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If a certain Premier can *decide* to be an Epidemiologist-for-a-day, I figure I can take a crack at being an Economist. A lot of “party line” misinformation is still being circulated by @shandro et al. Docs’ concerns are about MUCH more than money, but Facts are still impt: 
Myth 1: AB doc pay is 35% higher than comparable provinces
Fact: CIHI “small print” warns against using data out of context & NOT to compare. Adjusting for ALL types of payment (not just Fee-For-Service); differences in specialist:GP numbers; incldg ALL comparable prov = 16.6%
Fact: CIHI “small print” warns against using data out of context & NOT to compare. Adjusting for ALL types of payment (not just Fee-For-Service); differences in specialist:GP numbers; incldg ALL comparable prov = 16.6%
(Myth 1) Facts (cont): a significant number of ON “technical fees” and other clinical payments (eg. BC funding pools) were not included in CIHI’s national physician database. Adjusting for this omission = 15.4% higher
(Myth 1) Facts (cont): Cdn Med Assoc’n Workforce survey revealed that AB physicians spend more time doing clinical work than other provinces; post adjustment = 13.3% higher
Other provinces’ doc assoc’ns have negotiated Increases for 2019-2022; adjusted = AB is merely 5.7% higher
Other provinces’ doc assoc’ns have negotiated Increases for 2019-2022; adjusted = AB is merely 5.7% higher
(Myth 1) Facts Context:
“Once proper adjustments are made, Alberta’s average physician compensation is projected to be 5.7 percent higher than our comparator provinces by 2021/22...”
https://www.albertadoctors.org/services/media-publications/presidents-letter/pl-archive/Flawed-data-equals-flawed-decision-making?fbclid=IwAR1Na5U4ge_dz_lFQSyGYnMKhg2OYmrzilrrctaSSAv9MsBjj-iNCUldD3o by @Albertadoctors
“Once proper adjustments are made, Alberta’s average physician compensation is projected to be 5.7 percent higher than our comparator provinces by 2021/22...”
https://www.albertadoctors.org/services/media-publications/presidents-letter/pl-archive/Flawed-data-equals-flawed-decision-making?fbclid=IwAR1Na5U4ge_dz_lFQSyGYnMKhg2OYmrzilrrctaSSAv9MsBjj-iNCUldD3o by @Albertadoctors
(Myth 1) Facts Context (cont):
“But again, context matters, which is why it’s important to point out that this projection is based on current status and does not factor in any government cuts (i.e., [when] consultation proposals are implemented).”
AMA President Dr. C. Molnar
“But again, context matters, which is why it’s important to point out that this projection is based on current status and does not factor in any government cuts (i.e., [when] consultation proposals are implemented).”
AMA President Dr. C. Molnar
Additional Facts: AB industrial aggregate wage level (impacting staff and overhead costs) is 15.4% higher than other provinces.
According to an independent consultant, with other prov increases, & expected population/doc #’s, by 2021/22, AB will be BEHIND comp provinces = -2.5%
According to an independent consultant, with other prov increases, & expected population/doc #’s, by 2021/22, AB will be BEHIND comp provinces = -2.5%
Even with AB docs soon to be -2.5% BELOW comparator provinces, @Albertadoctors recognized AB’s tough economic realities. Rather than @shandro’s disastrous cuts that unevenly cut different specialties (and devastated primary care), the AMA offered a 5% across the board REDUCTION.
Numerous AMA & indiv docs warned @shandro about the “consequences” to patient care & the functioning of the health system if he imposed his targeted cuts. Despite the -5% reduction offered being equivalent to projected “savings” by the Minister’s cuts, the hatchet job proceeded.
Myth 2: AB physicians received 300% increases since 2002.
Fact: 18 years is an odd “arbitrary” timeframe. Increases in the early-mid 2000’s were catching up following Klein’s cuts. Since then, AB docs have not even kept pace with CPI increase, with total freezes the last 7 yrs.
Fact: 18 years is an odd “arbitrary” timeframe. Increases in the early-mid 2000’s were catching up following Klein’s cuts. Since then, AB docs have not even kept pace with CPI increase, with total freezes the last 7 yrs.
Myth 3: @jkenney promised to “maintain health spending” and a physician budget of “$5.4 B”
Fact: not a complete myth but rather “myth-leading”. Keeping a flat health budget ignores pop’n increases, aging and growing complexity of pts & increased docs (many recruited by AHS)
Fact: not a complete myth but rather “myth-leading”. Keeping a flat health budget ignores pop’n increases, aging and growing complexity of pts & increased docs (many recruited by AHS)
Myth 4: “docs promise to cut costs but this never yields any savings”
Fact: AB docs HAVE “bent the cost curve” with savings initiatives and system stewardship changes. All negotiated (and honoured) under the last two AMA Agreements. Savings of $438 M that WOULD have been spent.
Fact: AB docs HAVE “bent the cost curve” with savings initiatives and system stewardship changes. All negotiated (and honoured) under the last two AMA Agreements. Savings of $438 M that WOULD have been spent.
(Myth 4) Facts (cont): $438 M NOT in physician pockets was a considerable “win” for gov’t in partnering with AMA. But, in addition, these savings are GONE from the Phys Budget, meaning savings compound annually as the billing/services changes docs made have not been reversed.
Myth 5 (associated with 4): “docs just increase utilization of codes (i.e. provide more services) to compensate for any reductions/limits”
Fact: aside from an ugly accusation of inappropriate billing underlying this myth (their myth-take!), this is NOT shown to be the case...
Fact: aside from an ugly accusation of inappropriate billing underlying this myth (their myth-take!), this is NOT shown to be the case...
(Myth 5) Facts (cont): data obtained directly from AB Health itself reveals that docs have been consistent in utilization of billing codes.
Myth 5 Conclusion: docs partnered with gov’t to find savings - we delivered & did NOT “game” it. Docs take system sustainability seriously.
Myth 5 Conclusion: docs partnered with gov’t to find savings - we delivered & did NOT “game” it. Docs take system sustainability seriously.
Myth 6: docs should be responsible for any overtures in the Physician Services Budget
Fact: as demonstrated, docs do NOT inappropriately ramp up billings to make up for cuts. Docs can NOT control population, political policies/promises, CPI, aging OR the unknown (eg. COVID)
Fact: as demonstrated, docs do NOT inappropriately ramp up billings to make up for cuts. Docs can NOT control population, political policies/promises, CPI, aging OR the unknown (eg. COVID)
(Myth 6) Facts (cont): docs recognize fiscal responsibility and system sustainability are critical for ALL of AB. We WANTED to work with gov’t to keep making changes that incent high quality, evidence based care; while recognizing medicine evolves & stewardship/changes are needed
DESPITE the poor faith shown in rejecting AMA’s offer of -5% across-the-board reductions, denying docs the right to arbitration and tearing up our contract... Docs STILL want a strong AB health system & excellent pt care. So we REMAIN willing to partner with gov’t towards this.
Should have put at outset: ALL credit for the analysis/presentation is to @Albertadoctors Health Economics staff. Amazing & super talented bevy of economists (whatever grps of econ’s are called!).
My part was merely some minor “translating” & wedging into 280 character snippets.
My part was merely some minor “translating” & wedging into 280 character snippets.
