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It’s always a sad sight when a provincial government, used to operating with a surfeit of cash, has to suddenly begin reining in its spending.

The exercise is invariably unpleasant, and can ignite confrontations with groups that have grown accustomed to lucrative contracts handed out by those cash-rich administrations that don’t want the headaches that come with hard bargaining.

After all, it’s great being part of a professional cohort that is the highest paid in the country, and it can be quite jarring when governments have no choice but to say “no, there is no more money for you.”

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We have been seeing this play out in the recession-battered province of Alberta for a few years now. But the war that Alberta Premier Jason Kenney and his Health Minister, Tyler Shandro, have declared on the province’s doctors has taken the ethos of belt-tightening to another level. We don’t know what the end result will be, but it has the potential to alter the relationship between the medical profession and the province for years to come.

The drama began earlier this year, when talks between the two sides broke down and the government ripped up the existing contract, putting doctors on notice that the old way of doing things was a thing of the past. With the aim of saving $2-billion in physician costs over the next three years, the province also ended binding arbitration and made changes to the way doctors dealt with overhead costs, a move that many said was going to cost them big bucks.

The dispute has ignited a propaganda war. No one agrees on the information the other side is putting out. Doctors say the annual cost of their compensation is $4.5-billion; the government says it’s $5.4-billion. The government says doctors are paid 20 per cent more than their counterparts in the rest of the country; the doctors say that figure is grossly misleading.

The Alberta Medical Association (AMA), which represents physicians, recently released the result of a survey of its members that showed 42 per cent are considering leaving the province because of the shabby way they are being treated by government. At least 54 of them have already withdrawn or have threatened to withdraw their services.

The government initially dismissed the survey results. Why would doctors leave Alberta to be paid less in another province? But clearly Mr. Kenney and his Health Minister are concerned. Mr. Shandro has written to the Alberta College of Physicians and Surgeons asking it to institute a rule that would prevent doctors from withdrawing their services en masse.

The government has also posted roughly 200 physician jobs on a website that caters to international applicants. Some doctors have likened this to bringing in “scab” labour.

I told you this dispute was ugly.

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The AMA recently took out newspaper ads – how quaint – offering to accept a three-year pay cap while it worked with government to craft new pay models. In return, the government would have to restore binding arbitration and pay for the hiring of additional physicians. The government’s response: No dice.

The timing of this conflict couldn’t be worse. Who picks a fight with physicians in the middle of a pandemic? The doctors clearly have a large segment of the public on their side, not to mention the opposition NDP, too: Party Leader Rachel Notley insists the changes that the government is trying to institute amount to the privatization of health care, a statement that might be a tad hyperbolic.

Doctors can be a tough lot with whom to deal. Just ask any premier in B.C. over the past 30 years; some of the battles there between the two sides have been epic. But the one we are witnessing in Alberta has the potential to be ground-shifting, and not in a good way.

It’s easy to paint the Alberta government as the bad guy in it all. It does, too easily, turn everyday disputes into major confrontations. If you’re not with the government, you’re against it, and therefore an enemy of the people. But that’s not as easy to do with a group as essential as doctors, especially amid a global crisis.

That said, the government does have to do something about its brutal fiscal situation. And government workers, including doctors – long the envy of their counterparts elsewhere in this country – are going to have to adjust to a harsh new reality.

In this war, there will be no winners.

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