Contract disputes and strikes are commonplace in universal health care systems throughout the world whether it’s Canada, the UK, Australia, Brazil, Greece, South Africa or India. Wherever government controls access to doctors and hospitals you’ll find patients who are caught in the middle of disputes over rising prices and declining quality.
Here in Canada, contract negotiations between the Alberta government and the Alberta Medical Association (AMA) are in limbo following the government’s threat to impose fee cuts on doctors. A fight over public opinion on the income of doctors is now playing out in the media with each side staking a claim to the best interests of patients.
Do doctors get paid too much under Medicare? How do governments and medical associations value medical services? How do medical associations divide the money pie? How can we assess value for money when doctors are prohibited from setting their own prices and patients are prohibited from paying for their own medical services? Without any competition on quality and price there is no information to help us identify and reward excellence. We have no way of knowing if good doctors are paid too little or bad doctors are paid too much because under Medicare they’re all lumped together.
Doctors and patients often believe that a change in government will bring a kinder, gentler master, but it doesn’t matter which political party assumes power as they all support Medicare. Our politicians continue to use legislation, regulations and price controls to prevent free market health care in Canada, yet when they leave the country for medical care it’s a free market they seek.
In its latest rebuttal to politicians, Setting the Record Straight on Physician Compensation, the AMA says, “Let’s stop dwelling on the wrong data and the wrong questions and the wrong ideas and get back to job one: successful conclusion of mediated negotiations. Negotiations are about far more than money. They are about reaching an agreement that aligns health care delivery’s different components – primary, secondary, tertiary care, academic medicine, roles, relationships and the way physicians are remunerated – all with the goals of improved patient care, access, quality and productivity. In short, the negotiations and the agreement address the big question: How do we make health care better for patients?”
These negotiations are not just about money, they’re also about the loss of individual freedoms of doctors and patients. Political promises for timely access to high quality care are not enough. The only way to make health care better for Canadian patients is to save the doctor-patient relationship by setting it free.
There are currently two patient cases challenging the government’s monopoly on health care filed in the Alberta Court of Queen’s Bench.