Province encouraging Alberta Doctors to see more patients by lifting daily cap

Improving Albertans’ access to doctors

To help increase patient access to physicians, there will no longer be a daily cap on the number of visits a physician can fully bill.

During the negotiations with the Alberta Medical Association (AMA), Alberta’s government heard that Alberta’s doctors could safely see more patients than the current cap allowed.

Albertans want to know that they can see a doctor when they need one, and physicians want to be able to provide Albertans with the health-care services they need. By changing the daily cap policy, some of the immediate pressures for services provided by general practitioners and specialists, including pediatricians and ophthalmologists, will be addressed. By lifting the cap, physicians will be fully compensated for every visit rather than receiving a discounted rate if they provide more than 50 visit services in one day, which is the current practice.

“We’re moving forward to implement the new agreement, starting with ending the daily visit services cap policy and working to put rate increases in place. We’ve heard from some physicians that the daily visit cap was having a negative impact on patient access, so this change addresses those concerns. It is also part of the new agreement with the AMA where we are listening to physicians and working with them as partners moving forward.”

Jason Copping, Minister of Health

“The AMA agreement allows physicians and government to work together on challenges facing patients and physicians in the health-care system. This early step to remove the services cap is an important example that will allow more physicians to care for more patients while helping to stabilize physician practices.”

Dr. Fredrykka Rinaldi, president, Alberta Medical Association

Lump sum payment

The agreement between the AMA and the province also includes a one per cent rate increase in each of the next three years and a one per cent recognition lump sum payment in 2022-23.

Alberta physicians were at the forefront of the pandemic and the one-time payment for eligible practising physicians is in recognition of that work during the 2021-22 fiscal year. This lump sum payment is approximately $45 million and will go to the AMA to distribute to their members by the end of 2022.

In addition to the lump sum payment, the government is working with the AMA to implement the one per cent rate increase for 2022-23. The increase applies to fee-for-service and alternative relationship plan rates, providing an additional $46 million to physicians.

As outlined in the AMA agreement, the rate increase is heavily weighted to specialties facing the greatest pressures, such as family medicine. Alberta’s government and the AMA are working together to distribute these increases across and within specialties. Increases will be effective April 1, 2022, and are expected to be finalized by March 31, 2023.

Quick facts

The daily visit services cap policy was introduced as part of the Physician Funding Framework in 2020.
The intent of the policy was to support quality patient care by reducing physician burnout while addressing fiscal constraint for the province.
It applies to all physician services that are defined in the Schedule of Medical Benefits (SOMB) as “visits” with a “V” category code that physicians provide to patients in person, including physician office visits, consultations and counselling services. Procedures and tests that physicians provide are not billed as visits.
Under the current policy, physicians are compensated 100 per cent for up to 50 visit services billings in a day, 50 per cent for between 51 and 65 visit services, and there is no compensation for visit services billings greater than 66.
Physicians working in rural and remote areas, hospital visits and virtual care are exempt from the current policy.
The policy change (to lift the cap) aligns Alberta with most other jurisdictions.
Alberta Health is working on updating the SOMB and billing system to operationalize this change. A Medical Bulletin and a new SOMB will be posted when information technology changes are complete.
The daily visit services cap policy change will be reviewed and its impacts assessed before determining the future policy beyond the current fiscal year.

Related Topics:#AlbertaMedicalAssociation #DailyVisitServicesCap #ImprovingAccessToDoctors #PhysicianFundingFramework AMA feature

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Ottawa’s avalanche of spending hasn’t helped First Nations

Published on November 19, 2024

Todayville

From the Fraser Institute

By Tom Flanagan

When Justin Trudeau came to power in 2015, he memorably said that the welfare of Indigenous Canadians was his highest priority. He certainly has delivered on his promise, at least in terms of shovelling out money.

During his 10 years in office, budgeted Indigenous spending has approximately tripled, from about $11 billion to almost $33 billion. Prime Minister Trudeau’s instruction to the Department of Justice to negotiate rather than litigate class actions has resulted in paying tens of billions of dollars to Indigenous claimants over alleged wrongs in education and other social services. And his government has settled specific claims—alleged violations of treaty terms or of the Indian Act—at four times the previous rate, resulting in the award of at least an additional $10 billion to First Nations government.

But has this avalanche of money really helped First Nations people living on reserves, who are the poorest segment of Canadian society?

One indicator suggests the answer is yes. The gap between reserves and other communities—as measured by the Community Well-Being Index (CWB), a composite of income, employment, housing and education—fell from 19 to 16 points from 2016 to 2021. But closer analysis shows that the reduction in the gap, although real, cannot be due to the additional spending described above.

The gain in First Nations CWB is due mainly to an increase in the income component of the CWB. But almost all of the federal spending on First Nations, class-action settlements and specific claims do not provide taxable income to First Nations people. Rather, the increase in income documented by the CWB comes from the greatly increased payments legislated by the Liberals in the form of the Canada Child Benefit (CCB). First Nations people have a higher birth rate than other Canadians, so they have more children and receive more (on average) from the Canada Child Benefit. Also, they have lower income on average than other Canadians, so the value of the CCB is higher than comparable non-Indigenous families. The result? A gain in income relative to other Canadians, and thus a narrowing of the CWB gap between First Nations and other communities.

There’s an important lesson here. Tens of billions in additional budgetary spending and legal settlements did not move the needle. What did lead to a measurable improvement was legislation creating financial benefits for all eligible Canadian families with children regardless of race. Racially inspired policies are terrible for many reasons, especially because they rarely achieve their goals in practise. If we want to improve life for First Nations people, we should increase opportunities for Canadians of all racial backgrounds and not enact racially targeted policies.

Moreover, racial policies are also fraught with unintended consequences. In this case, the flood of federal money has made First Nations more dependent rather than less dependent on government. In fact, from 2018 to 2022, “Own Source Revenue” (business earnings plus property taxes and fees) among First Nations bands increased—but not as much as transfers from government. The result? Greater dependency on government transfers.

This finding is not just a statistical oddity. Previous research has shown that First Nations who are relatively less dependent on government transfers tend to achieve higher living standards (again, as measured by the CWB index). Thus, the increase in dependency presided over by the Trudeau government does not augur well for the future.

One qualification: this finding is not as robust as I would like because the number of band governments filing reports on their finances has drastically declined. Of 630 First Nation governments, only 260 filed audited statements for fiscal 2022. All First Nations are theoretically obliged by the First Nations Financial Transparency Act, 2013, to publish such statements, but the Trudeau government announced there would be no penalties for non-compliance, leading to a precipitous decline in reporting.

This is a shame, because First Nations, as they often insist, are governments, not private organizations. And like other governments, they should make their affairs visible to the public. Also, most of their income comes from Canadian taxpayers. Both band members and other Canadians have a right to know how much money they receive, how it’s being spent and whether it’s achieving its intended goals.

Author:

Tom Flanagan

Professor Emeritus of Political Science and Distinguished Fellow, School of Public Policy, University of Calgary

Uncategorized

Musk, Ramaswamy to lead Trump efforts to cut waste, fraud in federal government

Published on November 13, 2024

Todayville

From The Center Square

By Brett Rowland

During his campaign, Ramaswamy proposed cutting 75% of the federal workforce. Musk recently suggested that he could cut $2 trillion from the federal budget, or about one-third of total U.S. spending.

President-elect Donald Trump picked Tesla CEO Elon Musk and businessman Vivek Ramaswamy to lead a newly created Department of Government Efficiency.

The department’s acronym, DOGE, is a nod to Musk’s favorite cryptocurrency, dogecoin. Trump said the new group will pave the way for his administration to “dismantle government bureaucracy, slash excess regulation, cut wasteful expenditures and restructure federal agencies.”

Trump laid out lofty goals for the group in his announcement this week.

“It will become, potentially, ‘The Manhatten Project,’ of our time,” Trump’s announcement said. “Republican politicians have dreamed about the objectives of ‘DOGE’ for a very long time.”

It won’t be an official government agency, which will likely allow Musk and Ramaswamy to avoid public financial disclosures.

Trump said the change he’s looking for won’t come from within the existing federal government.

“To drive this kind of change, the Department of Government Efficiency will provide advice and guidance from outside the government, and will partner with the White House and Office of Management & Budget to drive large scale structural reform and create and entrepreneurial approach to government never seen before,” the announcement noted.

Trump said he looks forward to what Musk and Ramaswamy can accomplish.

“Importantly, we will drive out the massive waste and fraud which exists throughout our annual $6.5 trillion of government spending,” he said.

Trump also gave them a deadline: July 4, 2026.

“A smaller government, with more efficiency and less bureaucracy will be the perfect gift to America” on the 250th anniversary of the Declaration of Independence, according to the announcement.

Ramaswamy, who dropped out the race for the GOP nomination to endorse Trump in January, has previously proposed significant cuts. During his campaign, Ramaswamy proposed cutting 75% of the federal workforce.

Musk recently suggested that he could cut $2 trillion from the federal budget, or about one-third of total U.S. spending. He’s been tossing out ideas on X, previously Twitter before Musk bought the company and changed the name.

“The world is suffering slow strangulation by overregulation. Every year, the noose tightens a little more,” Musk wrote in a post on X on Wednesday. “We finally have a mandate to delete the mountain of choking regulations that do not serve the greater good.”

Musk also said he isn’t a threat to democracy, but a threat to bureaucracy.

DOGE already has an X account. It’s first post: “Working overtime to ensure your tax dollars will be spent wisely!”

Some budget experts have called Musk’s pledge to cut $2 trillion a pipe dream, noting that many of the problems DOGE wants to address have proven intractable.

Brian Riedl, a senior fellow at the Manhattan Institute think tank, called Musk’s proposal “a random number unattached to reality.”

Marc Goldwein, the senior vice president and senior policy director for the Committee for a Responsible Federal Budget, said it could be done with 10 aggressive policies, mostly focused on Medicare and Medicaid.

“The government can legitimately save trillions over a decade by reducing waste and improving efficiency – and I hope we do,” Goldwein wrote on X. “Achieving these savings requires major changes to how and how much we pay for health care.”

Medicare (annual cost of about $1 trillion) is a federal health insurance program for people 65 or older, and some people younger than 65 with certain disabilities or conditions. Medicaid (annual cost of about $558 billion) is a joint federal and state program that helps cover medical costs for some people with limited income and resources.

The Government Accountability Office, which serves as the research arm of Congress, estimated annual fraud losses cost taxpayers between $233 billion and $521 billion annually, in a report in April. The fraud estimate’s range represents 3% to 7% of average federal obligations. The Office of Management and Budget publicly questioned that estimate, calling it “not plausible.”

“OMB has significant concerns that this report will not further efforts to prevent and reduce fraud, but rather will create confusion and promote misleading generalizations that have no factual connection to specific federal programs,” Jason Miller, the deputy director for management at the Office of Management and Budget, wrote of OMB concerns in a three-page letter to officials with the Government Accountability Office.

On the campaign trail, Ramaswamy detailed his plan to reduce the federal workforce by 75% during an event at the America First Policy Institute in Washington in 2023.

Ramaswamy said he would shutter the FBI (about 35,000 employees); the Bureau of Alcohol, Tobacco, Firearms a nd Explosives (5,099 employees); the U.S. Department of Education (about 4,200 employees); the Nuclear Regulatory Commission (about 3,000 employees); and the Department of Agriculture’s Food and Nutrition Services (about 1,500 employees).

Under Ramaswamy’s campaign plan, some 15,000 FBI employees would be moved to other agencies such as the U.S. Marshals Service, U.S. Secret Service, Treasury’s Financial Crimes Enforcement Network, Drug Enforcement Administration, Defense Intelligence Agency, and Commerce’s Bureau of Industry and Security.

Some groups called the Department of Government Efficiency goals a stretch. Others had more pointed things to say.

Lisa Gilbert, co-president of Public Citizen, a progressive consumer advocacy organization founded by Ralph Nader, said the government agencies and regulations Ramaswamy proposed cutting are in place to protect people.

“The purpose of government regulations is to protect the American people,” she said in a statement. “We all depend on these regulations to protect our air, water, workers, children’s safety, and so much more. ‘Cutting red tape’ is shorthand for getting rid of the safeguards that protect us in order to benefit corporate interests.”