Just wondering, but is Newton’s Third Law no longer part of the basic science curriculum? Or did someone just forget to inform Alberta’s physicians in their pre-med classes that, as Sir Isaac Newton taught us back in 1687: “For every action, there is an equal and opposite reaction.”
It turns out that Newton’s Third Law of Motion doesn’t merely deal with physical motion but with politics as well.
So when Alberta’s most powerful union — the Alberta Medical Association, which represents the province’s 7,200 physicians in fee negotiations with the provincial government — slammed the government of Premier Alison Redford during the campaign leading up to the April 23 provincial election, they really should have thought about the potential reaction.
Readers with functioning mid-term memories will recall that, in the weeks before the vote, HMS Redford appeared to be about to slip beneath the political waves, swamped by the passing USS Wildrose, guns popping and pennants aflutter.
Ah, but this was not to be. It turned out that Alberta’s voters had another idea entirely. More Albertans than the physicians’ association leadership ended up with egg on their face, of course. Pollsters, politicians of various stripes, pundits, and not a few bloggers succumbed to the temptation to believe that, this time, political change really was coming to Alberta — even if it was political change of a particularly scary sort.
But unlike the docs, most of the rest of us didn’t have sensitive pay negations with the government scheduled immediately after the election.
Last March, just before the election, the Redford Government tried to buy some pre-election peace with the docs by signing on to a short-term agreement in principle that was supposed to lead to a collective pay increase of $181-million for the AMA’s members. (To put that in its proper perspective, their total annual compensation costs the province about $3.5 billion.) The deal was to run to June 30 — that is, until last Saturday.
The agreement, signed by Health Minister Fred Horne and AMA President Linda Slocombe, called for a 2.5-per-cent fee increase over two years, retroactive to April 2011, plus increased funding of $12 for every patient enrolled in a doctor-run Primary Care Network.
The AMA said thanks very much for this consideration by immediately running newspaper ads attacking the government at its most vulnerable moment. The ads, which generated tons of additional free publicity, pointedly asked: “Just how sick is Alberta’s health-care system?” Pretty sick, readers were invited to conclude. Sick enough to require a new government, presumably.
Dr. Slocombe also went after the premier herself, picking up Wildrose talking points and accusing her of breaking her promise to call a judicial inquiry on intimidation of physicians in the provincial health-care system.
From the government’s perspective, it just got worse from there, with Slocombe leading the charge, repeating the “culture of mistrust” refrain, sniping at Redford’s plan to open 140 Family Care Clinics, whinging about physicians not being consulted and pressing home an attack that it’s hard to believe wasn’t intended to defeat the government and put in power a party committed to the speedy privatization of medical services, if not the entire health care system.
Remember, Canadian physicians’ associations have rarely been good friends to public health care, and this one certainly didn’t seem to be one during the spring of 2012.
But things did not end up as we all thought they would. Redford now has a handsome majority of 61 seats and four years to enjoy it, just as negotiations for an extension of the pre-election deal are about to commence. Surely Slocombe and her advisers ought to be wondering, “What were we thinking?”
At any rate, Horne is now proving to be no pushover in the reopened negotiations with the docs, who appear to be shocked by this change in the weather.
The AMA’s beloved Primary Care Networks, which just seem to confuse everyone else including the province’s auditor-general, are no longer nearly as a big a priority for the provincial government. Maybe they’re not a priority al all.
Slocombe warns plaintively that if nothing is done to make the doctors happy, in the words of the Calgary Herald, “the government will risk having an unstable and difficult relationship with the medical community.”
Well, welcome to the world of real politics. It ain’t beanbag, doctors! One senses that the Redford Government is prepared to take that risk, for the moment at least. Perhaps things will turn around when the AMA has new leadership at the helm.
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Meanwhile, another group may have indicated today an inability to think about likely consequences is not unique in the annals of Alberta medicine.
Facing strikes against low-paying private continuing-care facilities by members of the Alberta Union of Provincial Employees and the likelihood of more at other nursing homes before the summer is out, the Alberta Continuing Care Association issued a news release yesterday calling on the province to ban strikes at their kind of businesses.
“Current labour laws that prevent strikes in auxiliary hospitals and in continuing care facilities operated directly by Alberta Health Services are meant to protect residents in the event of a labour dispute,” the ACCA wrote in its release. “However, those same laws fail to protect residents in nursing homes and designated supportive living facilities operated by non-profit and private providers.” The association wants the same thing — by the sound of it without having to feel the need to pay fair salaries.
Leaving aside the argument of the manager of one of the struck nursing homes that striking employees “are not poorly paid. They are paid to the ability of the operator.” This, as the Edmonton Journal pointed out in an editorial, suggests that whatever for-profit nursing homes decide to pay is by definition fair.
But has it not occurred to these private operators that, if workers lose the right to strike as they have in public hospitals, they are almost certain to gain access to binding arbitration to replace it? Arbitrators pay attention to what people are paid to do the same work elsewhere, and what the government gives private operators to cover their wage bills.
This does not seem like a promising strategy for increasing the profit margins at private nursing homes.
Perhaps the nursing home operators feel this would strengthen their bargaining position for fee increases from the province. Or perhaps they think Redford can be persuaded to adopt the full Wisconsin on the labour front. But that would suggest Redford doesn’t remember who got her elected — a failure of memory the current contretemps with Alberta’s physicians suggests is not very likely.
This post also appears on David Climenhaga’s blog, Alberta Diary.
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