As we know, health costs take a huge chunk of provincial budgets, and physician costs are a huge part of that. Ontario recently decided to roll back fees for certain procedures that because of improvements in technology etc. have become more lucrative for certain specialists. Some other provinces are thinking along the same lines.
Alberta doesn't have the best history when it comes to relations with doctors, and the docs didn't do themselves any favours when they further antagonized the government during the recent election, when they figured it wasn't too risky to do so.
In a cost-conscious environment, there aren't a hell of a lot of options available. People keep pushing the idea of nurse practitioners, which would be great in terms of improving access to care, but its a non-starter financially, since on top of regular salaries, they'd also need to be paid full benefits, holidays, overtime, overhead, education leaves, and all those other things that most doctors have to pay for themselves. Good luck with that.
People think doctors only want more money, but I think a lot of that is because of the low trust they have in the system, and how many times they've been screwed around because of it (Klein, AHS, etc.). I think there are other things they want, and they could be persuaded to take a modest cut in billings to pay for it.
What might docs be effectively willing to pay for? How about a better work environment.
Here's my proposal...
Pursue a real inquiry into physician intimidation. Government and health administration needs to stop treating physicians as enemies. And stop trying to confuse the public by inferring raw billings equates to salary.
Gut the ridiculous number of non-patient-care administrative staff in the AHS hierarchy, AHW, and the hospitals, and greatly increase accountability and transparency in terms of health outcomes there. The amount of frustration physicians have fighting with these organizations to care for their patients is epic.
Cut down on all the administrative and political fiefdoms, again by radically increasing accountability and transparency system-wide. Properly coordinate services and share knowledge rather than setting up multiple overlapping organizations that compete against each other for resources.
Frankly, reducing the frustrations that doctors have just trying to provide care for their patients in today's system should save most docs enough in alcohol and therapy bills to make up for any reductions in billings.
Once you get past a certain level of income to meet your basic needs, most people will be willing to pay to improve their quality of life. I'd say most doctors qualify.
So to recap, the gov't would save by lower physician billings and possibly lower admin overhead costs, offset by the costs of some really good people to truly bring in that level of accountability and transparency, and the associated costs inherent in any streamlining (not restructuring, we've had quite enough of that thank you). Docs would benefit by not having to put up with quite as much shit during their days.
Of course, there is a wee little problem.
For this to work, there would need to be a lot more trust on both sides, and real confidence that the system should, can and will be improved, with everyone fully committed to this.
A modest proposal indeed.