Presto! Change-O!


In a nifty bit of sleight-of-hand the people responsible for the tentative fee-for-service contract being offered to New Brunswick’s doctors have pulled another somewhat bedraggled bunny from the hat in support of the provincial EMR monopoly.

Within days of the end of the juicy cash handouts to Velante clients – courtesy of the Canada Health Infoway – the proponents of the exclusive Velante/Department of Health electronic medical records scheme have come up with a clever way of offering even more taxpayer money to Velante conscripts.

Buried on Page 10 of the 21-page Tentative Fee-For-Service Contract, is the puzzling Section 26, which states the following:

Effective April 1, 2014, in an effort to support early adopters who wish to switch to the Provincial EMR (Velante) and to help off-set enrolment costs and monthly license expenses for FFS physicians, the parties have agreed to an Electronic Medical Records Protected Funding Pool of $1.5 Million (recurring) to support the Provincial EMR Program (Velante).   Any unused funds will be retained by the NBMS to support EMR adoption through the Provincial EMR program.

It’s puzzling because this clause has NO PLACE in an agreement which, by its very name, is intended to address how doctors are compensated for the work they do.    It doesn’t belong in this agreement.   It should be part of a separate deal, and should be voted upon independently by the general membership.

The fact that it is buried in the middle of a fee-for-service contract says to me that those pushing the Velante monopoly are admitting, once again, that the business plan they have devised cannot stand on its own merits, and requires an ongoing infusion of taxpayer money to preventing it from collapsing under its own weight.  Cleverly, they are going to embed this latest nugget in an agreement which will see doctors receive fee increases of 4% over two years.

The overwhelming majority of doctors don’t have EMR’s, so Section 26 matters not to them.   What most physicians will see is that, after being handed 0% and 0% over the last two years, 4% looks pretty good.   And it is.   And that’s why the agreement will be overwhelmingly ratified by the province’s doctors.

When it is, the $1.5 million dollars per year will effectively land on the lap of Velante to use “to support EMR adoption throughout the Provincial EMR program,” whatever that means.

To me, it looks very much like another needy, greedy corporation – unable to compete in a free market – coming to the government with its hand out saying “Please, may I have some more money?”

And now, Velante is going to get it… in spades.

This slippery bit of prestidigitation is annoying enough by itself, but when you consider the role of the Department of Health in forging this contract, it really becomes galling.    The logic fails me.   How can a government, on the one hand, claim to support a free-market economy – one of the hallmarks of conservative ideology – while simultaneously pumping millions of dollars in the direction of one particular EMR vendor?

Enough.   It’s a mugs game.  The cards have been stacked and the outcome has been predetermined.

New Brunswick appears to be destined to be saddled with an exclusionary, second-rate EMR monopoly, and taxpayers are going to be ridden into the ground.

And there is not a damn thing you can do about it.


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