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Alberta health minister to doctors: Shut up and take your medicine!

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Michael Giuffre

When Alberta's most powerful union -- the Alberta Medical Association, which until yesterday represented the province’s 8,250 physicians in fee negotiations with the province -- slammed the government of Premier Alison Redford just a few days before the April 23 provincial election, they really should have thought about the potential reaction they might get.

Yesterday, they got it. Health Minister Fred Horne told the docs, in effect: Here's your medicine. It won't taste very good. Swallow it anyway and call me in the morning!

With a cheerful news release yesterday afternoon announcing Alberta's Progressive Conservative Government was "ensuring they remain the best paid doctors in Canada," Horne imposed the government's last "best offer" on the province's physicians. The AMA had rejected it after receiving it on Oct. 2.

The deal will cost $463 million over four years, the government said in its statement. To put this in perspective, Alberta doctors' total annual compensation cost the province about $3.5 billion before the changes were imposed.

In a letter to the AMA's president, Dr. Michael Giuffre, Horne said this was the doctors' new reality whether they like it or not, complained about the AMA's rejection of two previous government offers, and pointedly reminded the association that "physicians in Alberta, on average, are the best paid in the country at 29 per cent above the national average."

You've got great places to work, and your numbers are increasing quickly (should you decide to bug off), he also noted. That may be why Horne didn't feel the need to remind Alberta's physicians that Ontario Premier Dalton McGuinty just froze his province's doctors’ wages for two years. Nor did he come right out and tell the AMA it was quite welcome to drop dead if it didn't like it!

Actually, from the perspective of an Alberta trade unionist who's been kicked to the curb by friends of this government with a little help from a previous premier, this imposed settlement doesn't sound all that bad.

Count on it, though, that the doctors won't see it that way. After all, they're not fellows who are accustomed to having to link arms and sit on the pavement in the middle of an Alberta winter to try to get what they see as a fair deal.

Yesterday, it sounded as if Giuffre was still coming to terms with what the government had just done to him. In a letter to AMA members, he said the Redford Government had refused the association's pleas for binding arbitration to settle the dispute. According to the Edmonton Journal, Horn in effect told AMA leaders if in future they want arbitration provisions, they're going to have to negotiate them like any other union.

Giuffre also told the AMA reps that because the government was giving them a lump-sum payment instead of a percentage increase -- an idea rank and file trade unionists will be sadly familiar with -- "the average loss to those physicians per year would be over $30,000."

"It is exceedingly unfortunate the minister failed to choose a reasonable process," Giuffre lamented, telling the CTV "this is the first time in the history of the province the government has chosen to impose on physicians." He called the government’s action "disheartening in terms of process, disheartening in terms of imposition."

Which brings us back to the history lesson. Just before the provincial vote last spring, at a time it looked very much as if the privatization-leaning Wildrose Party was about to win a big majority, the AMA made the classic political miscalculation of backing the wrong horse, Wildrose Leader Danielle Smith.

The month before, in March 2012, the Redford Government had tried to buy some pre-election peace with the docs by signing a short-term agreement in principle that was supposed to lead to a collective pay increase of $181-million for the AMA's members. That deal was to run until June 30 this year, when the docs could have negotiated a better agreement for the longer term.

That agreement, signed by Horne and the AMA's then president, Dr. 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 full-page newspaper ads attacking the government at its most vulnerable moment.

The ads, which generated tons of additional publicity, none of it very positive from the government's perspective, pointedly asked: "Just how sick is Alberta's health-care system?" Readers were implicitly invited to conclude it was sick enough to elect a Wildrose government.

Slocombe also went after the premier herself, picking up Wildrose talking points and accusing Redford 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 after that, with Slocombe leading the charge, repeating the Wildrose Party's "culture of mistrust" refrain, sniping at Redford's plan to open 140 Family Care Clinics, complaining 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 many medical services, if not the entire health care system.

Alas for the AMA and the physicians it represents, things did not end up quite as everyone expected on the day Slocombe dropped her bombshell.

By the time election day had rolled around, Alberta voters were getting antsy about the possibility they were about to punish themselves more severely than the government they wanted to spank. So when the votes were counted, Redford's party had recovered enough of its support to win a handsome majority of 61 seats.

Today, Smith is the Opposition leader, commanding only 17 MLAs in her corner of the Legislature. Premier Redford still has three and a half years in which to enjoy her comfortable majority.

But if the AMA thought this Tory government -- well known to have the memory of an aggrieved elephant -- wasn't annoyed by what happened, well, they weren't paying attention to the way things have worked in Alberta for generations.

As a result of the failure to reach a deal, Horne instructed in his letter to Giuffre, "I must regretfully conclude that a negotiated compensation agreement will not be reached based on the government's negotiation framework and the best offer I reviewed with you. And unfortunately our discussions yesterday confirmed for me that we are clearly at an impasse."

Horne closed his letter to Giuffre with the sentiment that "I look forward to continuing our work together." But what work together would that be? And don't imagine for a moment the government is really feeling any regret about what's just happened.

This post also appears on David CLimenhaga's blog, Alberta Diary.

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