Skip to main content

Home/ CUPE Health Care/ Group items tagged bargaining

Rss Feed Group items tagged

Govind Rao

Health union hearings near climax; Arbitrator meeting this week to decide on structure ... - 0 views

  • The Chronicle-Herald Tue Feb 3 2015
  • Hearings to determine who will represent whom in Nova Scotia's health-care system entered the final stretch Monday. Arbitrator Jim Dorsey was at an airport hotel outside Halifax along with representatives for the four health-care unions and the employer for final submissions on representation under the Liberal government's Health Authorities Act. The bill reduces the number of bargaining units to four from 50 and this will likely be the final week for unions to make their case.
  • Such a scenario would see unions keep their respective members but use an amalgamated bargaining team when it comes time to negotiate contracts. Dorsey ruled that that option makes sense for health-care and support, where no union has a clear majority. Although the government appears to be on side with that plan, for nursing and clerical, the government's preference is for the majority union to represent the bargaining unit. NSGEU has the clear majority for clerical. Last week, the government changed a regulation in the act that, in effect, gives the Nova Scotia Nurses' Union the majority of nurses.
  • ...3 more annotations...
  • Monday's session focused on the support bargaining unit. Tuesday will focus on the clerical bargaining unit. The health-care unit is scheduled for Wednesday, with nursing, the most contentious of the units, to be addressed Thursday. Joan Jessome, president of the Nova Scotia Government &General Employees Union, said it is no one's preference to take members from other unions. It is her belief that Dorsey's decision from last month "allows the unions to sit down together and put in place an amalgamated union for each of the four bargaining units."
  • Unions will make submissions on the appropriateness of the regulatory change Tuesday, with a representative for the attorney general in attendance. Nurses' Union president Janet Hazelton said her union would support a bargaining association, but it doesn't seem to be an option for nursing. The regulation change, which considers IWK Health Centre nurses and nurses from the other health authorities as having one employer for the purpose of bargaining, makes sense, said Hazelton.
  • "We've always treated them as one bargaining unit. We have one collective agreement that applies to both groups. We hold a vote (and) they're included in the vote. They sit on the bargaining committee. So we have treated the IWK and the rest of our employers as one since 1990." Unifor Atlantic regional director Lana Payne, whose union, along with the Canadian Union of Public Employees, has remained unwavering in its support for bargaining associations, said the process has been a roller-coaster ride for everyone. Payne expects a challenging week, but she remains optimistic that amalgamated units will work. "Our commitment is there, and I'm hopeful that we can pull it through." CUPE president Danny Cavanagh said the goal is to come out of the week representing as many workers as they did at the start, "if not more."
Govind Rao

Not a slam dunk for government | Halifax Media Co-op - 0 views

  • KJIPUKTUK), HALIFAX - "We are happy with this decision. It creates four bargaining units and ensures that all nurses can be represented by one union," said Health and Wellness Minister Leo Glavine in a press release issued short
  • The idea of four bargaining units was never disputed, labour leaders say, so that's hardly a victory for the government.
  • And as far as the one union for nurses is concerned, Dorsey states that he doubts whether any one health-care union has the numbers to claim a majority.
  • ...5 more annotations...
  • While the government has the right to wind up district health authorities and dismiss executives and managers in restructuring, it cannot reach across the table and assign new representational rights and responsibilities for independent trade unions or tell employees who will be their bargaining agent,” Dorsey writes.
  • Dorsey suggests that in the next arbitration phase, scheduled for early February, the unions explore the idea of amalgamated successor unions for at least some if not all of the four proposed bargaining units. An amalgamated successor union is a legal entity, with its own bylaws, leadership, and all the legal trimmings, made up of the relevant existing health care unions. Those unions keep their own leadership, members, etc.
  • “This isn't the slam dunk that the Liberal government wanted,” Danny Cavanagh, regional vice-president of the Canadian Union of Public Employees (CUPE) tells the Halifax Media Co-op. That collaborative approach to bargaining is really not that different from the bargaining associations all four affected unions were proposing earlier, Cavanagh argues. At that time the government rejected that idea. Now Dorsey ruled that response was wrong.
  • Dorsey thinks that there is nothing in Bill 1 that forbids the collaborative bargaining approach. “We could have been off to the races without going through the arbitration process,” Cavannagh says. Now there is another opportunity for the unions to come up with a collective bargaining structure. More formal than a bargaining association, the so-called amalgamated successor union, will need to encompass all the legal attributes of a bargaining agent.
  • The next phase of the arbitration hearings starts on February 2nd. It's not yet known whether the meetings will be open to the public.
Govind Rao

Facilities complete two weeks of bargaining talks | Hospital Employees' Union - 0 views

  • Bargaining bulletin January 24, 2014
  • Two weeks of negotiations for a new collective agreement covering 47,000 workers in B.C. hospitals, care homes, emergency health services and the health care supply chain are now completed. Representatives of the Health Employers Association of BC and the 11-union Facilities Bargaining Association (FBA) exchanged proposals on a number of non-monetary issues at the bargaining table.
  • “We identified scheduling, the health impacts of shift work, and the need to reduce injury rates, workload and bullying as priorities,” said Pearson.
  • ...1 more annotation...
  • Negotiations are scheduled to resume on February 11.
Govind Rao

CUPE slams designated bargaining; Union argues arbitrator has other options in deciding... - 0 views

  • The Chronicle-Herald Wed Dec 10 2014
  • The first day of arbitration hearings between Nova Scotia's health-care unions and the provincial government opened with a final attempt by CUPE to prevent unions from being assigned to designated bargaining units. Arguing based on a charter of rights protest against Bill 1, the legislation that merges nine health authorities, CUPE lawyer Susan Coen told arbitrator Jim Dorsey that he has the power to consider other options. While Bill 1 calls for each of the four unions to be assigned to one of four new bargaining units, the Canadian Union of Public Employees continues to advocate for a bargaining association model that would allow unions to keep their respective members but come together to bargain on behalf of each of the new units that would impact their members.
  • Although a lawyer for the health districts portrayed this as unions calling for the status quo, Coen said the four unions (CUPE, Unifor, the Nova Scotia Nurses' Union and the Nova Scotia Government &General Employees Union) reached consensus on the association model through a lot of effort. "It is far, far more than just unions agreeing to work together," Coen said. The province ruled out the proposal last summer, saying it did not go far enough to streamline bargaining. Mediation failed last month, triggering the arbitration. Bill 1's approach to labour causes unnecessary upheaval, she said. The other issue touched on during Tuesday's session was the legislation's call to put all registered nurses and licenced practical nurses in one bargaining unit. Lawyers for CUPE and the NSGEU, who stand to lose thousands of members under that plan, noted there are concerns, given the salary disparity between the two jobs and fears some registered nurses may have about their roles being eroded by licenced practical nurses.
Govind Rao

Grits should get a grip as health merger guru takes too many liberties - Infomart - 0 views

  • The Chronicle-Herald Sat Jan 24 2015
  • "... the nursing bargaining unit is composed of all unionized employees who occupy positions that must be occupied by a registered nurse or a licensed practical nurse." Dorsey explains his view of the "majoritarian principle," arguing that principles of democracy require a union to be supported by a majority of members to be certified. Of course, that is not the way our democracy works. It has been three decades since any party won more than 50 per cent of the vote in a Nova Scotian or Canadian election. And when one party has a plurality, but not a majority, of seats, it still gets to form the government. As a practical matter, only the clerical group (NSGEU) has a majority from one union. No matter. Dorsey tells us that "it cannot be the legislative intent in this restructuring for the first time in Canadian history to impose certification of three unions as exclusive bargaining agents for bargaining units of employees without majority employee support."
  • And "... no employer wants to bargain with a union ... that does not represent a majority of its employees." Any plain reading of the act tells us that was exactly the intent of the employer, because for three of the groups, there is no majority union. Both the IWK and the regional health authorities (RHAs) had plenty of opportunity to object. They did not. The NSNU has a majority of nurses (RNs and LPNs) at the IWK and in total. Dorsey estimates that the NSNU has 48.9 per cent of the nurses in the amalgamated authority. He appears to have searched everywhere for a pebble to stumble on and finds it there. It is crystal clear that the straightforward path to follow the act is by certifying the NSNU for those employees. Premier Stephen McNeil has eliminated this unnecessary impasse by combining the nursing units for the provincial health authority and IWK Health Centre into a single or common employer unit for bargaining purposes, without compromising the IWK's independence. Good.
  • ...3 more annotations...
  • Needless to say Dorsey, likewise, cannot abide allowing Unifor and CUPE, the two other unions, to represent the health-care and support groups since there is nothing close to a majority share of representation in either. Instead, he argues that each individual union local is a union for this purpose and invites them and the relevant NSGEU locals to fashion amalgamations. They seem to be amalgamations in name only: "(it) can also take the form of an amalgamation in which each of the former unions continues to exist, perhaps only with a change in name. There can be minor changes with the unions (by which he means the relevant union locals) continuing to operate with their pre-amalgamation structures and organization essentially unchanged." In other words it looks like a bargaining association, which the government has rejected, dressed up in different clothes. Worse, it preserves obsolete boundaries for no reason that benefits members.
  • Dorsey argues that the amalgamations meet the province's requirement for single bargaining agents, and that what he is proposing is "not a council of trade unions, not a bargaining association and not a joint structure of autonomous unions." Union leaders are getting a different message. They believe that they can keep their members after amalgamation. How can such an arrangement serve the interests of the new union's members? Since there is to be only one contract, why is there a continuing need for different locals? He invites the unions to create amalgamations for the health-care and support groups, but he does not exclude it for the others. The members of these new creations will not have voted for them - so much for majoritarian principles.
  • It's time for government to get a grip. It was not expecting this outcome. The process has already dragged on longer than it was supposed to, and no conclusions on representation have been reached. The unions may not reach an amalgamation agreement, or may present one that government views as unsatisfactory, but which Dorsey chooses to accept. The government must define clear timelines for a complete decision on representation to be reached, and specify the conditions it expects, including the degree of autonomy, in any new amalgamations that are proposed as candidates. The government has patiently and effectively moved this file along since the day it was elected. It should not let the project become derailed at this late stage.
Irene Jansen

Tentative agreement reached for B.C. health science professionals < Bargaining, British... - 0 views

  • After almost a year of bargaining for a new contract, the Health Science Professionals Bargaining Association (HSPBA) has reached a tentative agreement for nearly 17,000 health science professionals working in hospitals and communities across British Columbia.
  • The tentative agreement includes wage increases totaling 3 percent, and makes permanent a market adjustment of between 9 and 14 percent over and above the basic wage rates for pharmacists.
  • provisions that protect the health and safety of health science professionals in short supply who often work on call
  • ...5 more annotations...
  • fairly compensate those who work extraordinary shifts
  • The agreement brings a return to a 37.5 hour work week
  • includes a commitment to a Pharmacare tie-in which is comparable to pharmaceutical coverage offered by BC Pharmacare, and a joint process to realize savings in extended benefit coverage
  • CUPE represents approximately 550 health science professionals in the bargaining association.
  • CUPE represents approximately 550 health science professionals in the bargaining association. T
Govind Rao

Health employers urged to pick up pace at Facilities bargaining table | Hospital Employ... - 0 views

  • Bargaining bulletin
  • February 28, 2014
  • With just over a month remaining before the current collective agreement expires, health unions are looking for concrete progress in contract talks covering 47,000 health workers.
  • ...1 more annotation...
  • Bonnie Pearson, spokesperson for the multi-union Facilities Bargaining Association, says that while both the unions and employer have tabled their packages, moving forward will require the Health Employers Association of BC (HEABC) to show more flexibility.
Govind Rao

Health employers refuse to move on key issues | Hospital Employees' Union - 0 views

  • Bargaining bulletin
  • March 7, 2014
  • With just weeks remaining before the current contract covering 47,000 health care workers is set to expire, B.C.’s&nbsp;health employers have failed to constructively or meaningfully address key bargaining issues.&nbsp; The multi-union Facilities Bargaining Association is pressing health employers to address workload, safer working conditions, and job security provisions that would provide stability in care delivery, reduce injuries, and provide economic security for members.&nbsp; In addition, the FBA wants the restoration of vacation days that were frozen in the 2010 round of bargaining.
Govind Rao

Nursing home asks Labour Board for clarity about status as employer - Infomart - 0 views

  • The Daily Gleaner (Fredericton) Tue Apr 12 2016
  • Officials with the Nashwaak Villa nursing home in Stanley have filed an application with the New Brunswick Labour and Employment Board seeking clarity on whether or not they are the legal employer of the facility's staff because the facility hopes to gain greater control over the management of hiring protocols and other employee-related administrative matters. Daphne Noonan, executive director of the Nashwaak Villa, said a confusing situation has developed over the past 40 years, creating complexities around who is the legally recognized employer for her staff.
  • Over time, those responsibilities - such as payroll - were transferred to the health authorities, which has caused some complications, she said. Even though the Nashwaak Villa manages employee hours, Horizon Health Network issues the cheques and manages human resources issues and support. "It's just evolved through history. What that has resulted in is that it's unclear to everyone who the employer is," she said, explaining that her board cannot find any formal documentation that explains the division of responsibilities. "The nurses have a bargaining unit and the CUPE folks have a bargaining unit. Our folks are the only ones in the province who work in a unionized nursing home who are governed under the collective agreements of the public service. That's just the way it's been. They've always been considered members."
  • ...7 more annotations...
  • these facilities, ambiguities exist around the private and public entities involved in the management of each home and its employees. "The history is quite patchy. Think about how much government has changed in 40 years, how the health authorities are structured. From what we understand, and this is extremely confusing, we think that the five homes were always owned and operated as non-profit legal entities, with local boards, and the staff within those homes were clearly employees of the homes," said Noonan.
  • But what we think happened, at least in our area, is that an organization [called Health Services Management Group] wanted to have a presence in these communities. So they co-located themselves, we think, next to these homes. They sometimes shared facilities." Sometimes, the two entities would share space, resources, even people, Noonan says. In the early 1990s, Health Services Management Group was given some of the responsibilities for the management of these nursing homes by the provincial government.
  • And Nashwaak Villa isn't the only facility trying to sort this question out. She said similar scenarios exist at the White Rapids Manor in Fredericton Junction, W.G. Bishop Nursing Home in Minto, Wauklehegan Manor in McAdam, and Fundy Nursing Home in Blacks Harbour. However, officials with the unions that represent these employees say the move isn't needed, given that they believe collective bargaining agreements are in place that should be respected. At each of
  • There are times the situation has created problems for administrators. "It's hard to manage the day-to-day of the nursing home in a way that is efficient and that's not distracting from the resident care when you're constantly navigating through these different channels and there's ambiguity. When I call the payroll department, for example, and ask them to pay a new nurse a certain amount of money, following the collective agreement, they might say to me, 'No, Horizon doesn't pay that way.' I'm not being treated autonomously from the corporate entity of Horizon Health, even though we are a separate entity. It's a lot for the employees. The processes are such that it's unclear to them if they work for Horizon or Nashwaak Villa. And that creates a lot of tension, at times." In recent months, Noonan said her board asked the unions that represent her employees to work with them to sort this out. But those unions believe no changes are needed, taking the position that a collective bargaining agreement is in place and the nursing home facilities can simply work within the terms of those contracts.
  • Noonan said that her board of directors has decided it needs clarity and has filed an application with the provincial labour and employment board to investigate the matter. What would happen if the labour and employment board rules that Nashwaak Villa is completely autonomous from any other organization, which would mean its employees could no longer be part of a bargaining unit involving colleagues from the Horizon Health Network? It could mean that the facility's employees could retain, or lose, their seniority. Their pay could increase, or decrease, as could their benefits. There are many uncertainties at this point, said Noonan. "We haven't begun any discussions around a transition, if there is one. So that would be done in a negotiation," she said.
  • "But we think [the impacts would be negotiable] in terms of what the salaries might be. Our funding model would change, as we're funded through the Department of Social Development. But what it would mean for the employees is that they've been part of a bargaining unit, one of the largest units, and the big question mark is: Would I get to keep my seniority? We don't know the answers to that because all the parties haven't gotten together to talk. That's what we're trying to do with this." Obviously, that's concerning for the employees, said Noonan, who added they are in uncertain times. Ralph McBride, provincial co-ordinator for CUPE Local 1252, said the spectre of layoffs, related to a quest for efficiencies within the province's health authorities or to proposed changes to the professional staffing ratio in nursing homes, has created concerns for the employees at Nashwaak Villa.
  • That's one of the bad things for the employees to be caught up in," he said. "With their employment status with Horizon, if there is a skill-mix change, and there does happen to be layoffs, or a reduction in care-givers, they'd have a bigger pool to bump into. If they become a single employer, as they've indicated, then that limits the ability for people to move around and find a new job." He said his union will do what it can to support its members, explaining that in his view the current situation is manageable. "We're saying they've got a collective agreement. I think what the Villa is trying to say is that they're not recognizing that," he said.
Irene Jansen

Health Authorities and the IWK Health Centre Taking Common Approach to Collective Barga... - 0 views

  • Nova Scotia's nine district health authorities and the IWK Heath Centre are taking a common approach to collective bargaining, to ensure that the province’s health care system remains affordable
  • On February 6, Capital Health and NSGEU (Local 42 – Healthcare) began collective bargaining
  • The new approach to bargaining – which will see the districts and IWK bring forward a common set of proposals – is part of a larger effort to reduce costs, find efficiencies and improve the delivery of health care services across the districts and IWK. Over the past two years, the districts and IWK have reduced their administrative costs to 5.1%, now below the national average of 5.2%. Along with the provincial government, they are working to further reduce the costs of administration and support services through a shared services initiative.
  • ...1 more annotation...
  • Compensation, including wages, represents approximately 70% of the districts/IWK operational costs.
Govind Rao

Unions seek constructive dialogue in contract talks | Hospital Employees' Union - 0 views

  • Bargaining bulletin Facilities bargaining covers 47,000 health care workers January 14, 2014
  • Negotiations for a new collective agreement covering 47,000 workers in B.C. hospitals, care homes, emergency health services and the health care supply chain begin today in Vancouver. The 11-union Facilities Bargaining Association (FBA) is hoping for a constructive round of talks focused on improving working and caring conditions in a system under pressure. The FBA’s lead negotiator, Hospital Employees’ Union secretary-business manager Bonnie Pearson, says health care workers are also looking for employment security and fair and reasonable improvements in wages.
Govind Rao

Job security, protecting benefits among top priorities at Facilities bargaining confere... - 0 views

  • Newsletter November 15, 2013
  • More than 230 HEU delegates concluded deliberations at the union’s 20th Facilities Bargaining Conference in Vancouver on Friday, setting the union’s course for the next round of bargaining.
  • In particular, job security and protecting benefits – along with a fair wage increase – were identified by delegates, providing a focused and strategic direction to HEU’s newly elected 13-person bargaining committee.
Govind Rao

Compass-Marquise deal offers wage and vacation improvements | Hospital Employees' Union - 0 views

  • Compass-Marquise deal offers wage and vacation improvements Bargaining bulletin November 14, 2013
  • After nearly a year of bargaining and a successful strike vote, the HEU Compass-Marquise bargaining committee reached a tentative agreement with the employer early Monday for a four-year contract. Members will receive a signing bonus of 20 cents per hour –approximately equal to $390 for a full-time employee. Additional raises of 35 cents per hour on Oct. 1, 2013, 25 cents on Oct. 1, 2014, 30 cents on Oct. 1, 2015 and 10 cents on April 1, 2016 will follow. A probationary wage of $1.25 less per hour for all new hires will come into effect July 1, 2014.
Govind Rao

What you need to know about Bills 30 and 37 - NS Liberals' Essential Services Legislati... - 0 views

  • Apr 7, 2014
  • The NS Liberal Government’s attack on collective bargaining What you need to know about Bills 30 and 37 – Essential Services Legislation Nova Scotia’s Liberal Government has now passed two laws – Bills 30 and 37 – that represent an unprecedented attack on our bargaining rights.&nbsp; These bills essentially take away our right to free collective bargaining and stack the deck heavily in the employers’ favour. Bill 30 This was the first of the two Bills passed by the Legislature and was aimed at home support workers.&nbsp; It affects five of our locals, 3936, 3885, 3953, 3986 and 4354 but will now be superseded by Bill 37. CUPE has already launched a legal challenge on Bill 30. Bill 37 On Friday, April 4 after almost a full week of debates and delaying tactics in the Legislature, the Liberals used their majority to ram through a second law, Bill 37. This bill is sweeping in its scope, forcing essential service agreements on almost 40,000 health care AND community services workers in seven different unions. For CUPE, it means some 9,000 members – basically half of our provincial membership – have just had their bargaining rights trampled on.&nbsp; Here is who Bill 37 affects:
Govind Rao

Sodexo closer to new agreement with Abbotsford members | Hospital Employees' Union - 0 views

  • Patience is running out says HEU April 11, 2014
  • Bargaining resumed on April 9 and 10 between Sodexo and your HEU three-person bargaining committee, representing 240-plus members at Abbotsford Regional Hospital and Cancer Centre (ARHCC). During the last round of bargaining in March, your committee put forward wage and benefit improvements similar to those Sodexo had ratified with HEU in other facilities last fall. In this round, the employer replied to the union’s demands, but their initial offer fell far short. As a result, the employer was forced to sharpen their pencils and tabled a monetary package on day two with improvements to their original wages and health care benefits offer.
Govind Rao

MEDIA RELEASE: Unions Seek Clarity on Minister's Recent Comments | CUPE Nova Scotia - 0 views

  • MEDIA RELEASE: Unions Seek Clarity on Minister’s Recent Comments Leaders of the four health care unions affected by Bill 1 have written to the Minister of Health &amp; Wellness this morning, requesting urgent clarification on his recent comments that government would accept a model of collective bargaining that would see the lead union in each of the four proposed bargaining units conduct bargaining on behalf of all employees in that sector. &nbsp;“Minister Glavine’s comments seem to suggest that government would allow each of the four Unions to continue to represent their current membership,” says Rick Clarke, President of the Nova Scotia Federation of Labour. &nbsp;“These public comments appear to contradict what is contemplated in Bill 1.” &nbsp;The Union leadership, therefore, has requested an urgent meeting with the Minister today to discuss how to reconcile his public comments with the legislation and to explore in detail the exact nature of his proposal. All of the union leaders are currently at the legislature and available to meet.
Govind Rao

Nova Scotia can cut number of health bargaining units: arbitrator - Halifax | Globalnew... - 0 views

  • HALIFAX – An arbitrator has ruled that Nova Scotia can reduce the number of bargaining units that represent workers in the health care sector from 50 to four.But James Dorsey has postponed a decision on which union will represent those workers.
  • Some of the unions had argued the proposed structure was unconstitutional because it denied freedom of association provisions of the charter, but Dorsey rejected those arguments.
  • Dorsey says he will resume hearings on Feb. 2 on the remaining issue of which union will represent each of the four bargaining units.
Govind Rao

HIV and AIDS Bargaining checklist | Canadian Union of Public Employees - 0 views

  • Oct 15, 2015
  • The HIV and AIDS bargaining checklist is a resource tool for local unions, bargaining committees, members and other activists to support those infected and affected by HIV and AIDS.
Heather Farrow

Health-care costs need more haggling; Must study how public funds flow through system -... - 0 views

  • National Post Sat Aug 20 2016
  • The whole idea of a doctors' union is, on its face, preposterous. Doctors are not typically to be found among society's downtrodden, lacking marketable skills or bargaining power: on the contrary, they are among the highest-paid professionals in the country, and would be with or without a medical association to negotiate on their behalf.
  • More to the point, doctors are not civil servants. While some are paid a salary or per-patient "capitation" fee, most are in private practice, and charge for each treatment they perform. They are small business operators, really. And yet they are entitled to bargain collectively, like coal miners or factory workers, their fees set not by competition in the marketplace but in marathon negotiations with the government.
  • ...11 more annotations...
  • Just now in Ontario this arrangement would appear to have hit a wall. Having negotiated a four-year deal offering average annual fee increases of 2.5 per cent, the Ontario Medical Association executive was dismayed to find it rejected by nearly two-thirds of its members, who complain it does not make up for cuts in fees imposed last year. How things should have broken down to this extent need not detain us here. But it does perhaps point to the need to find another way.
  • Because doctors' fees, as such, are not the issue. To be sure, they are part of the puzzle: at $11.5 billion annually, they are roughly one-fifth of Ontario's health-care budget. But all the hard bargaining in the world isn't going to rescue Canada's health-care system from the fiscal cliff to which it is headed. Much more important than doctors' fees are doctors' decisions, as the gatekeepers dictating how resources are allocated within the system: how many tests are ordered, what procedures are done, and so on.
  • The problem is that decisions about treatment are too often divorced from decisions about budgets. Governments set a budget constraint at the macro level, which filters down through the various regional health authorities and local health networks the provinces have seen fit to establish. But doctors typically do not: they make whatever they can bill. And the incentives of feefor-service are to perform as many surgeries and other treatments as they can. Absent changes in those incentives, simply capping fees isn't going to change much.
  • You can see why doctors felt the need to organize. Governments had set themselves up as sole purchasers of medical services. The idea was supposed to be that they could exploit that monopoly power to drive down costs. But it didn't quite work out that way: politicians in need of re-election, it seems, do not make terribly tough negotiators (who knew?). It was always easier to pass the problem on to the next government, or the next generation - or, as federal governments got in on the act, Ottawa. In consequence, health-care spending skyrocketed through much of the 1970s and 1980s.
  • Traditionally, doctors have been paid per service, while hospitals have been funded on a block grant basis. The key to reform is to turn this around: giving groups of doctors a fixed amount per patient, with which to purchase services from hospitals, clinics and other providers, that is on a per-treatment basis. Paying doctors a lump sum localizes the budget constraint, forcing doctors to take account of costs in decisions on treatment; paying hospitals per service makes it possible for lower-cost competitors to undercut them.
  • Even in the more recent wave of cuts following the last recession, these have been largely untouched. As documented in a new study by the C. D. Howe Institute
  • ("Hold the Applause: Why Provincial Restraint on Healthcare Spending Might Not Last"), governments have largely resorted to the familiar public-sector strategy of starving the capital account to feed the operating account: while capital spending has been sharply curtailed, physicians' fees have not.
  • This is not sustainable in the long run - as new doctors enter the profession, and most of all, as the population ages. As it is, provinces are now spending more than 40 per cent of their budgets on health care; by 2030, a recent Fraser Institute paper projects the number will have risen to nearly 50 per cent. Yet wait times continue to mount: at more than 18 weeks, on average, from GP referral to treatment, they are nearly twice what they were 20 years ago.
  • Clearly the answer does not lie in more money, least of all more federal money: for every additional dollar in federal transfers the Howe study's authors find that provincial health spending increases by 36 cents. But neither is the answer ever stricter doses of austerity - any more than one would improve a car's mileage by putting less gas in the tank. Rather, what's needed is systemic reform, altering the way that public funds flow through the system, and how the different players within it are remunerated.
  • Only with the onset of the early 1990s recession, and particularly the sharp cut in federal transfers as Ottawa tried to stabilize its finances, was there the first serious effort at retrenchment. But as the fiscal crisis eased, and particularly after the 2004 health-care accord, with its massive 10-year increase in federal transfers, whatever impetus for reform there might have been dissipated. Rather than "buying change," most of the new money went to increases in provider compensation.
  • In sum, rather than doctors and governments negotiating with each other at one gigantic bargaining table, what we need are lots of little bargaining tables, at which providers can haggle with each other.
Govind Rao

Community health collective agreement ratified by HEU and other unions | Hospital Emplo... - 0 views

  • Bargaining bulletin February 3, 2014
  • Members of the multi-union Community Health Bargaining Association (CBA) have voted in favour of a five-year contract with the Health Employers Association of BC.&nbsp;
1 - 20 of 320 Next › Last »
Showing 20 items per page