Wednesday, June 02, 2004

BCMA wait-list campaign a sure winner with public

VICTORIA - Give the Liberals full marks for avoiding a pre-election battle with the BC Nurses Union.
But don't bet any money on them being quite so successful with the doctors.
The deal with the nurses works for both sides. The union and government have agreed on no changes to wages and benefits. If they can't reach agreement on other issues, the old contract will roll over for another two years.
It's not going to be so easy with the BC Medical Association, which has already launched its PR campaign.
The doctors' agreement expired March 31. A conciliation panel will recommend a settlement. If government says no, doctors are free to launch job action.
From the outside, a deal looks possible. Doctors say they'll accept no fee increases for the first two years of a deal. But while the amount a doctor is paid for fixing a hip wouldn't go up, they do want more money budgeted so the same doctor could fix more hips (and make more money).
It's a pretty good pitch, because it puts doctors and the public on the same side. More new hips means shorter waiting lists.
So far, the government isn't buying. Health Minister Colin Hansen says the doctors are the highest paid in Canada and their funding went up 21-per-cent over three years in the last deal. They should do more surgeries without extra pay. The budget stays frozen.
It's going to be a tough line to hold. Money is available - from Ottawa, and from health sector wage cuts. And the public is likely to accept the idea that someone doing more work should get more money.
The BCMA is certainly off to a fast start in trying for that support. The doctors have been running newspaper ads noting that waiting times for surgery have increased under the Liberals. They commissioned a poll by Ipsos-Reid that confirmed that people feel they are waiting too long and are worried. (It also revealed the Liberals' fatal weakness in this dispute, as we'll see.)
The poll found 91 per cent of British Columbians are concerned about the waiting time for surgery, with 66 per cent "very concerned." Only 40 per cent say they're very concerned about health care costs, the priority the Liberals will be forced to defend.
The BCMA has also launched a campaign for wait list guarantees. Doctors note that the median wait for knee replacement has increased from 21 weeks to 30 weeks since the election; for cardiac surgery the median wait has climbed from 13 to 18 weeks. The wait is longer for almost every procedure.
The BCMA says government should establish a maximum wait time for each procedure. If the system can't deliver, the government commits to paying for an operation outside the province or coming up with some other solution to honour the guarantee
Saskatchewan has already started such a program, and other countries have made them work. Patients at least know where they stand (or lie in pain) and we can have an honest public debate about how long we are prepared to make people wait in the name of cost control.
It's going to be tough for the government to explain why that kind of commitment can't be made in B.C. - especially when 88 per cent of those polled supported the idea.
In fact, it will be tough for the government period. This dispute will come down to a question of who the public supports, doctors or politicians. And doctors almost always win.
The poll asked who should be believed when making pronouncements on how to manage health care. Almost 90 per cent of respondents found their family doctor believable; 77 per cent believed the BCMA. But only 44 per cent found Health Minister Colin Hansen believable. Only 37 per cent said they would believe Gordon Campbell.
If this turns into a battle for public support, the government has already lost.
Footnote:The poll highlighted Campbell's credibility problem. It found 38 per cent of those surveyed found him "not at all believable" as a source of information on managing health care. Hansen fared much better - only 21 per cent found him to be completely lacking in credibility.

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