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RUSSELL WANGERSKY: A poor prescription for a pressing problem

 According to the head of the Alberta Medical Association, many new doctors are concerned that, as small business owners, they will have a tough time planning for an uncertain future.
Bill 21, the “Ensuring Fiscal Stability Act,”  in Alberta has significant implications for doctors. STOCK PHOTO

You know, I don’t think it’s going to work. 

And in the world of carrots and sticks, it’s most definitely a stick. 

If you could read government legislation like tea leaves, the newish Alberta government could have written its ideology in the titles of its first four bills: it’s literally a whole play in four acts — “An Act to Repeal the Carbon Tax,” “An Act to Make Alberta Open for Business,” “Job Creation Tax Cut (Alberta Corporate Tax Amendment Act” and “Red Tape Reduction Act.” 

It all sounds pretty free market, doesn’t it? 

But looks can be deceiving. 

Think about Bill 21, the “Ensuring Fiscal Stability Act.” 

Part of the 132-page omnibus bill is the kind of change that some might see as an attempt at something close to socialism, rather than the free-market economy Premier Jason Kenney’s United Conservative Party espouses. 

It’s a system that can be used to dictate where new doctors practice in the province, and whether they will be allowed to practice their specialties. 

The change spells out how new doctors will need to get a permit to be allowed to take part in the province’s health care plan. 

“For the purposes of determining the maximum number of physicians who may be opted into the plan in the province, the minister shall, at the times determined by the minister, limit the number of practitioner identification numbers that may be issued under Sect. 28.4(2) or reactivated under Sect. 28.4(4) within each of the following categories: (a) geographic area of practice; (b) practice type or specialty; (c) any other category prescribed in the regulations.” 

Sounds innocuous enough, right? 

Think again. 

As a doctor, you can’t be part of the health care plan unless you have a practitioner identification number: if you’re a newly-minted general practitioner wanting to practice in Calgary, it might turn out you can only get a number in Lethbridge, or Grande Prairie or somewhere much smaller. 

It’s always been hard to get doctors to relocate to rural parts of Canadian provinces and territories — some government have tried to force new doctors to rural locations, while others have tried a variety of carrots: help with tuition debt, internships or residencies in rural areas to help acclimatize new doctors to the benefits of rural practice, and the list goes on. 

It’s funny how often governments wave a cost-cutting deficit-reducing banner, and yet increase costs and run higher deficits. 

The proof of the pudding is in the eating — and there are still rural doctor shortages right across the country. Alberta claims it’s different, that it has plenty of doctors — the only problem is that they are concentrated in the wrong places. And the government’s going to fix that — by law. or business, and it’s going to be cutting red tape, unless you happen to be a new doctor, in

So, Alberta’s going to be open for business, and it’s going to be cutting red tape, unless you happen to be a new doctor, in which case, neither might be true.

The problem is that doctors are mobile. 

Here’s the head of the Alberta Medical Association, Christine Molnar, talking to the National Post: “It’s a 1970s solution for a 21st-century problem … I would have left, like, when I graduated. I had opportunities across Canada and in the United States. Why would you stay here in this environment that is not supportive, that is introducing a level of uncertainty and risk? Why would you stay here?” 

Why indeed? 

It’s funny how often governments wave a cost-cutting deficit-reducing banner, and yet increase costs and run higher deficits. 

It’s funny, also, how governments that claim to want to let the market run free, still see the need to legislate controls on that freedom. 

It’s a case of trying to have your free-market cake and eat it, too. 

And frankly, I think new doctors are going to simply choose a different restaurant. 

Russell Wangersky’s column appears in SaltWire publications across Atlantic Canada. He can be reached— Twitter: @wangersky 


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