Improving Albertans’ access to doctors
To help increase patient access to physicians, there will no longer be a daily cap on the number of visits a physician can fully bill.
During the negotiations with the Alberta Medical Association (AMA), Alberta’s government heard that Alberta’s doctors could safely see more patients than the current cap allowed.
Albertans want to know that they can see a doctor when they need one, and physicians want to be able to provide Albertans with the health-care services they need. By changing the daily cap policy, some of the immediate pressures for services provided by general practitioners and specialists, including pediatricians and ophthalmologists, will be addressed. By lifting the cap, physicians will be fully compensated for every visit rather than receiving a discounted rate if they provide more than 50 visit services in one day, which is the current practice.
“We’re moving forward to implement the new agreement, starting with ending the daily visit services cap policy and working to put rate increases in place. We’ve heard from some physicians that the daily visit cap was having a negative impact on patient access, so this change addresses those concerns. It is also part of the new agreement with the AMA where we are listening to physicians and working with them as partners moving forward.”
“The AMA agreement allows physicians and government to work together on challenges facing patients and physicians in the health-care system. This early step to remove the services cap is an important example that will allow more physicians to care for more patients while helping to stabilize physician practices.”
Lump sum payment
The agreement between the AMA and the province also includes a one per cent rate increase in each of the next three years and a one per cent recognition lump sum payment in 2022-23.
Alberta physicians were at the forefront of the pandemic and the one-time payment for eligible practising physicians is in recognition of that work during the 2021-22 fiscal year. This lump sum payment is approximately $45 million and will go to the AMA to distribute to their members by the end of 2022.
In addition to the lump sum payment, the government is working with the AMA to implement the one per cent rate increase for 2022-23. The increase applies to fee-for-service and alternative relationship plan rates, providing an additional $46 million to physicians.
As outlined in the AMA agreement, the rate increase is heavily weighted to specialties facing the greatest pressures, such as family medicine. Alberta’s government and the AMA are working together to distribute these increases across and within specialties. Increases will be effective April 1, 2022, and are expected to be finalized by March 31, 2023.
- The daily visit services cap policy was introduced as part of the Physician Funding Framework in 2020.
- The intent of the policy was to support quality patient care by reducing physician burnout while addressing fiscal constraint for the province.
- It applies to all physician services that are defined in the Schedule of Medical Benefits (SOMB) as “visits” with a “V” category code that physicians provide to patients in person, including physician office visits, consultations and counselling services. Procedures and tests that physicians provide are not billed as visits.
- Under the current policy, physicians are compensated 100 per cent for up to 50 visit services billings in a day, 50 per cent for between 51 and 65 visit services, and there is no compensation for visit services billings greater than 66.
- Physicians working in rural and remote areas, hospital visits and virtual care are exempt from the current policy.
- The policy change (to lift the cap) aligns Alberta with most other jurisdictions.
- Alberta Health is working on updating the SOMB and billing system to operationalize this change. A Medical Bulletin and a new SOMB will be posted when information technology changes are complete.
- The daily visit services cap policy change will be reviewed and its impacts assessed before determining the future policy beyond the current fiscal year.
Saskatchewan begins forming new police service; critics question lack of oversight
Christine Tell, Saskatchewan’s minister of corrections, policing and public safety, speaks to the media after the throne speech at the Legislative Building in Regina on Wednesday, Oct. 27, 2021. THE CANADIAN PRESS/Michael Bell
By Jeremy Simes in Regina
The Saskatchewan Party government has begun establishing a new provincial police service, but the minister in charge says it won’t have an oversight body until boots are on the ground.
Christine Tell, minister of corrections, policing and public safety, now has authority to form the new Saskatchewan Marshals Service, said a recent order-in-council. The order states the province’s deputy minister will act in place of a board to oversee operations.
Tell said the province is to create a board for the marshals once it’s operational in 2026.
“What that looks like is still under development,” Tell said in an interview. “But in the interim, the deputy minister is the interim board as we get this thing developed.”
The province announced last fall it would create the marshals service to help enhance public safety, particularly in high-crime areas.
Most policing organizations have boards, commissions or advisory bodies made up of civilians and elected officials who provide oversight when police make decisions.
That’s why Opposition NDP policing critic Nicole Sarauer says she’s concerned the marshals won’t have a board from the get-go.
“This flies in the face of the principles of policing in Canada, the importance of the independence of police from political bodies, including government, and it’s a slap in the face to the rule of law,” Sarauer said.
“It’s very clear who’s going to be in charge of the marshals and it’s the Sask. Party.”
Tell said a board isn’t initially needed because the ministry has to develop the structure of the marshals and hire a chief.
“It is not a political function,” she said. “It’s an operational function that will assist when the chief marshal is hired, assists the chief marshal in getting all of that infrastructure in place.”
She said the province is looking at the Ontario Provincial Police’s structure, but added the marshals service will be different than a full-blown police force.
Premier Scott Moe has said the service isn’t meant to replace other policing entities, including the RCMP.
When the marshals were announced in the fall, Saskatchewan RCMP Assistant Commissioner Rhonda Blackmore questioned what the plan meant for the force. Some policing unions also raised concerns, arguing the dollars could be better spent on existing services.
The order-in-council states the marshals are to detect, disrupt and deter criminal activity in rural and remote areas. They are also to enforce provincial and federal laws, locate and apprehend prolific offenders on warrant and investigate farm thefts and damage done to crops caused by trespassing.
“(Their duties) are broad. We’re not going to be prescriptive,” Tell said.
She said the marshals can work with RCMP and other municipal forces, providing additional assistance if needed. It would need to sign agreements with those forces to do so, she said.
The marshals are to be based out of Prince Albert, but can move to other regions as needed. Tell said they will be armed, but it hasn’t yet been decided whether they’ll wear uniforms.
She said the ministry is establishing a training program geared toward experienced officers.
Tell said the ministry plans to spend $7 million this year on establishing the marshals, but added more dollars will be required next year.
Once fully operational with 70 officers, it’s expected to cost the government $20 million annually.
This report by The Canadian Press was first published Aug. 16, 2023.
Prigozhin, the mercenary chief urging an uprising against Russia’s generals, has long ties to Putin
Yevgeny Prigozhin, the owner of the Wagner Group military company, arrives during a funeral ceremony at the Troyekurovskoye cemetery in Moscow, Russia, on April 8, 2023. On Friday, June 23, Prigozhin made his most direct challenge to the Kremlin yet, calling for an armed rebellion aimed at ousting Russia’s defense minister. The security services reacted immediately by calling for his arrest. (AP Photo/File)
By Ellen Knickmeyer
Once a low-profile businessman who benefited from having President Vladimir Putin as a powerful patron, Yevgeny Prigozhin moved into the global spotlight with Russia’s war in Ukraine.
As the leader of a mercenary force who depicts himself as fighting many of the Russian military’s toughest battles in Ukraine, the 62-year-old Prigozhin has now moved into his most dangerous role yet: preaching open rebellion against the leadership of the country’s military.
Prigozhin, owner of the Kremlin-allied Wagner Group, has escalated what have been months of scathing criticism of Russia’s conduct of the war by calling Friday for an armed uprising to oust the defense minister. Russian security services reacted immediately, opening a criminal investigation and urging Prigozhin’s arrest.
In a sign of how seriously the Kremlin took Prigozhin’s threat, riot police and the National Guard scrambled to tighten security at key facilities in Moscow, including government agencies and transport infrastructure, Tass reported. Prigozhin, a onetime felon, hot-dog vendor and longtime associate of Putin, urged Russians to join his “march to justice.”
Prigozhin and Putin go way back, with both born in Leningrad, what is now known as St. Petersburg.
During the final years of the Soviet Union, Prigozhin served time in prison — 10 years by his own admission — although he does not say what it was for.
Afterward, he owned a hot dog stand and then fancy restaurants that drew interest from Putin. In his first term, the Russian leader took then-French President Jacques Chirac to dine at one of them.
“Vladimir Putin saw how I built a business out of a kiosk, he saw that I don’t mind serving to the esteemed guests because they were my guests,” Prigozhin recalled in an interview published in 2011.
His businesses expanded significantly to catering and providing school lunches. In 2010, Putin helped open Prigozhin’s factory that was built on generous loans by a state bank. In Moscow alone, his company Concord won millions of dollars in contracts to provide meals at public schools. He also organized catering for Kremlin events for several years — earning him the nickname “Putin’s chef” — and has provided catering and utility services to the Russian military.
In 2017, opposition figure and corruption fighter Alexei Navalny accused Prigozhin’s companies of breaking antitrust laws by bidding for some $387 million in Defense Ministry contracts.
Prigozhin also owns the Wagner Group, a Kremlin-allied mercenary force that has come to play a central role in Putin’s projection of Russian influence in trouble spots around the world.
The United States, European Union, United Nations and others say the mercenary force has involved itself in conflicts in countries across Africa in particular. Wagner fighters allegedly provide security for national leaders or warlords in exchange for lucrative payments, often including a share of gold or other natural resources. U.S. officials say Russia may also be using Wagner’s work in Africa to support its war in Ukraine.
In Ukraine, Prigozhin’s mercenaries have become a major force in the war, fighting as counterparts to the Russian army in battles with Ukrainian forces.
That includes Wagner fighters taking Bakhmut, the city where the bloodiest and longest battles have taken place. By last month, Wagner Group and Russian forces appeared to have largely won Bakhmut, a victory with strategically slight importance for Russia despite the cost in lives. The U.S. estimates that nearly half of the 20,000 Russian troops killed in Ukraine since December were Wagner fighters in Bakhmut. His soldiers-for-hire included inmates recruited from Russia’s prisons.
WHAT IS THE GROUP’S REPUTATION?
Western countries and United Nations experts have accused Wagner Group mercenaries of committing numerous human rights abuses throughout Africa, including in the Central African Republic, Libya and Mali.
In December 2021, the European Union accused the group of “serious human rights abuses, including torture and extrajudicial, summary or arbitrary executions and killings,” and of carrying out “destabilizing activities” in the Central African Republic, Libya, Syria and Ukraine.
Some of the reported incidents stood out in their grisly brutality.
In November 2022, a video surfaced online that showed a former Wagner contractor getting beaten to death with a sledgehammer after he allegedly fled to the Ukrainian side and was recaptured. Despite public outrage and a stream of demands for an investigation, the Kremlin turned a blind eye to it.
RAGING AGAINST RUSSIA’S GENERALS
As his forces fought and died en masse in Ukraine, Prigozhin raged against Russia’s military brass. In a video released by his team last month, Prigozhin stood next to rows bodies he said were those of Wagner fighters. He accused Russia’s regular military of incompetence and of starving his troops of the weapons and ammunition they needed to fight.
“These are someone’s fathers and someone’s sons,” Prigozhin said then. “The scum that doesn’t give us ammunition will eat their guts in hell.”
CRITICIZING THE BRASS
Prigozhin has castigated the top military brass, accusing top-ranking officers of incompetence. His remarks were unprecedented for Russia’s tightly controlled political system, in which only Putin could air such criticism.
Earlier this month, Putin reaffirmed his trust in the Russian military’s General Staff, Gen. Valery Gerasimov, by putting him in direct charge of the Russian forces in Ukraine, a move that some observers also interpreted as an attempt to cut Prigozhin down to size. Prigozhin somewhat toned down his harangues against the military leadership after that, but remained defiant.
Asked recently about a media comparison of him with Grigory Rasputin, a mystic who gained fatal influence over Russia’s last czar by claiming to have the power to cure his son’s hemophilia, Prigozhin snapped: “I don’t stop blood, but I spill blood of the enemies of our Motherland.”
A ‘BAD ACTOR’ IN THE US
Prigozhin earlier gained more limited attention in the U.S., when he and a dozen other Russian nationals and three Russian companies were charged in the U.S. with operating a covert social media campaign aimed at fomenting discord ahead of Donald Trump’s 2016 election victory.
They were indicted as part of special counsel Robert Mueller’s investigation into Russian election interference. The U.S. Treasury Department has sanctioned Prigozhin and associates repeatedly in connection with both his alleged election interference and his leadership of the Wagner Group.
After the 2018 indictment, the RIA Novosti news agency quoted Prigozhin as saying, in a clearly sarcastic remark: “Americans are very impressionable people; they see what they want to see. I treat them with great respect. I’m not at all upset that I’m on this list. If they want to see the devil, let them see him.”
The Biden White House in that episode called him “a known bad actor,” and State Department spokesman Ned Price said Prigozhin’s “bold confession, if anything, appears to be just a manifestation of the impunity that crooks and cronies enjoy under President Putin and the Kremlin.”
AVOIDING CHALLENGES TO PUTIN
As Prigozhin grew more outspoken against the way Russia’s conventional military conducted fighting in Ukraine, he continued to play a seemingly indispensable role for the Russian offensive, and appeared to suffer no retaliation from Putin for his criticism of Putin’s generals.
Media reports at times suggested Prigozhin’s influence on Putin was growing and he was after a prominent political post. But analysts warned against overestimating his influence with Putin.
“He’s not one of Putin’s close figures or a confidant,” said Mark Galeotti of University College, London, who specializes in Russian security affairs, speaking on his podcast “In Moscow’s Shadows.”
“Prigozhin does what the Kremlin wants and does very well for himself in the process. But that’s the thing — he is part of the staff rather than part of the family,” Galeotti said.
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