Alberta physicians topped the $1-billion mark in total fee-for-service billings in 2001/02, an increase of more than 10%. Annual payments averaged more than $208 000, an increase of nearly 6%.
Those numbers were among a flood of data released in the 2001/2002 Alberta Health Care Insurance Plan Statistical Supplement. The annual report indicates that more people are using health services and more doctors are delivering them. As well, drug costs have nearly doubled in 4 years.
Alberta Health spokesperson David Dear said population growth and a growing number of doctors account for most of the increase in fee-for-service payments. Alberta Medical Association President Steve Chambers added that a recent 3-year deal that increased physicians' fees by nearly 22% also had an impact.
Chambers defended the raise, arguing that “it makes it more attractive for a physician to come here and stay here.” He says that with only 20% of Alberta doctors accepting new patients and with the average age of doctors approaching 50, incentives are needed to avert a crisis.
The report also warns of potential problems regarding drugs costs. In 2001/02, Alberta paid nearly $350 million for prescription drugs, an 89% increase from 1997/1998, when drugs cost $185 million. Dear said drugs now cost the province $1 million per day, and that will grow by 17% to 20% in 2003.
Five years ago, Alberta struck a committee cochaired by a physician and a pharmacist to study cost containment. One of several measures to emerge is the “checkpoint program” for first-time prescriptions of 30 days or more duration. In an effort to reduce waste, the drug plan now approves only a 7- to 14-day trial first to ensure the drug works.
The province has also instituted an “academic detailing program” that allows physicians to get advice from designated pharmacists regarding the range of drugs available. It's supposed to stop MDs from relying on a single therapy when more efficient ones are available. One drug, omeprazole, accounted for 6% of government drug spending in 2001/02.
Modern medicine faces a quandary, Chambers said. Drug companies are marketing effective new products, but they are expensive and they also keep people alive longer. Seniors are healthier and more active than ever, and Chambers said the rising costs are a sign of this.
Dear said drug costs can't be viewed in isolation. “They bring enormous value to the system in the good they do for patients, and they represent a kind of savings to the system by keeping patients out of it.” — Lisa Gregoire, Edmonton