Update on government discussions

July 28, 2016

Dr. Carl W. Nohr, AMA President

Dear Member:

Discussions with government have been underway since the new year. As I have mentioned in previous President’s Letters, we have been working under a Memorandum of Agreement (MOA) for good faith negotiations “to explore issues of common interest during the term of the AMA Agreement, with the aim of managing the rate of growth with respect to the physician services budget, improving the effective provision of health care to Albertans and jointly ensuring the sustainability of the health care system.” The 2011-18 agreement remains in place; any proposed changes as a result of these negotiations would be subject to a ratification vote by physicians.

Everyone is familiar with the extreme financial pressures facing government. The profession has acknowledged our role as stewards of the health care resources that we use – and I have written to you several times on that front. Neither government nor physicians can go it alone. To help manage the health care budget as stewards, we will need effective relationships and a shared understanding of what is important – along with acceptance of risk sharing and the tools to manage it.

By tools, I mean things like:

  • Data to identify innovation that will make the system better for patients. Innovation may also yield savings that can be applied for better patient care.
  • Developing a needs-based, provincial physician resource plan for planning and budgeting purposes, based on the best available data.
  • Aligning incentives with the way that care is delivered today, from fee-for-service changes to an updated primary care compensation model option and increased alternative relationship plans, etc.

Working together toward such efforts – and taking on new roles – will redefine the profession’s relationship with government. We will also need to strengthen external relationships through involvement at various levels of other key stakeholders who may be involved or affected by the working of the AMA Agreement.

These are the kind of issues that are being discussed to promote a sustainable health care system that is both fiscally prudent and focused on quality.

Holding our discussions in the context of an existing agreement to which both parties are committed has allowed the parties to explore wide-ranging opportunities that are in the interests of both. We have made considerable progress in some areas while some still remain to be resolved. We may be nearing the conclusion of this work and I will keep you updated.

As is typical in such discussions in the past – and as provided for in the MOA – we have allowed the negotiating teams to work confidentially and in due course. You can be sure, however, that the Board of Directors has provided ongoing close oversight. As always, the Representative Forum will be briefed and consulted on the outcomes of the discussions.

Although negotiations have been going on for some time, I remain hopeful that we can accomplish something that is fair and reasonable, and that moves us toward positive system changes that will contribute to fiscal sustainability.

As always, please let me know what you think. Email president@albertadoctors.org or leave a comment below.

Kind regards,

Carl W. Nohr, MDCM, PhD, FRCSC, FACS
President

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