Archive for June, 2010
Redwater Mayor Mel Smith:
“To be honest, I’m just not sure how much I did get out of it,” said Smith who considers himself a Progressive Conservative supporter but who for a moment sounded a tad skeptical if not downright cynical: “I’m not sure this wasn’t one of their steps to say that we’ve had consultations and then they’ll do what they like.”
“We all agreed we’d pay more taxes or pay medicare premiums again to keep our public health care, but you have to be cautious about a new law.”
What problem are they trying to fix? They don’t say… With these vague, nice principles, like patient-focused care, equitable access, well, they’re making a nice icing and then they go away and bake the kind of cake they want after.”
Edmonton MLA Kevin Taft:
“People wanted to ask the question: Do we need a new Alberta Health Act? And there was also a lot of resistance to the patient charter, but all that was overruled. The group was told there will be a patient charter and asked to comment.”
“People there understood the patient charter won’t address the real immediate problems, for instance, the shortage of cancer doctors.”
The Friends of Medicare will be continuing their province-wide series of open public consultation meetings about the Alberta Health Act this week with two meetings in northern Alberta.
June 22: 7:oo PM – 9:00 PM - Grande Prairie – Rotary Room Montrose Cultural Centre 9899 104 Ave SW
June 23: 7:00 PM – 9:00 PM – Peace River – Holy Family Catholic School 10307 99 St
The Edmonton Journal got an exclusive glimpse into the normally closed-door consultations when Friends of Medicare and Public Interest Alberta made their presentations about the Alberta Health Act with the media present.
Since they were opened to the public this week, the Friends of Medicare are beginning to receive a growing number of comments and reactions from regular Albertans who are attending the Government’s Alberta Health Act meetings. Here are some of the comments:
I attended the meeting last night. I asked a number of questions to see why they were trying to put this legislation in place – I didn’t get an answer that I was satisfied with. Personally, I don’t think any Albertans were asking the government to do this – the impetus must have come from someone other than citizens. The government should be listening to the will of the people – if that is the case, there should have been some public outcry to have new legislation put in place – however, as you and I both know, there was no public outcry – there is some hidden force behind this.
…it appears that they are pushing this legislation through without giving Albertans the opportunity to say anything about it. I feel that this process is more of a formality so they could say they consulted Albertans.
There is the illusion that the government wants to know what we think, but the reality is that they will likely disregard our comments and push through their agenda regardless of what we want.
The very tight structuring of the meetings with only set questions being answered troubled me. Although our answers were recorded (written and taped), I am concerned that the response that Fred Horne will write will just continue along preset party lines.
I said again and again that we did not need the Alberta Health Act or the Charter for patients, as these issues are covered in the health acts we have in place, plus the 100 resolutions, and 30 pieces of legislation. I also said quite strongly that this process is simply to take away those pieces of legislation and acts which have been hard won over the past generations. I truly expected to be shot.
After significant public pressure, Alberta Health and Wellness has made public the invitation only, closed door consultations on the new Alberta Health Act. Dr. Barbara Lacy, Chair of the Lethbridge Advisory Council on Health, was quoted in the Lethbridge Herald on Tuesday as saying the meetings were meant to be invitation only events, but after a recent meeting with the province’s health bosses the process has been opened up. “They’ve said they won’t turn away anyone who comes”, says Dr. Lacy. This has been confirmed by Friends of Medicare, who contacted Alberta Health and Wellness on the issue.
The following quote from the Lethbridge Herald provides context: “Sessions were originally announced as by invitation events, Lacey says, with advisory councils asked to suggest names of those who’d be interested. But they were opened to the public after Friends of Medicare suggested the government wanted to hear only from those who supported its changes to Alberta’s health care system.”
Dr. Lacy concedes Alberta Health has not done much to advertise this fact, or much about the meetings themselves. Friends of Medicare has been very critical of the closed door, invitation format of these meetings, and has been holding fully public consultations around the province to discuss changes to the laws governing health care in this province. “It’s a bit late to suddenly say the health consultation meetings are open to the public”, says David Eggen, executive director of Friends of Medicare, “I hope they advertise that the doors are now open and no one will be turned away.”
Now that the meetings are open to the public, Friends of Medicare is encouraging all Albertans who have concerns about the health care system to attend the meetings in their area. Albertans can book ahead by calling 1-888-436-0986 or emailing firstname.lastname@example.org, although now the meetings are open to the public, no one will be turned away.
Many Albertans are concerned that legislative changes will open the door to more private health care in the province. Current provincial law protects Albertans from such private health care practices as extra billing, private insurance and American style twotier private medicine. Existing Alberta law also sets standards for areas such as hospitals and nursing home care.
The Friends of Medicare has been holding open public consultations on the Alberta Health Act across the province. Here are some photos from recent meetings in Lethbridge, Medicine Hat, and Camrose.
Participate in a consultation in your part of Alberta!
The Parkland Institute has released a new report highlighting the risks and opportunities of the new Alberta Health Act. Read the report.
Bankruptcy of for-profit Calgary clinic portends worse, more costly system
By Diana Gibson,
A version of this was published in the Edmonton Journal on June 3, 2010
In the same month as the Alberta Government launched consultations on a new Alberta Health Act, one of its prodigal private surgery centres, the Health Resources Centre in Calgary, declared bankruptcy. Before consultations have even begun, the Alberta Health Act initiative has been seriously undermined because the Act is all about that style of private for-profit delivery.
The only documents to emerge on the new Act to date are “A Foundation for Alberta’s Health System” and the online survey. These documents are drowning in warm sounding rhetoric about patients, families, quality and access. However, hidden within are terms like flexibility of delivery and personal responsibility which are Trojan Horses. Flexibility of delivery is often code for increasing for-profit health care, and individual responsibility means moving away from universality and public responsibility. It moves away from a focus on public policy solutions to public health challenges like smoking and obesity, to blaming the individual.
Of greater concern is the behind-the-scenes agenda for the Health Act. That agenda is clear in the submission from Alberta Health Services CEO, Steven Duckett, which states the goal as, “Recognize the role of private and non-governmental organizations in service delivery within the Canada health framework.”
Even more telling is the submission from the Calgary Chamber of Commerce, which has been advocating for a long time for this form of legislative change. Specifically it asks for the repeal of the Health Care Protection Act and stripping Alberta Health and Wellness of its role in regulating private surgeries and clinics.
Their submission also advocates for increased direct competition between private for-profit providers and public providers while at the same time allowing private providers to benefit from any economies of scale and other advantages of the public sector through a “levelling of the playing field and co-operation in the distribution of resources.”
The HRC bankruptcy reveals the folly of that approach. Albertans and Canadians should be alarmed and should watch the health act initiative closely.
Certainly there are serious challenges to be dealt with on the delivery side of health care. Hospital stays are becoming much shorter, and community or day-surgery alternatives have been growing. That sector is fragmented and mostly outside of the public health system and protections of the Canada Health Act.
Services such as rehabilitation services that were previously offered in hospitals are being offered in communities and homes, but no longer covered under the public umbrella. Long-term care is being downgraded to assisted living, and the sector is becoming increasingly dominated by for-profit providers.
On the flip side, the province has under-funded hospitals for many years, causing shortages of beds, nurses and physicians and has not adequately funded quality public services for seniors needing long-term care.
The growth of the for-profit involvement in those service areas has come at a cost, Albertans now have the highest out-of-pocket spending on health care in the country.
Not only has this path been costly, but it means lower quality. A number of academic studies have shown that care in for-profit institutions is often lower in quality than in not-for-profit institutions. These include studies by: P. J. Devereaux, et al, 2004 in the Canadian Medical Association Journal, Comondore et al, 2009, in the British Medical Journal,. Powe et al, 2009, New England Journal of Medicine and John Hopkins, and Woodlander and Himmelstein 2004, in the Canadian Medical Association Journal.
The Alberta government pays a lot of lip service to best evidence. Best evidence shows for-profit providers deliver poorer results at higher cost. It is time to learn from our mistakes and stem the tide. To this end, the Alberta Health Act initiative should not proceed as planned.
Certainly, there are challenges in health care, not only the fragmented delivery system that is increasingly for-profit but also the lack of attention to prevention and the social determinants of health such as poverty and inequality.
The act will not address these problems; the barriers to reform are political not legislative. Without the political will to account for the health impacts of social policies, without the political will to fund adequate public health services, and without the political will to limit the profits of pharmaceutical companies, pharmacies and private insurers, legislative changes will not significantly improve health care outcomes or sustainability in Alberta.
The public health system is now paying to bail out the HRC and surgeries are at risk.
Public health care is less expensive and better quality and the Alberta government should turn HRC back into a non-profit hospital and bring it under the public umbrella.
Beyond that, the health-act plans should be shelved and the government should get down to the business of delivering health care that is public, universal and affordable.
There is room for a new health act, but it needs to be one that limits for-profit involvement in health care and strengthens the public system which delivers the most cost effective, most accessible and best quality health care.
Diana Gibson is the research director at the Parkland Institute. This opinion piece is based on a new series of reports by the Institute on the proposed Alberta Health Act.