Posted in Access to healthcare, Canadian Health System, Economic Issues, Government Regulations, Healthcare financing, Medical Costs, Organizational structure, Policy Issues, Uncategorized

Alberta ends master agreement with doctors, new rules to be in place April 1 | CBC News


  • Supply is limited (it is a service & commodity that is rendered by others)
  • Demand is inexhaustible (innumerable definitions of healthcare needs and wants)
  • Fixing prices exacerbates shortages (resources flow to where they are valued)

This article instantiates the snares and trappings of gov’t financed systems where gov’t functions as a buyer, payer and regulator!  

In the case of this Alberta Canada conundrum, cutting fees is a surrogate for rationing. It encourages providers to short-cut care by reducing time spent with complex patients.  The dangerous flip side of that ugly coin is that the cuts encourage emphasis on increasing the number of shorter visits.


Health Minister Tyler Shandro says enforcing new rules on Alberta doctors is necessary to meet budget targets. (Colin Hall/CBC)

Last fall, Premier Jason Kenney’s United Conservatives passed Bill 21, which gives the government the right to unilaterally end the agreement.

A decade ago, Alberta added in an extra fee — called a complex modifier — to recognize that some patients have multiple or complex issues and doctors should be compensated for overly long visits.

If a visit went more than 15 minutes, doctors were able to extend it 10 minutes and bill the province a complex modifier fee of $18, for a total of $59.

As of April 1, the fee will be halved from $18 to $9, for a new total fee of $50.

As of April 1, 2021, the $18 complex modifier will return. But physicians won’t be allowed to bill for it until the 25-minute mark.

Doctors warn of cutting visits

Shandro’s ministry says the change is necessary for two reasons: more time is needed to assess complex patients and the current complex modifier is being abused, with too many doctors billing the $59 right at the 15-minute mark.

At a news conference announcing the changes, Shandro said the modifier was being used for almost 50 per cent of visits.

The Alberta Medical Association, the bargaining arm for doctors, has said extending the length of a visit to 25 minutes would reduce fees by a total of $200 million and devastate many family and rural practices.

The AMA has argued the complex modifiers are not only for exceptional cases and take into account all the work — preparation, follow-up and face-to-face time — needed for patients with complex needs. It also says it keeps those patients out of the hospital.

The issue has riled up some doctors, many of whom have put up signs warning patients they may have to cut future visits short to recoup funds needed to keep their practices going.

Posted in Access to healthcare, big government, Canadian Health System, Crony Capitalism, Dependency, Doctor shortage, Economic Issues, Government Regulations, Government Spending, Healthcare financing, Liberty, Medical Costs, Medical Practice Models, Medicare, Organizational structure, Patient Choice, Patient Safety, Policy Issues, Price Tansparency, Protocols, Quality, Uncategorized, Wait times to see a doctor

Dr. Whatley: Single-payer healthcare – the good, the bad and the nutty – THE DIRECT PRIMARY CARE JOURNAL

Dr. Shawn Whatley


Shawn Whatley is past-president of the Ontario Medical Association. He has worked in emergency medicine, as a coroner, in a vein clinic, and as a surgical assistant. He also held a leadership role at a large suburban hospital. He now practises family medicine in rural Ontario. Visit his blog at rural Ontario. Visit his blog at

The Nutty

  • Hospitals lose money for seeing more patients; doctors earn more for seeing more patients
  • Unlimited sick days for some nurses
  • March madness: hospitals spend like crazy before year-end or lose funding for next year
  • Pharmacists paid more for same service than MDs (e.g. flu shot)
  • Black market in radiology and lab licenses
  • NPs and midwives earn more per patient than MDs
  • Labs have fixed budgets: more tests means less profit per test

Bigger Issues

Single payer healthcare also raises other, more challenging problems:

Those who know cannot speak. The system suppresses dissent. People cannot speak up, because they have nowhere else to work. Professionals working in hospitals or academia must stay quiet. Single-payer systems give tremendous power to administrators who run the monopoly. It enriches and expands government. Price controls appear to limit costs, but profits are found in other ways. For example, price controls force doctors to shorten visits, unbundle care, up-code, or stop providing a service. Centrally planned single-payer systems function on Hayek’s Fatal Conceit, the assumption that planning is possible:

The curious task of economics is to demonstrate to men how little they really know about what they imagine they can design.

Local knowledge is impossible to capture or to use in managing the system. Single-payer systems incentivize collusion with government to exclude competition. It creates a psychological change in Canadians. Whereas choice empowers patients, single-payer fosters dependency on the system. It creates increased demand for fixed price services but decreased availability of those services. Single-payer assumes that bigger is always better. But bigger often becomes too big to manage. A CEO of A.T.&T. once said, “A.T.&T. is so big that, if you gave it a kick in the behind today, it would be two years before the head said ‘ouch.’”

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Canadian Health System, Economic Issues, Government Regulations, Government Spending, Health Insurance, Medical Costs, Medical Practice Models, Patient Choice, Policy Issues, Quality, Uncategorized

CMT CANADA: ‘I think one of the biggest misnomers about Canadian healthcare is that it is “free”. It definitely is NOT free.’ ~ | Concierge Medicine Today

The Canadian Health Act of 1984 is the law that frameworks healthcare in that country.  As individuals enroll in the program they are issued a health card which enables them to receive health care services which the government deems “essential”.  As I outlined in yesterday’s post, there are a multitude of services which are not covered and thus the individual must pay for themselves (either out-of-pocket or through insurance).  It is unlawful for private insurance to duplicate public healthcare system benefits.  Private insurance is only allowed to address coverage gaps, similar to supplemental insurance in the United States (yes, the AFLAC duck).

I think one of the biggest misnomers about Canadian healthcare is that it is “free”.  It definitely is NOT free.  Canadians pay heavily for healthcare through the tax system.  In 2013, the average Canadian family paid $11,320 in taxes just for the public healthcare insurance.  Furthermore, the cost of public healthcare (before inflation) has increased 53% just in the past 10 years and is now running a deficit of $540 billion.

via CMT CANADA: ‘I think one of the biggest misnomers about Canadian healthcare is that it is “free”. It definitely is NOT free.’ ~ | Concierge Medicine Today.