Alberta Politics
British Prime Minister Harold Wilson and U.S. President Lyndon B. Johnson in 1966 (Photo: Yoichi Okamoto, LBJ Library).

With COVID-19 in Alberta, Health Minister Tyler Shandro caves to docs on ‘complex billing’ battle

Posted on March 18, 2020, 2:13 am
7 mins

As Lyndon B. Johnson famously explained, in politics, chicken poop can turn over night into chicken salad.

Those weren’t exactly the words used by the late United States Senator from Texas, Senate Majority Leader, Vice-President and then, in tragic circumstances after Nov. 22, 1963, Democratic Party President of the United States. But they’re close enough for government work. LBJ was undoubtedly a profound political sage.

Alberta Health Minister Tyler Shandro (Photo: Government of Alberta).

Another political sage of that era, Harold Wilson, Labour Prime Minister of Britain twice in the 1960s and 1970s, observed with equal renown, using terminology safe for quotation marks, that “a week is a long time in politics.”

Both political maxims were proved again to have stood the test of time in Alberta yesterday.

As Alberta’s health care professionals brace for battle against the wave of COVID-19 cases now hitting the province, the Kenney Government dropped its effort to force Alberta’s physicians to swallow an unpopular new billing regime like the political hot potato it had become.

In the humiliating climbdown predicted in this space on March 8, Jason Kenney’s United Conservative Party Government dropped its plan to end the practice of “complex billing” in a way that would have cut revenue for many family physicians as much as 20 per cent over four years.

Alberta Medical Association President Christine Molnar (Photo: David J. Climenhaga).

Health Minister Tyler Shandro, in what must have tasted like ashes in his mouth, was quoted in the government’s press release saying that “during these unprecedented times, we want to ensure physicians on the front lines can focus solely on providing patient care.

“We’ve heard concerns that this change would result in what has been called ‘10-minute medicine,’” he continued. “While we respectfully disagree with that characterization, we are nevertheless halting this change so that doctors can concentrate on the critical tasks at hand.”

The implication, if you wanted see a subtle message in those words, was “we’ll be back with this again.” Well, whatever it takes to save their pride. They won’t. Leastways, they should have now learned what other Conservative governments have learned before in this province, and others. To wit: You can fight the docs, but you can’t win.

Christine Molnar, president of the Alberta Medical Association, graciously agreed to sign onto the government’s press release and not do a victory dance in the end zone. “We appreciate the removal of the complex (time) modifier from Alberta Health’s physician funding framework,” she was quoted saying. “This is a significant step in supporting patients and physicians. There is still work to be done. We will work in any venue to advance patient care and to reach a formal agreement between physicians and Alberta Health.”

Chief Medical Officer of Health Dr. Deena Hinshaw (Photo: Screenshot of Government of Alberta video).

The key point in the government’s surrender was listed in a bullet point in the release: “The first modifier that general practitioners bill for a visit will remain at the 15-minute mark at the current rate of $18.48. Other complex modifiers will remain available at current rates and current time requirements.”

Status quo ante bellum, in other words. What the AMA demanded.

A “physician compensation advisory panel” with members from the profession, the health department and the public will be struck to figure out a pay formula that physicians and their collective bargaining organization can live with. Whatever it turns out to be, they’ll be able to live with it.

Here endeth the lesson.

Emergency declared, bars closed, pubs still open, go figure …

Twenty-three additional cases of COVID-19 were recorded in Alberta yesterday, bringing the tally to 97. Today it will crest 100. Cases are now found in all regions of the province, Chief Medical Officer of Health Dr. Deena Hinshaw, medically tested as uninfected by the coronavirus and back from her self-imposed quarantine, told the daily briefing on the pandemic.

Yesterday, Premier Kenney announced the province had declared a provincial state of emergency, placing new and tougher restrictions on public gatherings and business activities and extending mandatory closings to a much wider range of public facilities.

Wexit Canada Party Leader Peter Downing (Photo: David J. Climenhaga).

Buffet restaurants — which never should have been allowed to open — are closed. Bars are closed but pubs remain open — beats me what the difference is. Libraries are closed — so will my fines be forgiven if the big stack of books I took home in preparation for such an eventuality is not returned on time? Restaurants, which are open, are apparently permitted to function as bars, which are not. Some muddled UCP-think going on here, methinks.

Weddings are discouraged; this being the Bible Belt, marriages, presumably, are not.

Wexit Canada leader’s credibility evaporates with a tweet

Wexit Canada Party Leader Peter Downing was busy on Twitter the past few days squandering what little credibility he ever had musing about how Ottawa wants to use COVID-19 as an excuse to shut down Alberta’s economy. “The ‘Climate change’ scare failed,” he screeched in a tweet. “Don’t fall for the new scare.”

Mr. Downing must’ve got the message from the ratio, and tried to walk it back a little later, but one does get the feeling Wexit Canada is done like dinner. Oh well, I’m sure there’s someone else Premier Kenney can use to try to scare his nemesis in Ottawa when things get back to normal.

21 Comments to: With COVID-19 in Alberta, Health Minister Tyler Shandro caves to docs on ‘complex billing’ battle

  1. Abs

    March 18th, 2020

    It’s hard to believe that just 10 days ago, the first pandemic case was reported in Alberta. People are staying home. Restaurants are voluntarily shutting down due to lack of customers. No, thanks, it’s about survival.

    I respectfully agree that 10-minute medicine is a misnomer. As my doctor told me, it’s actually seven minutes, because three minutes are used in charting.

    Tonight the budget passed, so can we assume the plans to lay off nurses are stll on? And while post-secondary students are fleeing campuses like citizens fleeing Godzilla in the movies, will there still be campuses for them to go back to? April 1 is not a misnomer. It’s a day we all set aside to recognize fools. Some jokes aren’t funny.

    Reply
    • Abs

      March 18th, 2020

      The nurses and health care workers can keep their jobs until May 31. Jason Kenney said today the virus should peak in four to five weeks. Obviously the UCP sees no need for these people by June 1.

      Reply
  2. Sam Gunsch

    March 18th, 2020

    This tweet… hahahaha… The tinfoil is super strong with this Downing/WEXIT dude… holy moly. File him with the Ku-da-tah clowns.
    ==================

    @peterdowningAB
    ·
    Mar 15
    Thank you @jkenney for playing along with the Wuhan Flu hysteria and shutting down Alberta schools & daycare – hence shutting down our economy on behalf of @JustinTrudeau
    . You are one magnificent treasonous bastard. #NotMyPremier #WEXITNOW

    Reply
  3. Bob Raynard

    March 18th, 2020

    I don’t know about St. Albert, but Edmonton Public Library has actually asked us to stop returning books through their outdoor return slots.

    Reply
  4. Jaundiced Eye

    March 18th, 2020

    You can always count on the UCP to do the right thing, after they have tried everything else.

    Reply
  5. Bruce Turton

    March 18th, 2020

    As a shut-in senior, the impact of COVID-19 will actually last several months. This will all become so much worse than most media and politicians assume (and I use that word in all its understandings!). The neoliberal provincial government majority will need to bite its collective lip and come up with a whole lot more collective response – well beyond all the wailing about the desperate need for MORE from the federal government. Do they have the ability to do so, despite their predilection to get all of us to ‘bite the bullet’ by ourselves (even the ones that will explode when chomped on too hard!).

    Reply
  6. Gail

    March 18th, 2020

    The fact it has taken a global pandemic to wake people to the fact our medical services are critical is terrible. Now that people realize it perhaps they’ll be more willing to push their government to stop privatizing and start really funding our public system. Starting with repairing the radiologist contract would be a good first step right now.

    Reply
  7. tom

    March 18th, 2020

    Behind every public sector agreement in Alberta will be the spectre of Jason Kenney’s thumb on the scales–otherwise known as Bill 21.

    Reply
  8. Simon Renouf

    March 18th, 2020

    The UCP passing the budget was an act of organized stupidity. WTI today is at $22.47. It would have to go up by 150%, and stay there for a year, for the budget’s revenue projection to be even close. That’s not magical thinking, that’s delusional.

    Reply
  9. John T

    March 18th, 2020

    Wouldn’t this be the time to use that Heritage Fund?

    Reply
    • Just Me

      March 18th, 2020

      If they could find it.

      Norway keeps their Fund in a giant cookie jar – that’s how it got so big.

      Reply
    • Murphy

      March 21st, 2020

      AIMCO runs it. Massive decline in the era in which corporate profits exploded like genital warts in Alberta. That’s why Tailgunner Jay’s people are rolling both my parents’ pensions into it. How else are the oil and gas job creators going to pay for their mistress/receptionists’s condos and their kid’s eighth stint in a US rehab?

      Reply
  10. alan

    March 18th, 2020

    “The relation between what we see and what we know is never settled.”

    And so it seems, sometimes, even in the Bible Belt that is Alberta. That being the case, it is somewhat surprising that the contents of Leviticus 26 have not been dusted off and proclaimed as the core reason for the current calamity, at least by some individuals, along with the usual self loathing. guilt, and punishment that is associated with the animal reality juxtaposed against the desire for both a Divine caretaker and a Garden of Eden. That is, ‘And if you walk contrary to Me, then I also will walk contrary to you and when you are gathered together within your cities I will send pestilence among you.”

    And that is not to imply that our ancestors were not very astute observers of both themselves and the natural world that is our lived reality, but only that 2000 years of scientific advancement has improved, if only marginally, our understanding of cause and effect in this world. See, for example, “Origins of major human infectious diseases”
    Nathan D. Wolfe, Claire Panosian Dunavan & Jared Diamond

    http://jareddiamond.org/Jared_Diamond/Further_Reading_files/Wolfe%20Dunavan%20Diamond%202007.pdf

    Reply
    • David Climenhaga

      March 19th, 2020

      Biblical literalists, in my extensive experience with the breed, tend to pick and choose which parts of the Bible to be literal about. DJC

      Reply
  11. Just Me

    March 18th, 2020

    Who is this guy calling himself Jason Kenney?

    There’s this guy who’s been on TV a lot who looks like Kenney, but doesn’t sound like him. At least not the Kenney we all know.

    He’s talking fiscal stimulus and government intervention into the economy. He’s presenting programs that provide all kinds of financial support for employers, employees, and students. (The last one caused me to give this a second take.)

    He’s talking about mandating that utilities to not shut off their services. That doesn’t sound like someone who believes that no one should interfere with the private sector.

    He’s also providing the equivalent of a guaranteed income to those who need it.

    Then, Rick Bell calls and implies that this is a lot of action for something that is temporary. The Kenney spoke of policies that reinforce hope. He cited that science is guiding these policies and economic realities will may mean that this will be policy action for the long term. Weird thing for this Kenney to say – but he is also on a first name basis with Bell.

    Strange days.

    Reply
  12. Valerie Jobson

    March 19th, 2020

    Craig Chandler was apparently making sceptical noises and continuing to hold PGIB meetings or something, but it looks like he postponed one today.

    Reply
  13. Lars

    March 19th, 2020

    Mr. Downing must’ve got the message from the ratio

    Did you mean radio here, or is this some new social-media metric I haven’t heard about?
    Having to move all my teaching online has taught me, if nothing else, just how little I know about these things.

    Reply
    • David Climenhaga

      March 20th, 2020

      I think you’re teasing me, Lars. Nevetheless, in case you missed it, if a tweet elicits more hostile replies than likes or retweets, indicating a high ratio of criticism to approbation, it can be said to have been ratioed. Or, as they frequently say on Twitter, “I’m only here for the ratio.” As for the radio, can you remind me what that is again? DJC

      Reply
  14. Dave

    March 20th, 2020

    The climb down is entertaining to watch, as is the reaction to falling oil prices. The government has gone from sounding like Thatcher Conservatives to R B Bennett’s almost new deal government almost fast enough to make your head spin. Of course, with all that is going on right now, they are hoping people will not be paying to close attention to this. It is a bit embarrassing.

    Most politicians are known for some flexibility, but not so much the Kenney government, at least until now. I suspect when they realized their political demise is imminent, it led to a bit more flexibility. However, the questions are: Is it enough and is it too late?

    One gets the sense what they are saying between the lines about health care changes and cuts is “we’ll be back”. They might have to retreat and regroup in the near term, but one wonders what will happen after the virus crisis is over. They will probably not take the doctors on in quite as poorly thought out and direct way next time, but one senses they will come up with some other plans.

    I also wouldn’t be surprised if Alberta ends up buying some energy company sometime in the next few years. This government seems ok with some socialism for the well off, but not so much for the rest of us.

    Reply
  15. Murphy

    March 21st, 2020

    Interesting choice of photograph. The destruction of Wilson’s government by the far-right is now filed away as yet another “conspiracy theory”. However, it was rolled up in all the super-fun activities of the Anglo-American intelligence operations against the citizenry. Mountbatten, whose greatest contribution to society was when he was rendered into fish-food by an IRA that was completely penetrated by British intelligence, was set up twice to overthrow Wilson or Heath in coups. The usual terrorism, black-mailed pedophiles and narcotics traffickers whirled around the whole thing, and Wilson bailed out of the cock-pit before the flames overtook him.
    “In 1972 Harold Wilson met with IRA leaders in Dublin, and the next year the Northern Ireland Minister, Willie Whitelaw, made similar contacts. This utterly shocked opinion in every officers’ mess in Ulster – and in MI5, who took over intelligence operations there from MI6 in 1973. Exactly like the French Army before it in Algeria, these key circles within the British Army now decided that in order to prevent a sell-out of the imperial position in the overseas province by leftists (Guy Mollet/Harold Wilson) or weak-minded centrists (Pierre Pflimlin/Edward Heath), the military must ensure that the right sort of government came to power in the metropole. Operation Clockwork Orange was precisely this: an attempt to smear and undermine Labour leaders and Tory wets alike, the short-term aim being to prevent Labour being elected in February 1974 or re-elected in October 1974 and to depose the likes of Heath and Whitelaw from the Tory leadership. Anyone – including Ian Paisley – who helped maintain the minority Labour government in power was fair game. Thanks to Peter Wright’s revelations we are more or less familiar with what went on in this period, though it is important to say that Wallace was the first to make public admission of these campaigns, well before Wright.

    Homosexual smears were directed against Edward Heath, Jeremy Thorpe, Norman St John Stevas and Humphrey Berkeley; bogus bank accounts (showing corrupt earnings) were contrived for Edward Short and Ian Paisley; Wilson was seen as the beneficiary of, and a possible participant in, the assassination of Hugh Gaitskell; lists were drawn up of such notorious Communists or Communist sympathisers as Brian Walden, David Owen, Robert Mellish, John Stonehouse, Roy Hattersley and Reg Prentice; and even a bogus pamphlet on ‘revolutionary strategy’ for the installation of socialism in Britain was contrived for off-the-record briefing of American journalists, the joint ‘authors’ being Tony Benn, Stan Orme and Denis Healey. One is tempted to say that even in the MI5 officers’ mess, the idea of Denis Healey collaborating with Messrs Benn and Orme on anything at all must surely have required the assistance of a few double whiskies. The unhappier truth is that the minds that made such things up were quite possibly stone-cold sober.
    Such incidents served to increase Wallace’s concern that the Army was moving away from its alleged primary role of fighting terrorism. Worse, he became uneasy that the increasing number of assassinations and bomb outrages against Catholics might be taking place with Army encouragement, perhaps even with covert Army planning. So in October 1974 Wallace announced that he didn’t wish to work on Clockwork Orange any more, that he was resigning in order to go back to fighting terrorism.
    A few weeks later Wallace also submitted a memo in which he set out at some length the dreadful scandal of the Kincora Boys’ Home in Belfast. Wallace had submitted his first report on Kincora more than two years before and had even put out a press statement in early 1973 which stated that William McGrath, head of the sinister Orange private army, TARA, was using ‘a non-existent evangelical mission as a front for his homosexual activities and also runs a home for children’ – whose address and phone number Wallace conveniently supplied. No newspaper in the UK was willing to follow this obvious lead or even to publish the story, despite the fact that McGrath’s associates constituted a virtual Who’s Who of Protestant Ulster. What was going on at Kincora was that the destitute boys were being systematically sodomised and abused by McGrath and his friends, who included Kincora’s official director and assistant director. This had been going on for many years, perhaps from as early as 1959, and repeated attempts by boys who had been raped to get the RUC interested in the matter had always failed. Nothing in Foot’s book is more heart-breaking than his recounting of how, over twenty years, a series of boys (and sometimes their families and social workers) tried desperately and unavailingly to put a stop to their dreadful pain, humiliation and buggery – and how the Police, the press and the authorities failed them over and over again. Quite clearly, neither the RUC nor Army Intelligence were at all keen for the Kincora story to be broken. This was so partly because McGrath and his friends were extremely well-connected within the Protestant Establishment. But the truth may have been worse than that. Intelligence services around the world often find it useful to maintain luxury brothels: not just for what they learn from pillow-talk but as multi-purpose centres of reward, blackmail and assignation. There was nothing luxurious about Kincora, but its rarity, in the Northern Irish context, as an unlimited source of boys who could be buggered without mercy or publicity seems likely to have made it an especially useful intelligence asset.”
    https://www.lrb.co.uk/the-paper/v11/n13/r.w.-johnson/r.w.-johnson-writes-about-a-national-disgrace

    Reply

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