Alberta Politics
Efforts to explain the depth of the government’s animus and its relentless aggression in the midst of a global pandemic have not cast much light on the conflict.

Side deals with specialists emerge as latest UCP tactic in escalating war with Alberta Medical Association

Posted on July 21, 2020, 3:10 am
6 mins

The Kenney Government yesterday again escalated its continuing war with the Alberta Medical Association, indicating it would consider letting rival groups representing medical specialties quit the doctors’ collective bargaining association and negotiate directly with the government.

In a statement obviously intended to rock the AMA, Health Minister Tyler Shandro commented favourably on a news release by the Eye Physicians and Surgeons Association of Alberta that called on the government to let it bypass the AMA and bargain directly on behalf of Alberta’s ophthalmologists.

Eye Physicians and Surgeons Association of Alberta President Vikram Lekhi (Photo: TheBotoxCourse.com).

Mr. Shandro also directly thanked EPSAA President Vikram Lekhi, who is also president of the AMA’s Ophthalmology Section, “for contributing to this important policy discussion.” Needless to say, given the timing, that contribution could seriously undermine the AMA’s bargaining position.

The EPSAA release yesterday called for legislative changes that would permit it and other medical specialists’ organizations to negotiate their own deals with the government.

In a longer open letter addressed to Mr. Shandro also dated yesterday, Dr. Lekhi, EPSAA Past President John Huang, and Executive Director Ian MacLeod complained the AMA has resisted “innovative systems changes” — a term that to many observers smacks of more privatization.

Meanwhile, in a statement to AMA members headed “We Are Under Attack,” AMA President Christine Molnar assailed Mr. Shandro for “disrespectful, misleading and, frankly, baffling behavior,” and argued the fact is now unassailable “that our profession is under attack by government.”

“The pillars of our profession are threatened,” she wrote. “We are witnessing changes to self-regulation at the College of Physicians & Surgeons of Alberta, with ministerial directives to the College that threaten basic Charter rights. … Our rights to arbitration have been taken from us.”

In an interview with the CBC, she called the United Conservative Party Government’s action since Mr. Shandro tore up the AMA’s contract without notice last February, “a premeditated plan.”

Dr. Molnar’s statement continued: “Having just received the news, I am disappointed that EPSAA colleagues believe that their interests are divergent from that of the AMA. We do not yet understand what process was followed and will be seeking more information.”

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

The backstory to the EPSAA’s split with the AMA is a longstanding and widespread view among ophthalmologists — and doubtless practitioners of other surgical specialties — that the AMA is too focused on the concerns of family physicians.

This has resulted in the perception among many Alberta eye surgeons that the AMA has not taken into account the true costs of their practice — which over time has been one of the highest-billing specialties in the medical profession.

The specialty also has its own internal disagreements — for example, competition between academic eye-surgery programs and non-hospital surgical facilities for public resources, but for now the eye surgeons’ rift with the AMA has given the government an effective wedge in its ongoing effort to weaken the association.

For most Albertans, of course, the government’s animus toward the AMA during a pandemic is inexplicable and certain to be causing growing unease — especially in light of talk by many family practitioners they are ready to leave Alberta for other provinces.

The CBC analysis yesterday tied the fight to the government’s pre-COVID-19 efforts to balance the budget and Premier Jason Kenney’s instinct “to seek out enemies and use them as rhetorical punching bags in service of his agenda.”

But that doesn’t really account for Mr. Kenney’s and the UCP’s apparent hostility toward family doctors, or the UCP’s ideological commitment to pushing private delivery of health care as far as possible under cover of the emergency created by the global coronavirus pandemic.

Could the bitterness of their fight be inspired by the fact the AMA negotiated with with the NDP during the four years of Rachel Notley’s government, instead of undermining it, as did other groups traditionally connected to Conservative politics in Alberta?

Meanwhile, Alberta’s COVID-19 emergency continues, with the province now reporting more than 1,100 active cases, the highest number since May 12. Alberta posted 165 new COVID-19 cases on Friday, 106 more on Saturday, and another 97 Sunday.

Nevertheless, Alberta Health officials are sticking with the narrative the surge in cases is caused by Albertans becoming complacent and tired of restrictions on their lives, not the timing of the government’s reopening of the economy.

13 Comments to: Side deals with specialists emerge as latest UCP tactic in escalating war with Alberta Medical Association

  1. Simon Renouf

    July 21st, 2020

    When the MacKinnon “blue ribbon” panel released its report last year a number of commentators (including our own DC) pointed out that it is possible to cut health spending in Alberta. Not easy, but possible. Close rural hospitals (as Ms MacKinnon had done in Saskatchewan) and reduce the number of physicians. Of course the UCP had a problem with that. It would have most affected the UCP’s rural base. So the UCP chose the politically preferable but inevitably doomed route that has bedevilled provincial governments for decades, and has never worked: Keep the numbers of physicians, nurses and other health care workers the same, while attempting to “get tough” with the AMA and health care unions. Predictably, pitting Jason Kenney’s caucus of fast food franchisees and inexperienced cabinet against seasoned professionals on the other side was never going to be a fair fight, although it could, and certainly will, get messy.

    Reply
  2. Abs

    July 21st, 2020

    Twitter revealed the Twitter followers of one of the eye guys you mentioned: Michelle Rempel . Hmmm, you don’t suppose this eye guy is one of “them”? Public information is a bit of a pickle sometimes.

    Reply
  3. Dave

    July 21st, 2020

    Having only been in power for a little over a year, Kenney and his government seem to have exceeded all previous records for bullying. It makes Redford look tame by comparison and we know what happened to her. Of course, some of the guys who stood up to her probably couldn’t stand the thought of a woman doing that sort of thing, so perhaps Kenney is on a bit safer ground. While he seems to ignore financial discipline when it comes to things like appointing defeated candidates and other favorites to plumb patronage positions like the War Room or to questionable trade offices abroad, at least he doesn’t have a daughter he is flying around on government aircraft. I suppose waste is waste, so perhaps the optics look a bit better to some, or they are just hypocrites.

    I have to wonder when all the disparate groups that have been treated badly by Kenney and the UCP might start to coalesce together to stand up to the bullying, as that will probably be the only thing to stop it, that or the voters in the next election. Those on the left have are trying, but I suppose many on the right seem content or fearful so far. Kenney has taken his party far from the original hopeful promise to incorporate the best of the PC’s non extremism and the Wildrose inclination to listen to the grassroots and not be corrupt. If anything, I would say at this point in the UCP, the worst instincts of the predecessor parties seems to dominate, it is run by extremists who do not listen much to the grassroots and reward insiders with plumb positions.

    So the war against the doctors and their association continues on, long past the point where any reasonable government would. The UCP seems to refuse to deal with them out of pride, stubbornness, rigid ideology and perhaps because the doctors have inadvertently somehow ended up on the government’s list of enemies for dealing with the previous government. However, all these political machinations can’t counter some fundamental facts. It is hard to attract doctors to rural areas and other places in Canada (and elsewhere) will offer a more hospitable environment for unhappy physicians to go to. So unless ophthalmologists want to start working in the emergency department of rural hospitals, this will not end well for the UCP; continuing to dig, while it may postpone the reckoning, only makes the hole bigger and the problems worse.

    Unfortunately, in its eagerness to engage in such political battles, the Kenney government has also taken its focus off the biggest problem facing us all right now. If things continue to deteriorate, it may take the removal of someone in a higher position than the health minister to start fixing the messes this government has created.

    Reply
  4. Murphy

    July 21st, 2020

    Good ol’ eye doctors. One of the more successful eye businesses in Calgary are so sciency that they always ask whether one would like some praying done on one’s behalf before the procedure is undertaken. Many doctors stopped just short of self-immolation in public when single-payer health came in all those years ago, so it should come as no surprise that those in “entrepreneurial medicine” are quite happy to play with the grifter-yokels.
    No question that the Covid “emergency” is out of hand. Almost 2% of .18% of the population is testing positive on some days! At this rate, none of us will be left alive in 90 years!

    Reply
  5. Just Me

    July 21st, 2020

    Now that Vikram Lekhi has broken agreement with the AMA, I expect him to be hauled into court for this breach. And he should be, because there should be no reward for his cowardly treachery.

    Reply
    • David Climenhaga

      July 21st, 2020

      Just: I’m a somewhat more sympathetic with the ophthalmologists than you are on this issue, although I recognize they are looking out for their own interests. I might call this shortsighted, but not cowardice or treachery. They’re a small group among a much larger number of doctors, and their field requires access to expensive high-tech equipment as well as unusually long and expensive training. Like all surgical specialists, they have historically had access to very high fees because of market pressure, which applies even in a collective bargaining in a country like Canada, and which I am sure they view as reasonable given how hard their credentials are to get. Normal unions run into this problem too when it’s hard to effectively represent the interests of small subgroups of employees who require specialized knowledge and don’t necessarily have the same issues as the bulk of their co-workers. Solidarity is always hard to maintain in such circumstances. We have a very bad government that is willing to exploit such situations, ultimately to the disadvantage of all. DJC

      Reply
      • St Albertan

        July 21st, 2020

        The bulk of the surgeries these specialists provide are done in public facilities with significant cash up-selling and users pay services. Wait times and costs could be reduced by de-privatizing. The surgeons know that and that the procedures they provide have been streamlined and de-risked by technological advances and that the base cost has declined while their billing has remained constant. They love the UCP. The day that they staff the night shift in Olds, Elk Point, or Stettler will be the day they deserve to bill for tax payer funded surgical support in major urban hospitals as is their current business model!

        Reply
      • David Harrigan

        July 22nd, 2020

        I assume your comment that the ophthalmologists are being shortsighted was intended to be droll. But the point that people are missing is that no one knows how many ophthalmologists the EPSSA actually represents. What is clear, is that ophthalmologists tend to favor private medicine and unlike a family doctor who may bill $300,000 a year and take home about $200,00 or less – the average Alberta ophthalmologist bills well over $1 million annually and takes home more than $600,000. They are looking for their friends in government to allow more and more private surgery. I am old enough to remember when the past President of the EPSSA bought the old Holy Cross Hospital in Calgary (valued at $20 million) for $4.75 million.

        https://edmontonjournal.com/news/local-news/time-for-war-tensions-high-as-alberta-doctors-meet-to-decide-income-fairness

        https://www.pressreader.com/canada/calgary-herald/20070923/282024732886111

        Reply
  6. Scotty on Denman

    July 21st, 2020

    On the neo-right upswing it was all so “shock-n-awe” and dystopic; now, on the backside winding down it’s so “last-stand” and apocalyptic. Sisyphean, perhaps? Or calmly scheduled bravado before the fervently imagined Armageddon?

    History is document, and tearing up a freely negotiated service contract symbolizes “The End of History” —the kind neo-right think-tanks have documented so well, the triumphant cowing of organized workers, once and for all. Such an act is supposed to make imposition of neo-right policy forever easier, but as a political act of itself, one has to wonder what political benefit derives. For example, the raft of mid-1930s Alberta Social Credit legislation struck down by the SCoC was, of itself, a bunch of kooky economic gnoses which the government knew would fail constitutionally, yet the exercise held the party in good stead for many years, allowing it to sell other policies to provincial citizens. During the more recent destruction of traditional conservatism, BC education minister Christy Clark dramatically tore up a teachers’ contract which had been negotiated with the previous NDP government, just as symbolically of ‘so-that’s-that’, a dismissal of teachers’ constitutionally enshrined right to collectively negotiate remuneration and working conditions. Having thus unfurled the BC Liberal flag atop a hill so recently hard won, the quintessentially neo-right governing party (as usual, disguised as ‘Liberal’ in name as is ‘Conservative’ by others of this brand of stealth neoliberal) endured a decade and a half, nine years of which the full gambit of courts struck down the act, then admonished the BC Liberals, then finally fined them before the government (with Christy now premier after taking several years hiatus after the stunt) begrudgingly began to make restitution. Even though tearing up the document was symbolic and ultimately a failure—even, perhaps, contributory to their defeat—the sheer extent of the BC Liberals’ sabotage of the province’s public enterprises argues it was a political success, if brazenly cynical—even criminal (re: the privatization BC Rail)

    But that was in the heyday of neo-rightism, before the cocky Premier Gordon Campbell way jumped the shark and his successor was swept away in the spotlight of partisan forensics, putting to bed the notion that history may be summarily ended. The irreversibility or extreme difficulty of repairing BC Liberal damage also argues that neo-right sabotage of governments’ capacity to tax and regulate private wealth and industry has been successful. Ideally it shouldn’t matter if parties of rival ideologies win power subsequently and, eventually, the BC Liberals started behaving as if this were practically true—and to some extent, it kinda is: despite fairly bold policies to reverse their predecessor’ perfidy, the current BC NDP government would need as many mandates (four) to undo the damage. And that, of itself, argues for the neo-right’s ultimate failure: it probably is possible for subsequent governments to reverse some, if not most, neo-right sabotages, maybe even to prosecute a few individuals culpable. It was always oxymoronic that politics in the long term could ever be framed both as a week or forever.

    The UCP certainly behaves as if its neo-rightism (basically the hobbling of democratic government to interfere with private profiting) will be successful, but it seems rather more retrospective than prospective (as were the BC Liberal or HarperCon visions), more appealing to the beginning of a bygone era like the Soviet collapse which flung the doors of neoliberalism open to a relatively virginal world, rather than fighting rearguard or defending a redoubt in retreat.

    History might be “ended” politically from time to time, but reality marches on, cyclically repeating Bilical-like calamities like floods and plagues. Insofar as humankind has reached a frontier of no-more-frontiers, it’s exceedingly tough for any Alberta government to rationalize the decline of its most recent, most powerful industry. And to have a pandemic make everything all the harder even as the neo-right has failed to actually end history and guarantee privateers hegemony forever more, and is indeed itself in full decline. The UCP might look as delusional as that other infamous destroyer of conservatism, The Orange-Flossed Half-Man, but everybody knows Premier Jason Kenney isn’t a fool, and he has three more years to make nice after doing the mean stuff early in his mandate. He might appeal to evangelicals and The Rapture (where history truly wouldn’t matter for the Blessed on Judgement Day), but I still find him too devious to truly believe that himself, at least not in the political here-and-now. So how can ostensibly myopic UCP polices on public spending, petroleum moribundity, and Covid 19 work, even in the short run?

    Separation leaves most of us outsiders scratching our heads, but it might make sense if non-UCP voters were to emigrate, leaving a wholly supportive polity no matter how fantastic the political vision. Certainly the rhetorical jousting between doctors and the UCP government plays on such a narrative—at least as far as doctors threatening to leave the province. But Shandro’s decree that even mentioning such a threat would warrant some kind of punishment rather paints another shade of separatism, something more like the separateness of North Korea where authority is total, no questions tolerated. Given Albertans need doctors—as if Covid doesn’t make this more painfully obvious—narratology says the result must be the latter while our constitution says it can never be, not so long’s Canada has any say about it. Remember: the corrupt BC Liberals got away with it for sixteen years—which is in the order of Alberta’s governing-party longevity.

    Or is that just another kind of “end of history”? —one that could be disproved on the cusp of an entirely new era? If the UCP’s policies make sense somehow, it either eludes or disturbs me.

    Hang tough, my Alberta friends!

    Reply
  7. Murphy

    July 21st, 2020

    Jason Luan, one of the more “limited” placeholders in the Used Car cabinet has just declared the hand-out of $5 million in taxpayer funds to establish 400 beds in “recovery communities” for people with addictions. First quarter of 2020, 142 people died from apparent accidental opioid poisoning. Somewhere around 15-20% of the population meets the criteria for substance-use disorder over their lifetimes in Canada, so, in Alberta, that’s 800 000 or so people. Recovery communities are the product of one of the kookiest scams ever perpetrated in the US, and there is no scientific evidence whatsoever to support their use here.
    https://www.cbc.ca/news/canada/edmonton/recovery-centres-addiction-mental-health-alberta-1.5651339

    “In 1970, George Lucas needed dozens of actors with shaved heads for his sci-fi dystopian movie THX 1138. He had trouble filling the roles at first, since so few actresses wanted to cut their locks, but Lucas eventually found the extras he needed in a strange utopian community where everyone worshipped sobriety and expressed solidarity by shaving their heads. It was called Synanon, and over the course of three decades it would become one of the weirdest and most vindictive cults of the 20th century.
    The Game was the medicine administered later, a kind of group therapy invented by Charles Dederich where people sat in a circle to express (and often shout) their frustrations at each other. The confrontational approach was a way to hash out everything that bothered you about others in your group. It was supposed to help you learn about yourself as well. While playing the Game, your frustrations didn’t even need to be true. Lying was just one of many strategies in The Game, which could last anywhere from one to 48 hours.”
    https://paleofuture.gizmodo.com/synanons-sober-utopia-how-a-drug-rehab-program-became-1562665776

    Eventually the cult members of Synanon resorted to putting rattlesnakes in their opponent’s mailboxes. Once again, Kons are taking the bull by the horns and bringing more of the greatest culture humankind has ever known up north of 49.

    Group confessionals with everyone wearing masks! Hail Gozer, the Gozerian!

    Reply
  8. Just Me

    July 21st, 2020

    It’s becoming clear that the UCP desire a massive ideological shift in Alberta’s population that can only be formed if there is a massive exodus from the province. Seeing, say, one million disgruntled people leave the province, with minimal to no replacements coming in, will cause seismic shifts rarely seen in North America.

    I recall Glenn Beck admonishing his listeners to not remain with people who are not like them (AKA liberals) He encouraged them leave and live in places where the people believe as you do. The Cultural Wars in the US have created rural enclaves of paleoconservatives, where the megachurch dictates from the pulpit overpower science and superstition rules. The UCP want the same in Alberta, because the populations of Alabama, Georgia, and Mississippi are compliant to any nonsense their respective conservative death cults want to impose.

    Alberta=North Korea. Don’t laugh because it will happen.

    Reply
  9. jerrymacgp

    July 25th, 2020

    I guess the ophthalmologists aren’t familiar with the quote — often attributed to Benjamin Franklin, perhaps apocryphally — that says,”if we don’t all hang together, we shall most assuredly hang separately”. Abandoning their solidarity with their colleagues will do nothing but greatly weaken both their own and the AMA’s positions.

    Reply
    • David Climenhaga

      July 27th, 2020

      I think this view misinterprets the class divide within the medical profession. Specialty surgeons will always be able to command high fees in a globalized system where there will always be competition for their services, abroad if not in Canada. Family doctors, general practitioners and rural docs, not so much. So I doubt any ophthalmologist will ever suffer for selling out the AMA and their colleagues. The interesting question to me is how many actually support their specialty association — I hear different stories, from almost all to about a quarter. DJC

      Reply

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