Working to protect our Master Agreement with the government

Issue: BCMJ, vol. 47, No. 1, January February 2005, Pages 8-13 President's Comment

This year is an important year for all BC physicians. In the fall of 2005 we will begin negotiations on the Master Agreement. The Master Agreement is the foundation of our working relationship with government. It defines the fundamental premise under which physicians provide their services to British Columbians.

While the nuts and bolts of the Master Agreement are not top-of-mind to most of us and the document is far too complex to make for compelling reading, I can’t stress enough how important it is and how vital the upcoming negotiations will be. The current second Master Agreement represents the cumulative evolution of many years of negotiations with successive governments.

The Master Agreement governs the overall relationship between government and physicians, including how the payment and provision of services should be managed. The Master Agreement also contains many important provisions that protect physicians’ autonomy and supports their economic and professional well-being. Some of the provisions that could be lost or diminished if the Master Agreement is significantly weakened or eliminated include the following:

• Physician control of the Fee Schedule

• Protection against the prorationing of fees.

• Physician benefits plans such as CME support, CMPA reimbursement, the Physician Disability Plan, the CPRSP, and maternity leave.

• The Rural Recruitment and Retention payments and their value.

• Limits on the government’s ability to unilaterally change the Fee Schedule, service contracts, or sessional or salary payments.

• Protections against coercing physicians to change from fee-for-service to other forms of payment.

• Maintenance of a single Available Amount (the budget for fee-for-service) which limits government in determining where physicians can practice.

• The requirement that government reimburse physicians for the costs when it changes its data or billing requirements.

• The requirement that government meaningfully consult with the BCMA and physicians on health policy initiatives.

• The right to have separate subsidiary agreements (currently Rural, Salary, Sessional, Service Contract, and General Practice).

• The right to be represented by the BCMA during their individual contract negotiations.

• The creation of physician advisory committees, including the Joint Utilization Committee and the Guidelines and Protocols Advisory Committee.

• Physician involvement in, or control over, audit and inspection and patterns of practice.

The BCMA has previously negotiated the sole right to bargain with the government on behalf of BC doctors. This ensures that no government can divide and conquer small groups of physicians who can’t muster the financial resources and expertise needed to mount an effective negotiation.

Preparations for the Master Agreement negotiations are a top priority and you have my commitment that we will mount a vigorous defence of its many important provisions and precedents. We owe this to our many past colleagues who have given thousands of hours of their time to ensure that our rights to practise with professional autonomy are protected. We owe this, as well, to our present and future colleagues. Most importantly, we owe this to our patients, who depend on their doctors to speak for them and ensure that our health care system delivers to them the highest quality of timely medical care.

—Jack Burak, MD

Jack Burak, MD. Working to protect our Master Agreement with the government. BCMJ, Vol. 47, No. 1, January, February, 2005, Page(s) 8-13 - President's Comment.

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