been rep­re­sented by unions but as in­di­vid­u­als, from ex­pe­ri­ence they nor­mally are not po­lit­i­cally pub­lic peo­ple par­tially be­cause they don’t have time and par­tially be­cause they don’t want to bite the hand that feeds them. Ap­par­ently that’s out the win­dow now.

Prairie Post talked to Dr. Sa­man­tha Myre about changes and what the physi­cians in her clinic in Pincher Creek were go­ing to do at the start of May.

Now, in a re­cent let­ter to Al­berta Health made pub­lic last week, ten MD’s from Taber, in­clud­ing two anes­the­siaol­o­gists, co-signed a re­cent let­ter which out­lined their con­cerns.

In it is reads: “On Fe­bru­ary 21, Min­is­ter Shan­dro en­acted Bill 21 and ter­mi­nated our agree­ment with the AMA. Physi­cians in Al­berta were, sud­denly and com­pletely, shut out of crit­i­cal de­ci­sion-mak­ing with re­spect to al­lo­ca­tion of physi­cian pay­ment and their im­pli­ca­tions on health care pol­icy. Shortly there­after, gov­ern­ment an­nounced a new “Physi­cian Fund­ing Frame­work” (im­ple­mented on April 1, 2020), which is a col­lec­tion of dras­tic changes to physi­cian fund­ing. This was widely rec­og­nized among physi­cians as un­fairly tar­get­ing ru­ral fam­ily physi­cians due to their unique work which spans mul­ti­ple health­care set­tings (Clinic and Hos­pi­tal; Emer­gency, ad­mit­ted pa­tients, ob­stet­rics and long-term care). The min­is­ter de­nies any re­duc­tions to over­all physi­cian fund­ing, but make no mis­take, these are def­i­nitely “cuts” to ru­ral health care fund­ing and fam­ily physi­cians…”

It con­tin­ued… “Con­sid­er­ing these con­cern­ing an­nounce­ments, ru­ral health care in this prov­ince ap­peared to be on the verge of col­lapse. The

Health Min­is­ter clearly felt the heat. In an an­nounce­ment on April 24, 2020, he re­pealed some of his pre­vi­ous changes to ru­ral physi­cian fund­ing. He re­ferred to this as an “$81 mil­lion in­vest­ment to ru­ral health care” and “sig­nif­i­cant in­vest­ments to pro­tect ru­ral physi­cian re­cruit­ment & re­ten­tion”. That is akin to a bank rob­ber re­turn­ing a por­tion of the money he has stolen and then call­ing it a char­i­ta­ble do­na­tion to the bank. A care­ful ex­am­i­na­tion of Mr. Shan­dro’s an­nounce­ments shows that ru­ral al­lo­ca­tion is not back to its pre­vi­ous level, and in­deed, some ru­ral physi­cians have been sub­jected to ad­di­tional new cuts through fine-print changes to the Ru­ral, Re­mote, North­ern Pro­gram – a pro­gram im­ple­mented to in­crease re­cruit­ment and re­ten­tion of physi­cians to our ru­ral towns.” Damn­ing.

While it seems rather lu­di­crous to at­tack the med­i­cal sec­tor dur­ing a time when peo­ple need nurses, doc­tors and hos­pi­tals the most, what is this re­ally all about?

Vain po­lit­i­cal pride and ar­ro­gance? Dur­ing a time when Chief Med­i­cal Of­fi­cer the un­flap­pable Dr. Deena Hin­shaw be­comes a folk hero with her calm de­meanour and non non­sense at­ti­tude to­wards over­all pro­vin­cial health, the premier has re­ceived crit­i­cism on wedg­ing in on press con­fer­ences and re­port­ing in­for­ma­tion which should come from some­body from medicine or even that un­com­fort­ably look­ing presser where Ken­ney ex­plains the launch­ing of Phase 1 of the re­open­ing of Al­berta with Hin­shaw sit­ting off to the side as some sort of le­git­i­macy prop. “The gov­ern­ment is in charge of the sit­u­a­tion eco­nom­i­cally, and those wor­ried about the health ram­i­fi­ca­tions, don’t worry be­cause our Chief Med­i­cal Of­fi­cer is sit­ting here with me so it must be okay.” Cringe.

Money? Re­mem­ber when Cana­di­ans used to mock the United States for their debt? Now in a me­dia re­port May 12, Par­lia­men­tary Bud­get Of­fi­cer Yves Giroux said it’s “not un­think­able” that

Canada’s debt could go to $1 tril­lion dur­ing this fis­cal year.

No, ap­par­ently there’s money to be spent if you re­ally want to dish it out…

The fi­nan­cial num­bers are stag­ger­ing yes, but be­fore Ken­ney de­cides to dec­i­mate ru­ral doc­tors and the ru­ral ar­eas, he has to re­mem­ber what the most im­por­tant thing is to each in­di­vid­ual hu­man: health. It seems hyp­o­crit­i­cal and short­sight­edly ironic that the gov­ern­ment is at­tack­ing the very thing you are de­pend­ing on to en­sure the econ­omy will func­tion in the fu­ture.

All any­one was talking about ini­tially in the early win­ter was the alarm­ing num­bers in China, then Italy, then the United States, Spain etc.; how is Cana­dian so­ci­ety go­ing to re­cover health wise… the seniors dy­ing in long term care cen­tres. No one was talking about money and how it was get­ting paid for…it was just done.

Yes, it is great to cut costs when you can, save when you can but be­cause of the money spent on prop­ping up the business and en­ergy sec­tors is im­por­tant yes but that one time you re­ally need a doc­tor or a nurse to look af­ter in the hos­pi­tal and it isn’t avail­able…

No, there aren’t emer­gen­cies all the time. No, talking with a med­i­cal pro­fes­sional isn’t a daily rou­tine for most peo­ple. How­ever, for some it is. For oth­ers, deal­ing with med­i­cal pro­fes­sion­als daily is life and death.

How much money is a life worth to those in the po­lit­i­cal ivory tower?

To see a gov­ern­ment play a dan­ger­ous game gam­bling on peo­ple’s health like they do in the United States where Amer­i­can health care is great as long as you don’t get sick. It is pos­si­ble we have yet to see the true ug­li­ness of 2020.

Maybe it is all about whose KoolAid you are will­ing to drink?

The gov­ern­ment’s or the med­i­cal com­mu­nity’s?

Stay safe. Stay healthy.

Ryan Dahlman is the edi­tor of Prairie Post East and Prairie Post West

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