December 3rd, 2020

Financial protection for health workers

By Lethbridge Herald Opinon on November 5, 2020.

Alberta failing to meet needs of health professionals

Charles S. Shaver, MD

“Sourcing masks from Orpyx, an established Calgary-based company, helps us continue protecting health-care workers and the public from COVID-19.” – Tyler Shandro, Minister of Health, Oct. 7.

He is referring to a $60-million two-year agreement to produce 40 million medical masks. This is excellent news, but Shandro is still overlooking the need for all Alberta health professionals also to be financially protected.

Paid sick benefits for those forced to self-isolate or those who contract COVID-19 should apply to all Canadian health professionals. The Canada Recovery Sickness Benefit (Bill C-4) recently passed Parliament unanimously and is a good start. It pays $500 per week up to two weeks, even to self-employed workers. However, it is an inadequate amount, and hardly meets the needs of physicians, many nurses and other fairly well-paid health professionals.

New cases in Alberta have set new records. In the past week, the positivity rate in the Edmonton zone rose to four per cent and the R-value to 1.3. Dr. Deena Hinshaw has warned that it is “absolutely critical” that all Albertans stay home when they have any symptoms. A “second wave” of the pandemic has definitely begun; indoor restaurants and bars are closing in Toronto, Ottawa and several regions in Quebec. Winnipeg has a higher prevalence of new cases per capita than Toronto, and has just entered code red.

Yet three provinces – Alberta, Manitoba and Ontario – continue to ignore the need for physicians to be fully financially protected if they themselves are forced to self-isolate or contract the coronavirus.

Unlike salaried nurses and respiratory therapists, most physicians are self-employed and rely on private insurance. Older physicians are at greater risk of developing severe or fatal disease, but those older than age 65 generally cannot qualify for private insurance. For even younger ones, there is usually a waiting period of days or weeks.

Most provinces have recognized this fact. The majority of British Columbia physicians under age 70 are already covered by a government-funded disability plan; this paid from day one of a quarantine period. Last spring, a special Quarantine Replacement Benefit was set up to protect those doctors not in the government plan.

Quebec, New Brunswick, P.E.I., Nova Scotia, Newfoundland and Labrador, Saskatchewan and the Yukon all cover their MDs for lost income from day one of self-isolation or illness. Only Alberta, Ontario, and Manitoba have left their physicians totally unprotected.

The Decent Work and Health Report of Aug. 19 stated that universal, paid sick days were a “necessary, evidence-based protection” to mitigate the second wave of COVID-19. In a March 20 policy statement, the OECD had agreed. It also supported “Extending paid leave coverage to non-standard workers, including the self-employed.” This would include physicians.

Provincial and territorial governments should demonstrate respect and appreciation to their physicians by at least covering their lost income during quarantine or illness with COVID-19. Some may find this difficult. Ontario now has a deficit of $38.5 billion (triple that of last year) and Alberta one of $24.2 billion.

As recently as 2019, Quebec’s net debt to GDP ratio was about the same as Ontario’s. Also, Newfoundland and Labrador has the highest combined federal-provincial debt per capital, yet both provinces have treated their physicians reasonably well during the pandemic. So should Alberta, Manitoba, and Ontario.

Recently, Manitoba Premier Brian Pallister stated, “We want to encourage people not to work when they are ill and we want to make sure they are not hurt financially in these difficult times as a consequence of making the smart and caring decision.”

Finance Minister Chrystia Freeland should agree to increase the Canada Health Transfer to the provinces and territories from $42 billion to $70 billion. They in turn should agree to use some of the additional money to provide pandemic sick benefits to all practising physicians as well as, if necessary, topping up federal benefits for part-time nurses and other health workers so as to adequately replace their lost income. This will encourage them to self-isolate, if necessary, and help control the pandemic.

Alberta has taken rather desperate measures to address its deficit. Last February, Tyler Shandro tore up the master agreement with physicians and unilaterally cut fees. Many, particularly rural MDs, threatened to leave the province. If Premier Jason Kenney and Tyler Shandro wish to restore normal, less confrontational relations with Alberta doctors, a good first step would be to guarantee sick benefits to them, as most other provinces have done.

This topic should be on the agenda when Justin Trudeau meets virtually this fall with the premiers. If we are “all in this together,” then all practising physicians and other health professionals in Canada deserve benefits when off work due to the coronavirus. They should not be deprived of these because they are self-employed, work part-time, or because of their age, pre-existing illnesses, or just because they happen to live in a certain province or territory.

Ottawa physician Dr. Charles S. Shaver is past-chair of the Section on General Internal Medicine of the Ontario Medical Association. The views here are his own.

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